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Community Water Fluoridation

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This collection of selected resources offers high-quality information about fluoridated community water. Use the tools below for further searching, or contact us for personalized assistance.

Key Facts

  Share these facts to help improve the oral health of pregnant women, children, adolescents, and their families.

  • Community water fluoridation is the best method for delivering fluoride to all members of the community regardless of age, educational attainment, income level, or access to routine oral care. 1
  • Community water fluoridation is a major factor responsible for the decline in prevalence and severity of dental caries (tooth decay) during the second half of the 20th century. 2
  • Consuming fluoridated water and beverages, and foods prepared or processed with fluoridated water, throughout the day maintains a low concentration of fluoride that enhances remineralization of tooth surfaces. 3
  • Community water fluoridation has been shown to save money, both for families and for the health care system. The return on investment for community water fluoridation varies with size of the community, increasing as the community size increases. Community water fluoridation is cost-saving, even for small communities. 4
  • Community water fluoridation is an effective public health strategy for delivering fluoride to prevent tooth decay and is the most feasible and cost-effective way to reach entire communities. 3
  • The addition of fluoride to community water supplies results in reduced incidence of tooth decay within a short period of time, and the elimination of fluoride from community water supplies results in increased incidence of tooth decay within a short period of time. These results have been consistently found regardless of date of analysis; this illustrates that benefits of community water fluoridation persist even in an era of availability of fluoride from other sources. 5
  • To be prepared and motivated to promote water fluoridation, dental school graduates need to be aware that water fluoridation promotion is an important public health issue, possess sound scientific knowledge about fluorides and water fluoridation, have experience discussing fluorides and water fluoridation with patients, have critical evaluative skills, and possess a professional and moral incentive to act. 6
  • Oral-health-promotion activities should take into account differing perceptions about community water fluoridation among various groups to tailor educational messaging. 7
  • Further research is needed on interventions to reduce common barriers to oral fluoride administration and reduce early childhood caries in communities lacking water fluoridation. 8


  1. Murthy VH. 2015. Surgeon general’s perspectives: Community water fluoridation–One of CDC’s “10 great public health achievements of the 20th century.” Public Health Reports 130(4):296–298.
  2. Centers for Disease Control and Prevention. 1999. Achievements in public health, 1900–1999: Fluoridation of drinking water to prevent dental caries. Morbidity and Mortality Weekly Report 48(41):933–940.
  3. U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation. 2015. U.S. Public Health Service recommendation for fluoride concentration in drinking water for the prevention of dental caries. Public Health Reports 130(4):318–331.
  4. Centers for Disease Control and Prevention. 2015. Community Water Fluoridation: Fluoridation Basics [webpage].
  5. Campos-Outcalt D, Celaya M, Nunez A, Rosales C. 2012. Community Water Fluoridation: An Evidence Review. Tucson, AZ: University of Arizona, Mel and Enid Zuckerman College of Public Health.
  6. Melbye ML, Armfield JM. 2013. The dentist’s role in promoting community water fluoridation: A call for dentists and educators. Journal of the American Dental Association 144(1):65–75.
  7. Mork N, Griffen S. 2015. Perceived safety and benefit of community water fluoridation: 2009 HealthStyles survey. Journal of Public Health Dentistry 75(4):327–336.
  8. Flood S, Asplund K, Hoffman B, Nye A, Zuckerman K. 2016. Fluoride supplementation adherence and barriers in a community without water fluoridation. Academic Pediatrics [Epub ahead of print].

OHRC Publications

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OHRC Library

This section contains recent materials, not including OHRC-produced materials.


American Academy of Pediatrics, Campaign for Dental Health. 2015. Fluoridation toolkit: A resource for health advocates. Elk Grove Village, IL: American Academy of Pediatrics, Campaign for Dental Health, multiple items

American Academy of Pediatrics, Campaign for Dental Health
345 Park Boulevard
Itasca, IL 60143

Telephone: (847) 434-4000
Fax: (847) 434-8000
E-mail: fluoride@aap.org
Website: http://www.ilikemyteeth.org
Available from the website.

This toolkit for advocates provides resources for educating communities about community water fluoridation. Contents include sample blog posts, a memo for newspaper editors, letters to the editor, tips for talking to reporters, remarks to help parents and health professionals talk to city council or local board members, a resolution observing community water fluoridation's 70th anniversary, and social media messages. A user's guide is included.


American Dental Association. 2016. Why fluoride in your tap water is a good thing. Chicago, IL: American Dental Association, 1 video (2 min, 59 sec)

American Dental Association
211 East Chicago Avenue
Chicago, IL 60611-2678

Telephone: (312) 440-2500
Fax: (312) 440-7494
E-mail: info@ada.org
Website: http://www.ada.org
Available from the website.

This video explains why adding fluoride to community water systems is safe and effective at preventing tooth decay. The video features commentary from oral health professionals and pediatric health professionals about the value of community water fluoridation for children and adults.


Children's Dental Health Project. 2015. Fluoridation advocacy: Pew's contributions and lessons that emerge. Washington, DC: Children's Dental Health Project, 27 pp

Children's Dental Health Project
1020 19th Street, N.W., Suite 400
Washington, DC 20036

Telephone: (202) 833-8288
Fax: (202) 331-1432
E-mail: info@cdhp.org
Website: https://www.cdhp.org
Available from the website.

This report summarizes the Pew Charitable Trusts' efforts to support and strengthen advocacy for community water fluoridation. The report examines the impact that Pew's work has had on advancing community water fluoridation and lessons that have emerged from Pew's experiences. Examples from Pew-assisted state campaigns' efforts to initiate water fluoridation or reaffirm its value are included.


DentaQuest Foundation. 2016. Community toolkit: Preserving and implementing water fluoridation in your community. Boston, MA: DentaQuest Foundation, multiple items

DentaQuest Foundation
465 Medford Street
Boston, MA 02129-1454

Telephone: (617) 886-1700
Website: http://www.dentaquestfoundation.org
Available from the website.

This toolkit presents strategies for implementing community water fluoridation (CWF) or preventing a rollback attempt. Contents include information and resources for assessing community readiness, talking about CWF, finding community champions, talking to policymakers, and addressing opposition to CWF. Links to websites and other resources about fluoridation, sample messages, talking points, a focus group guide, a worksheet for identifying champions, and a sample organizational support letter are provided.


Network for Public Health Law. 2015. Water fluoridation: Issue brief. St. Paul, MN: Network for Public Health Law, 9 pp

Network for Public Health Law
875 Summit Avenue
St. Paul, MN 55105

Telephone: (651) 695-7749
Fax: (651) 695-7749
Website: https://www.networkforphl.org
Available from the website.

This brief describes the water-fluoridation process, the public health impact of water fluoridation, and the legal framework governing water fluoridation. Topics include the complementary roles that federal, state, and local governments play in implementing water fluoridation.


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