Community water fluoridation is a safe, effective, and equitable way to improve oral health

Have you seen headlines in the news lately about community water fluoridation? You might be wondering if you or your community should be doing something different about fluoride in water. It’s good to have questions about things that affect your health! As your health department, we support community water fluoridation as a practical, cost-effective, and equitable way for communities to improve the oral health of people who live there, regardless of age, education, or income.

Here’s a quick overview of why communities fluoridate their water supplies and why we, as your health department, support it:

Community water fluoridation is a time-tested and evidence-based public health intervention.

Communities fluoridate their water because it bathes teeth with a low level of fluoride throughout the day. This helps strengthen a tooth's surface, making it more resistant to decay.

Adding fluoride to public water began in 1945 and was adopted throughout the country after seeing the dramatic reduction of tooth decay among children. Fluoride naturally occurs in many water sources but it’s often not at the level that will protect teeth. Community water fluoridation brings the naturally occurring amount of fluoride to optimal levels for oral health. 

Fluoridated toothpaste, community water fluoridation, and regular access to dental services work together as team to strengthen the enamel of the teeth and remove bacteria that cause cavities. These strategies together provide more protection than any strategy on its own.

More than 209 million people in the U.S. and 98.8% of people in Dane County on a public water system had access to fluoridated water (as of 2022).

Community water fluoridation also saves communities money. For every $1 invested in community water fluoridation, communities save $20 in healthcare costs.

Nearly all public health, dental, and medical organizations support community water fluoridation, including:

• American Academy of Pediatrics
• American Dental Association
• CDC
• U.S. Public Health Service
• American Public Health Association
• National Institutes of Health
• Wisconsin Department of Health Services

Community water fluoridation equitably protects our oral health.

Community water fluoridation equitably prevents cavities and promotes good oral health, regardless of age, race, ethnicity, education, income, insurance status, or access to dental care. This is critical because according to the CDC, 1 in 4 children living below the federal poverty level have untreated tooth decay, which can lead to pain, school absences, and difficulty concentrating, among other issues. In addition, half of adults in nursing homes have untreated tooth decay, which affects quality of life issues like the ability to chew food or speak clearly. Water fluoridation is an easy way to prevent this tooth decay, particularly among children and older adults who may not be able to see a dentist.

There is no evidence the current recommended level of community water fluoridation harms health.

As with all substances, the dose matters! The amount of fluoride added to the community water supply is extremely small. The fluoride levels discussed in recent reports and litigation are more than double the current levels used in community water fluoridation. Organizations such as the American Academy of Pediatrics and American Dental Association have written statements in 2024 that continue to support community water fluoridation.

As your local health department, we will continue to monitor national recommendations for changes and stay up to date on recent research.

Where can I learn more about community water fluoridation?

These are scientifically-backed sites where you can read the latest recommendations from experts:

• Community Water Fluoridation from the CDC
• I Like My Teeth from the American Academy of Pediatrics
• Fluoridation FAQs from the American Dental Association
• Community Water Fluoridation nuance translated by an epidemiologist and science communicator from Your Local Epidemiologist
• Fluoride and Community Water Fluoridation from the Wisconsin Department of Health Services