Water Fluoridation

Water fluoridation is the process through which some local governments add fluoride to their public water supplies in order to reduce and prevent tooth decay among their populations.  This practice is common in countries like the United States, New Zealand, and Singapore, but has been the cause of debates within the scientific community for more than six decades. Those who oppose water fluoridation argue that it might lead to unwanted side effects and that it raises important ethical questions.

The purpose of the present article is only to provide a primer to readers on the subject of water fluoridation and the debate that surrounds it.  However, this article is non-exhaustive and Victoria and Dr. T encourage readers to conduct further research based on reliable scientific sources, before forming their own opinions on the subject matter. 

What is fluoride?

Fluoride is a naturally occurring mineral found in nature, as well as foods such as shrimp, raisins, grapefruit juice, tea, and coffee. It is also used in dental products such as toothpaste.  In countries like the United States, people’s main source of fluoride is drinking water. [i]

What is water fluoridation?

Water fluoridation is the process by which fluoride is added to a community’s water supply until it reaches a concentration of approximately 0.7 ppm (parts per million) or 0.7 milligrams of fluoride per liter of water; according to the U.S. Public Health Service (PHS), this is the optimal level to prevent tooth decay.[ii]

What do those in favor of water fluoridation say?

The American Dental Association (ADA) states that water fluoridation is one of the safest, most affordable, and most practical methods of supplying fluoride to all members of the community, regardless of age. According to the ADA, this practice helps prevent at least 25% of tooth decay.[iii]

In 1999, the Centers for Disease Control and Prevention (CDC) highlighted water fluoridation as one of the “Ten Great Public Health Achievements” in the United States between 1900 and 1999. The CDC states that fluoridated water has great benefits and leads to a decreased need for fillings and/or removal of teeth, as well as decreased pain and suffering caused by tooth decay.[iv]

Moreover, the Colorado Water Fluoridation Organization says that fluoridated water strengthens tooth enamel and can prevent chronic and painful cases of cavities that can affect children’s physical, social, and academic development.[v]

What about those who oppose water fluoridation?

Those who oppose water fluoridation argue that the process is unethical because governments are forcing communities to consume medication without their consent. They also cite studies and argue that, despite the fact that the water supply in low-income neighborhoods in American cities such as Boston, New York, and Pittsburgh has been fluoridated for more than 20 years, there is still a severe dental crisis within those communities.[vi]

Furthermore, organizations such as the Fluoride Action Network (FAN) claim that more than 70 studies have shown that there is a close link between fluoride exposure and reduced IQ in humans and that exposure to fluoride during the first years of life can lead to damaged brain development in infants.[vii]


[i] National Institutes of Health (March 29, 2021), Fluoride – Fact Sheet for Health Professionals. Retrieved on January 13, 2022: https://ods.od.nih.gov/factsheets/Fluoride-HealthProfessional/#en3.

[ii] National Institutes of Health (July-August, 2015), U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries – U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation. Retrieved on January 20, 2022: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547570/?report=classic.

[iii] American Dental Association (2022), Fluoride in water – Facts, resources and advocacy for fluoridation as a proven way to prevent tooth decay. Retrieved on January 13, 2022: https://www.ada.org/resources/community-initiatives/fluoride-in-water.

[iv] Center for Disease Control and Prevention (December 24, 1999), Ten Great Public Health Achievements — United States, 1900-1999. Retrieved on January 13, 2022: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4850bx.htm.

[v] Colorado Water Fluoridation Organization (2016), Water Fluoridation Basics. Retrieved on January 13, 2022: https://coloradowaterfluoridation.org/water-fluoridation-basics/.

[vi] Fluoride Action Network (September 2012), 50 Reasons To Oppose Fluoridation. Retrieved on January 13, 2022: https://fluoridealert.org/articles/50-reasons/.

[vii] Fluoride Action Network (December 21, 2021), Fluoride & IQ: 74 Studies. Retrieved on January 13, 2022: https://fluoridealert.org/studies/brain01/.

Author: Cristian Ocampo
Editor: Pedro Calvo

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