Water Fluoridation

The Centers for Disease Control and Prevention states there are two public health measures proven to improve the oral health of a community:

  1. Community Water Fluoridation (reduces cavities by 25%)
  2. School Dental Sealant Programs (reduce cavities by 50%)Prevention first with water fluoridation

The number of communities and people who benefit from water fluoridation is continuing to grow. This effective public health intervention was initiated in the United States in 1945. In 2018, 73.0% of the US population on community water systems, or 207,426,535 people, had access to fluoridated water. The CDC monitors the progress of the nation and individual states toward meeting the Healthy People 2030 objective on community water fluoridation—that 77.1% of people on public water systems will receive water that has the optimum level of fluoride recommended for preventing tooth decay.

Fluoridation research

For fluoridation research, please go to the American Fluoridation Society.

For all kinds of fluoride science, go to FluorideExposed.org


FluorideExposed.org: Hi, we’re Effie & Kylie. We are scientists. We are moms. We are from Portland, OR.
And we founded this site to bring you real science about water, health, and teeth. More…

Fluoridation status

Children’s access to fluoridated water nationwide

Fluoridation by the numbers – top 10 states and the bottom 10

For your community’s fluoridation status: My Water’s Fluoride


  • Water fluoridation benefits people of all ages, regardless of socio-economic status.
  • Every reputable scientific organization reports that water fluoridation is safe.
  • Water fluoridation is the most effective and most cost-effective part of a community’s comprehensive dental program.

Average cost to fluoridate to optimum levels a city of about 1 million people = $6 per person for the first year due to costs of the equipment, and 50 cents per person every year thereafter.

– Average cost of one simple dental filling = $120

– A child that has one molar filled at age 10 will pay over $6,105 to maintain that tooth by the time he reaches the age of 79.  If he has several cavities, the cost will increase accordingly.

Fluoride: What is it?

FluoriteFluoride is a mineral found in rock and is a natural component of fresh water and sea water.  In some areas of Africa and China, the natural fluoride content in the water is over 20 parts per million.  People who live in those areas for a lifetime can have problems with their teeth and bones.  In other areas, water contains just a trace amount of fluoride – not enough to strengthen teeth or bones.

Fluoride can be added or removed from water to bring fluoride to the optimum level for oral health.  The optimum level of fluoride (0.7 parts fluoride per million parts water) produces a 25% decrease in cavities and also strengthens bones.  But people have to drink the tap water!  Tap water is more highly regulated (and therefore cleaner) than bottled water, therefore, we should all be filling up our water bottles with tap water.  Just make sure your water bottle does not contain Bisphenol A (BPA), a material found in some plastics.

Statements from the health community

American Academy of Pediatrics (2020): Parents will be interested to know that fluoride exists naturally in virtually all water supplies. Among the many respected organizations that have endorsed fluoridation as a safe, effective way to reduce decay are the American Dental Association, the American Academy of Pediatrics, the Institute of Medicine, and the Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention (2020): Many research studies have proven the safety and benefits of fluoridated water. For  75 years, people in the United States have been drinking water with added fluoride and enjoying the benefits of better dental health.

Surgeon General’s Statement (2016): Water fluoridation is the best method for delivering fluoride to all members of the community, regardless of age, education, income level or access to routine dental care. Fluoride’s effectiveness in preventing tooth decay extends throughout one’s life, resulting in fewer – and less severe – cavities. In fact, each generation born over the past 70 years has enjoyed better dental health than the one before it. That’s the very essence of the American promise.”

Pew Charitable Trusts (2020): Community water fluoridation helps all of us – the entire community – prevent unnecessary dental problems before they begin.

American Medical Association, Journal of (2020): Increasing a population’s access to community water fluoridation is associated with decreased caries-related visits and may also be associated with use of dental surgical services within high-risk populations [example of Oregon case].

American Academy of Family Physicians (2022): The American Academy of Family Physicians supports fluoridation of public water supplies as a safe, economical, and effective method to prevent dental caries.

American Public Health Association (2020): Studies show fluoridated water prevents at least 25 percent of tooth decay in children and adults, even with the use of other fluoride products. Community water fluoridation has proven to be a safe, effective and cost-saving public health measure for preventing tooth decay.

Oregon Health Authority (2022): Community water fluoridation is a powerful weapon in the fight for social justice and health equity. It reduces cavities for the entire population despite of insurance coverage, access to a dentist or ability to pay for care.

Beaverton, Oregon (2020): The City fluoridates our drinking water to improve the dental health for consumers of Beaverton’s water.

Tualatin Valley Water District (2020): TVWD fluoridates the Wolf Creek portion of the District at 0.7 part per million in accordance with the proposed guidance of the U.S. Department of Health and Human Services.

For more information, please go to Campaign for Dental Health.


History of Fluoride by Delta Dental

Community Water Fluoridation for Better Health

Fluoride in Our Water: Facts You Need to Make a Healthy Choice