Organizations Worldwide That Support Fluoridation

Fact – Community Water Fluoridation (CWF) is recognized a safe and effective public health measure by the World Health Organization and major and respected science and health organizations worldwide, including in the U.S., Canada, Britain, Europe, Australia, New Zealand and other countries. Health agencies of all 50 states in the U.S. a number of health insurance companies and the States/Provinces in Australia, Canada and New Zealand also support CWF.
There are no reputable science or health organizations that support the anti-F opinions.

Bottom Line: Trust The Experts!

Two interesting articles about public response to fluoridation in the 1950s - Anti-fluoridation arguments have changed little in over over 65 years.
Should We Put Fluorides In Our Water - MACLEANS, 1953.pdf
Fight Over Fluoridation - Saturday Evening Post, 1956.pdf (images)

Fluoridation Facts
Additional resources to help understand anti-science arguments
AAPD and 250 Leading Health Organizations Affirm Safety and Effectiveness of Community Water Fluoridation
April 15, 2025 Letter: “We, the undersigned organizations (250), are proud to affirm the safety and effectiveness of community water fluoridation.
Campaign for Dental Health: "More than 150 local, state, and national organizations are partners in the CDH. Our organizational allies are coming together to ensure that children get the basic dental care they need to grow, learn and lead healthy lives."

The World Health Organization and over 200 other specific examples of worldwide CWF support:

Academy for Sports Dentistry reference: “The CDC Division of Oral Health launched a new web feature with information on a variety of oral health topics and featured infographics. These open-access resources provide sharable information on a variety of oral health topics including cavities, dental sealants, gum disease, tooth loss, and community water fluoridation; as well as tobacco use, pregnancy, and returns on investment.” The CDC links don't work, but the pages are still available:
CDC Fast Facts, Community Water Fluoridation and Community Water Fluoridation Facts
Academy of Dentistry International (ADI): “Fluoride helps the teeth to become stronger and less likely to decay. Here are some of the ways you can get the benefits of fluoride. Due to fluoridation, 1 out of 5 kids have no decay. ... Many communities have added the correct amount of fluoride needed for good dental health to the community water supply. In areas where this is not done, fluoride may be added to the water supply by some institutions.”
Academy of General Dentistry (AGD): AGD Policy on Water Fluoridation: "When used appropriately, fluoride is safe and effective in preventing and controlling dental caries. Regular use throughout life will help protect teeth against decay. All water supplies, including bottled water, should have appropriate fluoride levels. All fluoridated items, including toothpaste, should be used as recommended by your dentist; The AGD support the use of public funds to assist local and state governments in seeing that their public water supplies are adequately fluoridated."
Academy of General Dentistry Supports Water Fluoridation: "The controlled addition of a fluoride compound to public water supplies is considered to be the most cost-effective way to prevent cavities and fight tooth decay.”
4/14/25 – “The Academy of General Dentistry (AGD) expresses disappointment with the recent decision by U.S. Secretary of Health Robert F. Kennedy to direct the Centers for Disease Control and Prevention (CDC) to halt its recommendation of including fluoride in community water supplies. The organization says this recommendation overlooks a long-standing body of established scientific research that continues to underscore the public health benefits of water fluoridation. This decision also disregards dental and health organizations' overwhelming support of water fluoridation and the role it plays in improving public health for children and adults. “ Search
Academy of Nutrition and Dietetics supports “optimal systemic and topical fluoride as an important public health measure to promote oral health and overall health throughout life. Fluoride is an important element in the mineralization of bone and teeth. ... Fluoridation of public water supplies continues to be the most costeffective dental public health measure in existence.”
Access Ready Inc. signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD
Alcan Dental Cooperative signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD
Allies for Independence signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD
Alliance of Independent Dentists: “Fluoridation of water has been one of the most studied public health initiatives in the United States. Fluoride is safe and effective at helping to prevent tooth decay (cavities) when used with good brushing and flossing and mindful snacking habits. This interview answers questions you may have about fluoride, which is a naturally occurring mineral.”
Alliance for a Cavity-Free Future states (ACFF): “Community water fluoridation (CWF) is the adjustment of the natural fluoride concentration of a community water supply to the recommended level for optimal oral health. Fluoridation is a public health measure against tooth decay that benefits people irrespective of age, gender, income, ethnicity, employment or access to treatment. CWF has long been a controversial topic with a lot of misinformation and ‘junk science’ shared through the media, on the internet and now also through social media. Caution should therefore be exercised in evaluating material in this area. … In over 70 years of CWF there have been no proven adverse health effects.”

American Academy of Family Physicians (AAFP): “The American Academy of Family Physicians supports fluoridation of public water supplies. Fluoridation is a safe, economical, and effective method to prevent dental caries.” Search

American Academy of Nurse Practitioners: AARP Policy Book 2011-2012: "According to the Centers for Disease Control and Prevention (CDC), the ten greatest US public health achievements of the 20th century are the development of vaccines, efforts to improve motor vehicle safety, workplace safety initiatives, control of infectious diseases, efforts to reduce deaths attributable to heart disease and stroke, food safety laws, maternal and child health initiatives, family planning efforts, fluoridation of drinking water, and recognition of tobacco use as a health hazard." (p. 7-110)

American Academy of Oral and Maxillofacial Pathology signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

American Academy of Pediatric Dentistry (AAPD) Policy Statement: “Recognizes that drinking fluoridated water and brushing with fluoridated toothpaste twice daily are the most effective methods in reducing dental caries prevalence in children. ... Endorses and encourages the adjustment of fluoride content of public drinking water supplies to an optimal level (0.7 ppm) where feasible.” 2023 Fluoride Therapy statement: "Fluoridation of community drinking water is the most equitable and cost-effective method of delivering fluoride to all members of most communities. As of 2018, 73 percent of the U.S. population on community water systems had access to fluoridated water."
4/15/2025 - The American Academy of Pediatric Dentistry (AAPD), the leading authority on children’s oral health, is joined by 250 of the foremost health professional organizations and research bodies in a coalition letter affirming the safety and efficacy of community water fluoridation.

American Academy of Pediatrics (AAP), ADA stand by fluoride recommendations following court ruling, 9/26/24: "The AAP continues to recommend children use age-appropriate amounts of fluoride toothpaste and drink optimally fluoridated water to protect their teeth."
AAP 8/19/2019 “continues to recommend children drink fluoridated tap water despite a new study linking fluoride intake among pregnant women with a small dip in their children’s IQ.” The Campaign for Dental Health (CDH), a program of the AAP, “was created to ensure that people of all ages have access to the most effective, affordable and equitable way to protect teeth from decay — community water fluoridation. The CDH is a broad network of oral health advocates, health professionals, child and family organizations, and scientists who are working together to preserve our nation’s gains in oral health. More than 150 local, state, and national organizations are partners in the CDH.” CDH Fluoridation information
Fact Checked: Fluoride is a Powerful Tool for Preventing Tooth Decay

American Academy of Periodontology: Signed the 4/15/25 fluoridation support letter to U.S. Representatives and Senators

American Association for the Advancement of Science objectives “are to further the work of scientists, to facilitate cooperation among them, to improve the effectiveness of science in the promotion of human welfare, and to increase public understanding and appreciation and the importance and promise of the methods of science in human progress, … request the Council of the Association, through the Board of Directors, through the Administrative Secretary, to go on record as endorsing fluoridation of community water supplies as a method for advancing dental public health…" (1954 Resolution, archived copy available)
The water fluoridation controversy: "Fluoride does not alter the taste, smell or appearance of water, but it does help protect teeth from cavities."

American Association for Community Dental Programs “is a partner in the Campaign for Dental Health, joining 30 other organization allies to support the campaign to promote water fluoridation.” Endorsement Policy: "The public health and evidence-based soundness of the endorsee initiative or program (e.g., community water fluoridation)."
A Guide for Developing and Enhancing Community - "Community Water Fluoridation: Since community water fluoridation is one of the primary contributors to improved oral health, it is important to learn about the status of water fluoridation in the community." (p. 13)

American Association for Dental Research (AADR): Policy Statement on Community Water Fluoridation – “During the 47^th Annual Meeting and Exhibition of the AADR, the AADR Council approved a new policy statement supp0orting the safety and efficacy of community water fluoridation for the prevention of dental caries. … Since the passage of the statement, a study published in the Journal of Dental Research further confirmed the efficacy of community water fluoridation in preventing caries in the primary and permanent teeth of US children and adolescents, a significant update to the evidence showing that community water fluoridation still plays an important role in oral health and caries prevention (Slade et al. 2018).”

American Association for Dental, Oral, and Craniofacial Research (AADOCR) “supports community water fluoridation as a safe and effective, evidence-based intervention for the prevention of dental caries. … Many studies point to the effectiveness of community water fluoridation in decreasing the prevalence and severity of dental caries. ... Community water fluoridation is a cost-effective method of delivering caries prevention to a large population. ... When added to drinking water, fluoride can be delivered to community residents regardless of socioeconomic status or ability to access dental services. ... Community water fluoridation is a safe method of delivering fluoride on a population level. There have been numerous systematic reviews on claims of the potential adverse health effects of water fluoridation. None has concluded that there is a significant or consistent association between water fluoridation and the outcomes examined, including neurologic conditions, cancer, and osteoporosis. ... Community water fluoridation is supported by many important health and public health organizations, including the American Association of Public Health Dentistry, the American Public Health Association, the American Dental Association, the American Academy of Pediatrics, and the World Health Organization, among others.” (3/20/25) Search

American Association of Endodontists (AAE):
1/30/25 - AAE and Dental Organizations Successfully Advocate for EPA Repeal to Support Water Fluoridation: “In January, the American Association of Endodontists (AAE) joined forces with 12 other prominent dental organizations, including the American Dental Association (ADA), to urge the Environmental Protection Agency (EPA) to safeguard water fluoridation programs. In a joint letter to the EPA, the dental coalition reaffirmed its strong support for maintaining optimal fluoride levels in local water supplies to prevent tooth decay and promote overall oral health.”
3/4/25 - “The AAE also expressed its appreciation for the ADA’s latest policy strengthening its Code of Conduct and disciplinary actions to address misinformation and false advertising on social media by influencers and ADA members. Additionally, the leaders discussed the growing misinformation surrounding water fluoridation and reaffirmed their commitment to educating the public on its significant oral health benefits.” Search

American Association of Oral and Maxillofacial Surgeons:
1/10/2025 - “We, the undersigned organizations, respectfully urge the Environmental Protection Agency to appeal the United States District Court for the Northern District of California’s ruling in Food & Water Watch v. EPA, Case No. 17-CV-02162-EMC. This ruling has profound implications for the EPA’s ability to regulate substances under the Toxic Substances Control Act (TSCA). It also reflects a fundamental misunderstanding and misapplication of the prevailing scientific literature on the safety of fluoride and community water fluoridation.”

American Association of Orthodontists: “The American Association of Orthodontists (AAO) and American Dental Association (ADA) are among the signatories of an April 15 joint letter to Congress affirming the importance of community water fluoridation in maintaining public oral health. … The group expressed concern that opposition to fluoridation has been driven by non-scientific narratives. “The recent discourse surrounding fluoridation is based on incomplete information and has been an exaggerated response driven by political and social rather than scientific perspectives,” it said. .. . Community water fluoridation has been a proven safe, effective, equitable way of helping us work toward that goal in the United States.” (4/15/25) Search

American Association of Public Health Dentistry (AAPHD) “reiterates its strong endorsement and support for the fluoridation of all community water systems as a safe and effective public health measure for the prevention of tooth decay." (March 2010 Resolution) Additional fluoridation information

American Association of Women Dentists:
6/19/2025: “Here are some key points to help you prioritize your oral health this month and beyond: 3. Stay Hydrated: Drink plenty of water, especially fluoridated water, to help wash away food particles and bacteria, and strengthen your teeth.”
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American Cancer Society does not indicate there is evidence that drinking optimally fluoridated water causes cancer. The ACS page, Known and Probable Human Carcinogens, does NOT list fluoridated water as a potential carcinogen – only Vinyl Fluoride.

American College of Dentists "The effect provided by fluoride is truly miraculous as it relates to dental decay prevention and oral health. In just slightly over fifty years since its discovery, fluoride has ef fectively reduced dental caries to one-third of its former prevalence in the United States and is responsible for over fifty percent of the current generation of children having no dental caries."

American College of Prosthodontists position statement "that water fluoridation is an effective public health intervention to decrease the incidence of cavities in children and adults. In communities where fluoridation has been implemented, the rate of decay typically decreases by about 25% in both children and adults.1 Fluoridation works in three ways to decrease decay. First, in the growing child, systemic fluoride is incorporated into the tooth structure, reducing solubility and increasing strength. Second, the topical action of fluoride enhances remineralization of tooth structure. Third, topical interaction with plaque reduces acid production of the bacteria in the plaque. Because fluoride contact with tooth structure is beneficial, fluoride-containing toothpastes and dentist-applied fluoride varnishes are also effective in reducing decay."

American Council on Science and Health reports: “Well, the media just handed these conspiracy theorists a gift on a giant silver platter: Multiple outlets are reporting that pregnant women who consume too much fluoride produce children with lower IQs. The reports are based on an extremely controversial study [2019 Green, et al.] just published in JAMA Pediatrics. Are the study's conclusions true? It's doubtful.” Time and the Anti-Fluoride Cause

American Dental Assistants Association: 2021 MANUAL OF POLICIES AND RESOLUTIONS: "Resolved, That all Local Organizations and State Associations of the American Dental Assistants Association promote the fluoridation of public water supplies; and be it further Resolved, That all Local Organizations and State Associations of the American Dental Assistants Association cooperate with all professional health organizations in their efforts to ensure fluoridation of the community water supply as a method to prevent dental caries..." Search

American Dental Association (ADA): "Fluoridation of Water Supplies (2022)
Resolved, that in the interest of public health, the American Dental Association recommends the fluoridation of community water systems in accordance with the standards established by the appropriate authority, and be it further
Resolved, that the American Dental Association supports ongoing research on the safety and effectiveness of community water fluoridation.”
2025 ADA Fluoridation Facts (eBook) – comprehensive answers to questions about fluoridation's effectiveness, safety, practice and cost-effectiveness – includes refutations of anti-fluoridation arguments. All About Fluoride -- Resources -- Fighting cavities with water fluoridation -- Fluoride in Water -- Search

American Dental Education Association (ADEA) states, “National efforts of community water fluoridation prevent oral diseases, deliver health care savings and reduce oral health disparities. ADEA strongly supports optimal fluoridation of community water. Community water fluoridation is safe, practical and the most cost-effective measure for the prevention of dental caries..” Search

American Dental Hygienists’ Association: April 9, 2025 – "The American Dental Hygienists’ Association (ADHA®) strongly opposes recent calls to remove fluoride from community water systems across the United States. In light of federal officials reconsidering fluoridation policies, the ADHA stands firm in supporting community water fluoridation as a crucial public health measure that helps Americans of all ages and income levels. “Decades of research back the safety and effectiveness of fluoridation at recommended levels,” said ADHA President Erin Haley-Hitz, RDH, BSDH, MS. “Removing fluoride from drinking water poses a significant risk to public health. The evidence supporting the safety and efficacy of fluoride is robust, and the potential consequences of increased dental decay and related health issues are alarming.”
2019: “The American Dental Hygienists’ Association supports community water fluoridation as a safe and effective method for reducing the incidence of dental caries throughout the lifespan. Research conducted over the past seventy years has consistently shown that fluoridation of community water supplies is a safe and cost-effective means to reduce the prevalence of tooth decay. ... The ADHA remains committed to supporting the fluoridation of public water supplies to help reduce to risk of tooth decay and the overall burden of dental disease. ”
Adult Fluoride Use: One of the recommendations for Fluoride Products to Reduce Tooth Decay: Community water Fluoridation, 0.7 ppm, recommended for everyone.
"Research conducted over the past seventy years has consistently shown that fluoridation of community water supplies is a safe and cost-effective means to reduce the prevalence of tooth decay. The ADHA remains committed to supporting the fluoridation of public water supplies at safe levels to help reduce the risk of tooth decay and the overall burden of dental disease."

American Dental Therapy Association:
March 2025 - ADTA Statement on Water Fluoridation: “Fluoride in drinking water has been shown to significantly reduce the prevalence of dental caries (cavities) in both children and adults. Studies have consistently demonstrated that communities with fluoridated water experience lower rates of tooth decay compared to those without it. Extensive research and decades of observation support the safety of water fluoridation at recommended levels. Public health authorities such as the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the American Dental Association (ADA) endorse water fluoridation. Fluoridation of public water is a cost-effective method for preventing dental disease, particularly for communities with limited access to dental care. The cost savings from reduced dental treatments significantly outweigh the costs of fluoridating water.”

American Dietetic Association “reaffirms that fluoride is an important element for all mineralized tissues in the body. Appropriate fluoride exposure and usage is beneficial to bone and tooth integrity and, as such, has an important, positive impact on oral health as well as general health throughout life. Fluoride is an important element in the mineralization of bone and teeth. The proper use of topical and systemic fluoride has resulted in major reductions in dental caries (tooth decay) and its associated disability.”

American Fluoridation Institute: “Our vision is for all communities in the United States on a public or community water supply to provide fluoridated water to its residents for better dental health.” “Our Mission: The primary mission of the American Fluoridation Institute is to educate community leaders and the public about the safety, health and economic benefits of community water fluoridation (CWF) – the most cost-effective prevention measure for better dental health.”

American Fluoridation Society aims, “1) To promote improvement of dental health by securing the optimum fluoride content of community water systems in areas where it is sub-optimal. 2) To promote and co-ordinate medical, dental, educational, and administrative efforts to achieve this remotely by means of electronic media and personal contacts. 3) To distribute information about dental health and the benefits/risks of optimally fluoridated water to the fluoridation decision-makers in the communities. 4) To provide direct support to communities across the United States that may need expert testimony from the American Fluoridation Society member(s). 5) To provide the necessary information to debunk the opposition to fluoridation’s pseudo-science.” Resource Library – selection from over 6,600 publish research papers.

American Heart Association: "The Dietary Guidelines for Americans suggest that water should be introduced in small amounts to infants after the first 6 months of life with the introduction of complementary food. Plain, fluoridated drinking water should be increased after age 1 to meet hydration and fluoride needs.”
“Fluoridation - No evidence exists that adjusting the fluoride content of public water supplies to a level of about one part per million has any harmful effect on the cardiovascular system.”- archive. Response to my query about fluoridation (email image), "We currently do not have any direct statements listed on our website related to the fluoridation of public drinking water. However, we always recommend following the CDC’s statements and guidelines for the most scientifically accurate information related to public health practices. Please visit the CDC’s Community Water Fluoridation page to learn more."

American Institute of Dental Public Health signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

American Medical Association: “(1) urges state health departments to consider the value of requiring statewide fluoridation (preferably a comprehensive program of fluoridation of all public water supplies, where these are fluoride deficient), and to initiate such action as deemed appropriate; and (2) supports the 2011 proposed fluoridation standards as promulgated by the US Department of Health and Human Services and the Environmental Protection Agency.”
3/30/25 -- Journal of the American Medical Association (JAMA) releases study on elimination of community water fluoridation: “Removing fluoride from U.S. public water systems would increase tooth decay by 7.5% and cost at least $9.8 billion over five years, according to estimates in a study published by the Journal of the American Medical Association Health Forum. The study, released May 30, seeks to determine the oral health outcomes for children and associated health care costs when water fluoridation stops.”

American Network of Oral Health Coalitions signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

American Nurses Association “recognizes the public health benefits of fluoridation of public drinking water systems and supports its use when the following conditions are met: a) The concentration of fluoride in the public drinking water is in accordance with the most current Public Health Service Recommendations for safe and optimal prevention of dental caries. b) State and local governments have carefully considered whether to fluoridate the public drinking water based on the existing water supply’s naturally occurring fluoride concentration. c) The most current, evidence-based, sound research supports the benefits of public water fluoridation and does not indicate harmful risks.”

American Osteopathic Association “supports the fluoridation of fluoride-deficient public water supply.” Search

American Pharmacists Association: "Strategies that have been successful in reducing cavities include fluoridation of the municipal water supply, fluoride-containing toothpastes, proper sing, and mouth rinses."

American Public Health Association “is a longtime, proud supporter of community water fluoridation as a safe, effective and cost-saving means of preventing tooth decay.”
4/9/25 - Secretary Kennedy and his policies are a danger to the public’s health.
4/14/25 - Public health fighting back against attacks on fluoride: “Public health experts are expressing concern as high-ranking federal officials question the value of community water fluoridation — a practice recognized as one of the 20th century’s greatest public health achievements. … Removing fluoride from water supplies will derail 80 years of disease prevention, oral health experts say. Since 1945, community water fluoridation has been a milestone of American public health, preventing tooth decay and avoiding suffering from tooth loss. Children and adults in communities with fluoridated water have 25% less tooth decay, helping them to retain their teeth throughout their lives.”
Position Paper Search APHA

American Society of Dentist Anesthesiologists signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

American Society for Nutrition: “Systematic reviews with meta-analysis revealed percentages of reduction in decayed, missed, and filled teeth by optimally fluoridated water, toothpastes, mouth rinses, gels, and varnishes of 26%, 23%, 27%, 28%, and 43%, respectively, compared with no treatment or placebo. Importantly, fluoride does not need to be ingested to protect against caries, because the protective effect is essentially “topical” (i.e., when the ion is in contact with the teeth). However, ingested fluoride also exerts its anticaries effect when the ion returns to the oral cavity via crevicular fluid or saliva. Moreover, the pre-eruptive effect of fluoridated drinking water has been recognized, at least for the prevention of caries in the pit and fissure surfaces of permanent molars, as these surfaces are less accessible to “topical” fluoride.”
Fluoride in Focus: "By adding small, controlled amounts of fluoride to public water supplies, health officials achieved significant reductions in tooth decay, as fluoride strengthens tooth enamel and promotes remineralization. Biochemically, fluoride also influences bone tissue, with small amounts stimulating bone formation, though excessive exposure can cause dental and skeletal fluorosis

American Student Dental Association “Fluoride is a naturally occurring mineral that, when included in community water systems, can reduce tooth decay by as much as 25 percent according to the ADA. More than 75 years of research supports the safety and efficacy of water fluoridation. The ADA also reports that communities with fluoridated water have an average return on investment (ROI) of $38 for every $1 spent on fluoridating water supplies.” Talking Points

American Water Works Association (AWWA) “supports the recommendations of the World Health Organization (WHO), American Medical Association (AMA), Canadian Medical Association (CMA), Centers for Disease Control (CDC), American Dental Association (ADA), Canadian Dental Association (CDA), and other professional organizations in the medical community, for the fluoridation of public water supplies as a public health benefit.” Search
** This support continues despite a 2008 threat of potential legal action from anti-fluoridation attorney, Robert E. Reeves: “IIf AWWA wishes to lower its potential liability related to fluoridation of water, please contact our office. We would suggest that one avenue AWWA may wish to pursue in the next month is to contact the National Kidney Foundation and its Chief Medical Officer Joseph Vassalotti. You could discuss with NKF a simultaneous public announcement by NKF and AWWA to voice a change in your organizations’ positions related to the safety of fluoridated water that you now no longer support the safety of fluoridated water.” (no longer on fluoridealert site, but can be found here)

America’s ToothFairy: “Don't Be an April Fool: Oral Health Myths You Shouldn't Believe - 5. Fluoride is an artificial chemical and, therefore, dangerous. In this age of “all-natural” and organic lifestyles, some people have grown wary of fluoridated water and oral health products that contain fluoride. However, fluoride is a naturally-occurring substance found in many water supplies. Only when supplies are deficient does the need for adjusted fluoridation arise. Fluoride is effective in preventing decay and is safe to consume. For more information, visit the American Dental Association website.”

Apple Tree Dental: June 10, 2025 - "New Study Shows Costly Consequences for States Banning Fluoride"

Arcora Foundation: “Fluoride, also known as “nature’s cavity fighter,” is a mineral that’s found in Washington’s rivers, lakes and Puget Sound. An overwhelming majority of American health experts encourage brushing twice daily with fluoridated toothpaste and drinking water with fluoride to prevent cavities. Fluoridated water also provides a cost-effective way to boost oral health in underserved communities that too often experience barriers to accessing preventive dental care. … Adding fluoride to water is a way to reach the entire population, especially those at the greatest risk and who wouldn’t get it otherwise.”

Association for Dental Safety (formerly OSAP): “During 2016–2021, a total of 4,080 community water systems safely fluoridated water 99.99% of the time, with levels below the secondary safety standard of 2.0 mg/L. However, 16.3% of nearly 8 billion population-weighted monthly fluoride measurements were <0.6 mg/L, placing the prevention of cavities in jeopardy.”

Association of Clinicians for the Underserved (ACU): "Remember that water fluoridation is a safe, equitable, and highly effective public health measure."

Association of Maternal and Child Health Programs: Essential Public Health Services To Promote Maternal and Child Health in America: “Diagnose and investigate health problems and hazards affecting women, children, and youth. ... Identify environmental hazards and prepare reports to inform the process of selecting and implementing community-level legislative and structural/physical interventions designed to mitigate health hazards to women, children, and youth, such as: ...• inadequate fluoridation of public water supplies.”

Association of State and Territorial Dental Directors (ASTDD) states, “The primary action of community water fluoridation is topical. Fluoride is ingested, and returns to the oral cavity through saliva secretion, via the salivary glands. The main implication of this mechanism of action is that the teeth are continuously bathed by fluoride-enriched saliva.36 Pre-eruptive systemic fluoride exposure remains important; however, current consensus recognizes that optimal oral health occurs when fluoride exposure continues after tooth eruption." (Resources, Best Practice Approaches) Search
Policy Statement: "The Association of State and Territorial Dental Directors (ASTDD) fully supports and endorses community water fluoridation in all public water systems at the optimal level recommended by the US Public Health Service.”

Australian Academy of Paediatric Dentistry (AAPD) states, “Clearly, support of effective preventive strategies aimed at minimising the burden of dental disease should be at the forefront of any effective dental care or policy. These include promoting water fluoridation and multi-modal fluoride therapies, oral care education, dietary counselling, consideration of a sugar tax and other possible Government support interventions, as well as influencing inappropriate advertising – these remain significant issues and important avenues for guidance.”

Australian Academy of Science: What's the deal with fluoride? "Teeth rot and cavities form due to acid damage, which in turn is produced by the bacteria that inhabit your mouth. What you eat affects the amount of acid damage—the more sugar you eat, the more acid damage. So how can fluoride keep your teeth from being corroded away by bacterial acids? First, fluoride enhances the repair and remineralisation process to fix up teeth when acid strikes. Second, it makes the surfaces of your teeth more resistant to acid damage. Third, it slows down the activity of the bacteria."
The science behind a sparkling smile: "It’s in chocolate, it’s in your bones, and it might be in your glass of water. Many communities around the world add fluoride to drinking water in an effort to keep your teeth—and everyone else’s—free of cavities. But like other aspects of public health, water fluoridation attracts persistent debate and misinformation. To help you scrape back the tooth gunk, we’ve rounded up the facts in this sweet and simple explainer. ... Water fluoridation in Australia decreases the occurrence and severity of tooth decay by up to 44% in children and adolescents."

Australian Dental Association (ADA) Policy Statement 2.2.1: Fluoride Use: “All Australians should have access to the benefits of fluoride. Water fluoridation is a safe, effective, and ethical way to help reduce tooth decay across the population. ... Fluoridation of community water supplies is preferred as a safe and effective means of reducing the prevalence of tooth decay in all age groups and should be implemented and maintained in those communities where there is an insufficient natural fluoride content for this purpose.” Search Fluoridation

Australian Government Department of Health, Disability and Ageing confirms, “Dental health in Australia has improved over the last 25 to 30 years. Changes such as adding fluoride to drinking water have helped to reduce tooth decay in children and adults.”

Australian Government National Health and Medical Research Council (NHMRC) Information Paper on Water fluoridation concludes, "The evidence shows that water fluoridation at current Australian levels reduces the occurrence and severity of tooth decay. Water fluoridation at current Australian levels is associated with dental fluorosis. In Australia, however, most dental fluorosis is very mild or mild, does not affect the function of teeth and is not of aesthetic concern to those who have it. There is evidence that water fluoridation at current Australian levels is not associated with cognitive dysfunction, lowered IQ, cancer, hip fracture and Down syndrome. There is no reliable evidence of an association between water fluoridation at current Australian levels and other human health outcomes." The 2017 Public Statement: "recommends community water fluoridation as a safe, effective and ethical way to help reduce tooth decay, and a range within which NHMRC supports states and territories fluoridating their drinking water supplies." Australia's National Oral Health Plan 2015-2024: "Community water fluoridation is a cost-effective and equitable initiative that is supported by overwhelming scientific evidence and recognized as one of the most important public health interventions. ... Fluoride plays a crucial role in reducing tooth decay and can be delivered through a range of methods, predominantly through the use of fluoridated water and toothpastes. Community water fluoridation is a cost-effective and equitable means of increasing exposure to the protective effects of fluoride, thereby reducing tooth decay across the population, and subsequently reducing pain, suffering and costs to individuals and government." (a new 2025 to 2030 Oral Health Plan is currently being developed)
Based on a thorough review, the NHMRC released its Public Statement in 2017: Water Fluoridation and Human Health in Australia. "The NHMRC recommends community water fluoridation as a safe, effective and ethical way to help reduce tooth decay across the Australian population. NHMRC supports states and territories fluoridating their drinking water supplies within the range of 0.6 to 1.1 milligrams per litre." Water fluoridation in Australia is governed by state and territory fluoride legislation and regulations and is the responsibility of state and territory governments.
Australian States and Territories:
1.            New South Wales: “Water fluoridation helps prevent tooth decay in people of all ages. Scientific research shows that water fluoridation is effective and safe. Adding fluoride to drinking water is important for protecting the health of people in NSW.”
2.            Queensland: “Along with a combination of a healthy diet, good oral hygiene, use of fluoride toothpaste and regular dental check-ups, water fluoridation is an effective strategy to prevent tooth decay.”
3.            South Australia: “Why we fluorinate drinking water: Fluoride in water acts like a repair kit for teeth, working in a number of ways to strengthen teeth and make them more resistant to tooth decay in people of all ages. Strong teeth result in fewer fillings, fewer extractions, fewer visits to the dentist and lower dental bills - resulting in healthy smiles and fewer dentures.”
4.            Tasmania: “Community water fluoridation is a public health measure that aims to reduce dental decay. It is the controlled adjustment of fluoride compound to a public water supply in order to bring the fluoride concentration up to a level that reduces tooth decay.”
5.            Victoria: “Water fluoridation is the most effective method of preventing tooth decay.”
6.            Western Australia: “Fluoride is naturally found in all water sources, including fresh and sea water. Fluoride is also found naturally in a wide range of food items including tea, fish and rice. When present in drinking water at the optimum level, or used in dental treatments, fluoride can promote dental health by helping to prevent tooth damage and decay.”
7.            Northern Territory: “Fluoride naturally occurs in our water or, where possible is added in small amounts, less than one milligram per litre, to help prevent tooth decay.”
8.            Australian Capital Territory: “Tap water is recommended because in most Australian communities it contains added fluoride which helps to protect and strengthen the teeth.”

Australian Medical Association (AMA) states, “Why we need fluoride in our water: Fluoride is a naturally occurring mineral found in water, soil, plants and some foods. It is recognized globally as one of the most important ways of preventing and limiting tooth decay. In 2008, the Queensland Government introduced mandatory fluoridation across the state.” Search

Australian National Health and Medical Research Council (NHMRC) is an independent statutory agency within the portfolio of the Australian Government Minister for Health, Disability and Ageing and the Minister for Disability and the National Disability Insurance Scheme. The NHMRC has publicly supported community water fluoridation as a population health measure since 1952 and regularly reviews the scientific evidence on this topic. Based on a thorough review, the NHMRC released its Public Statement 2017: Water Fluoridation and Human Health in Australia. The NHMRC recommends community water fluoridation as a safe, effective and ethical way to help reduce tooth decay across the Australian population. NHMRC supports states and territories fluoridating their drinking water supplies within the range of 0.6 to 1.1 milligrams per litre.

Australian Research Centre for Population Oral Health released Guidelines for use of ﬂuorides in Australia that stated, the 2019 “NHMRC Review searched the post-2006 literature for evidence of possible harmful effects of water ﬂuoridation on human health. The NHMRC Review concluded that water ﬂuoridation at current Australian levels is not associated with cognitive dysfunction, lowered IQ, cancer, hip fracture and Down syndrome. There was no reliable evidence of an association between water ﬂuoridation at current Australian levels and other human health outcomes.” (p 32)
"While sugar consumption and dental plaque remain as key aetiological factors for dental caries, the use of fluorides has been the cornerstone of caries prevention. Research has led to the development of two central preventive programmes involving water fluoridation and use of fluoridated toothpaste.6,7 Water fluoridation (WF) is recognized as one of the most effective public health interventions." (p. 30)

Authority Dental: "The type of treatment a dentist will use depends on the severity of the tooth decay. Fluoridation, fillings or crowns, and abscess intervention are just some of the possible treatments. ... Fluoridation: If your tooth decay has not gotten past chalky white spots, fluoridation may be enough."

Autistic Self Advocacy Network:
5/28/25 - ASAN Condemns Release of Make America Healthy Again (MAHA) Commission Report on Chronic Childhood Conditions : “In particular, the [MAHA] report claims fluoride has been linked to an increase in intellectual disability — this is false. It’s based on a flawed study that looked at naturally-occurring fluoride, at levels many times higher than what is added to water in the U.S, and could not separate the impact of fluoride from other contaminants like lead, which we know can cause intellectual disabilities. The results can’t be used to make any claims about the amounts of fluoride used to improve dental health.”

Berkley Life Sciences - "Today, fluoride is generally regarded by the Food and Drug Administration (FDA) as safe for use in consumer care products. Government health agencies currently support the fluoridation of public water supplies with the CDC reporting that roughly 73% of the U.S. population drinks fluoridated water."

Better Oral Health European Platform: Community Water Fluoridation:
England: “TThe aim of community water fluoridation (a well recognised strategy globally) is to reduce the prevalence of dental caries through the adjustment of naturally occurring fluoride in public water supplies to the optimum level of oral health. … Evaluation of fluoridation schemes in England has repeatedly demonstrated reductions in average levels of caries per child and increases in the proportion of caries-free children.”
Ireland: “Irish water fluoridation is a national, government funded programme which involves the addition of fluoride to water supplies at water fluoridation plants to a target of 0.6-0.8ppm. The aim of the programme is to prevent dental caries for the entire population without the need for compliance with any behavior dependent measures. Evaluations (surveys on oral health in Ireland) have shown a clear improvement in oral health/caries prevention linked to this initiative.”

Big Cities Health Coalition (BCHC) "joins the American Academy of Pediatric Dentistry and 250 additional health organizations to affirm the safety and effectiveness of community water fluoridation." AAPD

Bright Futures in Practice: Oral Health: “Using community water fluoridation as safe, effective way to reduce risk of early childhood caries (If bottled water is preferred, recommend a brand with fluoride added at a concentration of approximately 0.8 to 1.0 mg/L [ppm].” (p. 7)

British Association for the Study of Community Dentistry "Today we launch our Position statement on Community Water Fluoridation (2023 1st edition).
The position statement considers the evidence for community water fluoridation in the prevention of dental caries and discusses the implementation of and support for water fluoridation schemes in the UK and abroad. Based on this BASCD:
Strongly supports community water fluoridation as a safe, equitable and effective intervention, which should be implemented on a universal basis to reduce the prevalence and severity of tooth decay and reduce oral health inequalities.
Asserts that community water fluoridation should be seen as a key element in a multi-component contemporary approach to decay prevention and urge the implementation of community water fluoridation schemes to reduce the burden of this preventable disease."

British Dental Association (BDA)
9/23/2021 - "The BDA fully supports community water fluoridation as a safe and effective public health intervention, as part of a package of measures to improve dental health, where technically feasible and appropriate for local needs. The Health and Care Bill, currently before Parliament, is set to simplify the rollout of the policy in England. Dentist leaders are now urging all 4 UK administrations to restate their positions on water fluoridation in light of the statement. Public Health England modelling shows water fluoridation more than pays for itself in medium term, owing to reduction in treatment need. £1 spent equates to £12.71 savings in five years, rising to £21.98 in ten. The BDA has stressed that upfront investment by Government is vital to unlock these benefits.”
3/7/2025 – “Water fluoridation: Progress, but we need pace The British Dental Association has welcomed the rollout of fluoridation in the North East - as well as supervised brushing nationwide - but stressed these policies while effective have been needed for decades, and the delays they have faced reflect the lack of priority placed on oral health among successive governments and especially at the Treasury.”

British Fluoridation Society (BFS) “was founded in 1969 to work for improved dental health in the UK through the introduction of water fluoridation schemes.” List of organizations that support fluoridation. Evidence of fluoridation's benefits

British Medical Association policy book 2022-2023, p. 115
811. "... this Meeting notes that only 10% of the UK population are supplied with artificially fluoridated water following fragmented local introduction schemes since 1968 and:
i) acknowledges that this regional disparity has had detrimental effects on the dentition of areas where fluoridation is not routine;
ii) calls for a universal approach to water fluoridation; (Lapsed 2019)
iii) calls on Public Health England to renew its policy on water fluoridation, not just its guidance."
812. "... the BMA remains committed to the fluoridation of mains water supplies on the grounds of effectiveness, safety and equity and urges the Government to require that water companies fluoridate water supplies wherever this is formally requested by health authorities following proper consultation as required by the 1985 Water (Fluoridation) Act."

British Oral Health Foundation: “Fluoride can greatly help dental health by strengthening the tooth enamel, making it more resistant to tooth decay. It also reduces the amount of acid that the bacteria on your teeth produce. Children who have fluoride when their teeth are developing tend to have shallower grooves in their teeth, so plaque can be more easily removed. Plaque is a thin, sticky film of bacteria that constantly forms on your teeth."
New Proposals on water fluoridation offer fresh hope for nation's oral health: "The addition of fluoride to water has been researched for over 75 years, and water fluoridation has been proven to reduce decay by 35%. Fluoride can greatly help dental health by strengthening the tooth enamel, making it more resistant to tooth decay. ... Currently, some six million people in the UK receive a fluoridated water supply. Those in areas with fluoridated water have be shown to have lower rates of decay than those without. ... We believe that water fluoridation is the single most effective public health measure there is for reducing oral health inequalities and tooth decay rates, especially amongst children.”

British Society of Paediatric Dentistry: “Water fluoridation is a public health measure that was first introduced nearly 70 years ago and exists in 25 countries. It results in substantial reductions in dental decay and resulting sequelae such as abscesses, toothache, tooth extraction and need for general anaesthetic and hospital admission”

Campaign for Dental Health under American Academy of Pediatrics Search
Common Questions About Fluoride - 17 questions about fluoride and fluoridation. Additional fluoridation information.
The Debate Over Fluoridated Water: "The debate over fluoridation goes back 80 years to when communities began fluoridating water to prevent tooth decay. The issue: Is fluoridated water better for your health or not?"
What Do the Leading Health and Medical Authorities Say About Community Water Fluoridation?

Canadian Association of Public Health Dentistry "endorses community water fluoridation as an important public health measure to prevent dental caries (tooth decay) in a population. It is safe, effective, ethical, legal, reduces oral health disparities and is cost-effective.
The major conclusions from all these reviews and reports are:
• Community water fluoridation is safe. The weight of scientific research supports no increased risk of cancer, bone disease, I.Q. deficits, thyroid suppression, kidney disease, diseases of the immune or reproductive systems, nor genetic, neurological, developmental, or any other health effects.
• Community water fluoridation is effective in preventing tooth decay even when other sources of fluoride, e.g. toothpastes, topical fluorides, are used.
• The only adverse effect linked to community water fluoridation at the recommended level is an increased risk of mild dental f luorosis. It is a cosmetic, not a health effect, and mild dental f luorosis is not noticed by most people.
• Community water fluoridation is a public health measure that benefits all residents served by community water supplies, regardless of their age, sex, culture, social or economic status or educational level.
• Scientific research finds no evidence of negative environmen tal impacts from adding controlled amounts of fluoride to the drinking water.”

Canadian Dental Association (CDA) "supports community water fluoridation, as recommended by Health Canada, because communities with optimal levels of fluoride in their drinking water experience less caries (i.e., tooth decay). Based on available evidence, community water fluoridation is safe, effective and economical. ”

Canadian Dental Hygienists Association Board of Directors “Endorses the use of fluoride as an important oral health promotion and disease prevention approach; Recommends that water fluoridation be maintained and extended to additional communities where feasible.” (FAQs CWF 2017)

Canadian Government: “Fact sheet - Community water fluoridation: Water fluoridation can reduce tooth decay in a community by providing frequent and consistent contact with low levels of fluoride. … By preventing tooth decay, community water fluoridation has been shown to save money, both for families and for the health care system, and evidence continues to indicate that the economic benefit of community water fluoridation exceeds the costs (16; 20-22). Every $1 invested in a prevention measure like community water fluoridation at the optimal level can yield between $5.00 and $93.00 of savings per person in dental treatment costs.”

Canadian Medical Association policy, Resolution GC77-27: “That the Canadian Medical Association encourage programs to promote fluoridation of communal water supplies."
Policy: "Canadian Medical Association (CMA). In: CMA 1977 Québec QC, Proceedings of the 146th Annual Meeting including transactions of General Council, June 20-22, 1977. Québec QC: The Association; 1977.” Validated by email, 6/22/2022.

Canadian Paediatric Society: 1921 Position Statement The Use of Fluoride in Infants and Children, “All major Canadian and American dental and paediatric societies endorse the use of fluorides as safe and effective for caries prevention. … Community water fluoridation is safe, effective, and inexpensive and does not require daily adherence.”

Canadian Public Health Association: "Fluoridation is another method of preventing tooth decay. The fluoride ion reinforces the enamel after the tooth has surfaced, making it more resistant to decay. In fact, each dollar iAccording to a letter from the Saskatchewan Health's Authority regarding the recommendation to support putting fluoride in public drinking water, it states "many governments and health organizations, including the Public Health Agency of Canada, Health Canada, the Canadian Public Health Association, the Canadian Dental Association, the Canadian Medical Association, and the World Health Organization support the fluoridation of drinking water as an important public health measure to prevent tooth decay."
CPHA Fluoridation support since 1952, Position Paper #2A Water Fluoridation (documents used with permission)

CareQuest Institute for Oral Health:
4/17/25 – “Community Water Fluoridation: Facts and Myths Studies included in recent systematic review consistently showed that water fluoridation reduced the rate of new tooth decay by 25%–30% in baby teeth and adult teeth, even with widespread availability of fluoride toothpaste.”
5/29/25 – “New Study Shows Costly Consequences for States Banning Fluoride. The findings are clear: Ending water fluoridation could result in more than 25 million additional decayed teeth among children in the next five years, with the greatest impact on low-income and uninsured families. This would lead to an estimated $9.8 billion in added health care costs, further straining an already overburdened dental workforce and deepening the nation’s existing oral health crisis.”
“Decades of research have proven that, at optimal levels, fluoride is safe and plays a critical role in preventing tooth decay and promoting good oral health.” “What would be the consequences of removing fluoride from water systems nationwide? A new study in JAMA Health Forum says 25 million additional decayed teeth among children in the next 5 years and an estimated $9.8 billion in added health care costs.” More Information Search

Center for Medicare Advocacy:
4/17/25 - Supporting Community Water Fluoridation - “Community water fluoridation, which began in the United States in 1945, was identified by CDC as among the 10 great public health achievements of the 20th century, one that has reduced tooth decay by about 25% in children and adults. … “Water fluoridation equitably reduces the burden of oral disease for Medicare beneficiaries, many of whom lack dental coverage or cannot access affordable dental care.”

Center for Oral Health:
January 2025 - Water Fluoridation: Facts vs. Fears: “Since 1985, the Center for Oral Health (COH) has been a leading advocate for water fluoridation, building on decades of scientific evidence and community-focused efforts. Today, we reaffirm our commitment to fluoridation as an essential public health measure. This white paper addresses prevalent misconceptions and negative attitudes toward fluoridation—both in water systems and as a preventive dental measure— and highlights its proven benefits for health equity and economic sustainability.”

Center for Public Health Law Research states: “Water Fluoridation -- The Bottom Line: In the judgment of a Community Guide expert panel, there is significant evidence to support water fluoridation as an effective public health intervention aimed at reducing tooth decay.”

Center for Science in the Public Interest - MAHA Report: Anti-scientific ideas and deep contradictions: "The assessment regurgitates the same talking points we have heard from this administration since January: false claims about the “harms” of seed oils, fluoride, and vaccines, unsubstantiated claims about “ineffective” government nutrition programs, and an implied push for industry deregulation." Smoke & mirrors: How to spot health misinformation: "In 2021, the Center for Countering Digital Hate published a report exposing “The Disinformation Dozen,” 12 anti-vaxxers who spread misinformation about the Covid-19 vaccines. ... Among the dozen: alternative health guru Joseph Mercola. For decades, Mercola has peddled far-fetched health claims—like fluoride is a neurotoxin, radiation from wireless devices is linked to everything from anxiety to infertility, and diets fail because grains are addictive. Mercola is also happy to sell you a slew of supplements, water filters, pricey packaged foods, and more."

Centers for Disease Control and Prevention (CDC) states, “The safety and benefits of fluoride are well documented and have been reviewed comprehensively by several scientific and public health organizations. The U.S. Public Health Service; the United Kingdom's National Institute for Health Research, Centre for Reviews and Dissemination, at the University of York; and the National Health and Medical Research Council, Australia have all conducted scientific reviews by expert panels and concluded that community water fluoridation is a safe and effective way to promote good oral health and prevent decay.” Additional Information
Fluoride Legislative User Information Database (FLUID) “is a comprehensive database containing legal decisions by U.S. courts and current information on federal, state and local policies regarding community water fluoridation.”
5/15/2024 - CDC Scientific Statement on Community Water Fluoridation: "Water fluoridation is beneficial for reducing and controlling tooth decay and promoting oral health across the lifespan. Evidence shows that water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride, ultimately reducing tooth decay by about 25% in children and adults. Additional evidence shows that schoolchildren living in communities where water is fluoridated have, on average, 2.25 fewer decayed teeth compared to similar children not living in fluoridated communities. ... Because of its contribution to the dramatic decline in tooth decay, CDC named community water fluoridation 1 of 10 great public health achievements of the 20th century"
5/15/2024 - Return on Investment: Optimally Fluoridated Water: "Providing optimally fluoridated water to U.S. communities for one year saves $6.6B in dental treatment costs and offers an averate return on investment of $20 for every $1 spent. On average, communities with water fluoridation experience 24% fewer cavities, saving $32 per person annually by avoiding dental tretment costs and leading to fewer missed work and school days."

Children’s Dental Health Project states, “Overall, most major national and international health organizations consider water fluoridation to be a safe and very cost-effective public health intervention at current recommended levels. But those concerned about potential harms may want to moderate their fluoride exposure, especially from supplemental sources. … Here is an overview comparison of how fluoride alternatives may stack up for prevention: #1 - Fluoridated water – Very effective – Reduces cavities 15-30% vs non-fluoridated water As you can see, fluoride has the most significant impact on cavity reduction by fortifying enamel through systemic ingestion and topical exposure.”

Childsmile (NHS Health Scotland) “is reducing inequalities in oral health and ensuring access to dental services for every child across the country." The Programme Manual states, “Fluoride is a naturally occurring mineral. When fluoride is present in the saliva, the fluoride ions become concentrated in the plaque. Even at very low levels, fluoride in the plaque and saliva is able to alter the balance between demineralisation and remineralisation, favouring the remineralisation process. As the remineralisation happens in the presence of fluoride, the new mineral crystals are stronger and less susceptible to acid attack. … Fluoride can either be given to children systemically (in the form of drops or tablets; added to milk or water in Public Health Programmes) or be used topically in the form of gels, varnishes or mouthwashes.” (p. 19) Child Oral Health

Coalition for Oral Health for the Aging signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Community Catalyst:
4/8/25 - When Disinformation Shapes Policy, Communities Pay the Price: “Earlier this week, U.S. Health Secretary Robert F. Kennedy Jr. announced plans to instruct the Centers for Disease Control and Prevention (CDC) to stop recommending community water fluoridation—a safe, evidence-based public health measure that has dramatically reduced cavities, improved oral health, and saved communities billions in treatment costs over time. While Kennedy lacks the authority to ban fluoridation outright, this shift in federal guidance—especially when paired with disbanding the CDC’s Division of Oral Health—sends a dangerous message and opens the door for other states to follow Utah’s lead in banning fluoridation altogether. It’s a decision rooted not in science, but in disinformation.”
4/9/25 - ICYMI: RFK Jr.’s Move on Fluoridation Is a Dangerous Step Backward in Public Health: “This National Public Health Week, communities are facing unprecedented attacks on evidence-based practices that keep people healthy – from childhood vaccines to fluoride in drinking water.… “Community Catalyst’s latest blog, When Disinformation Shapes Policy, Communities Pay the Price, unpacks how this move is the latest chapter in a growing trend of policy driven by fear, not facts. … Secretary Kennedy’s announcement to halt CDC recommendations for community water fluoridation is not just a step backward in public health – it’s a dangerous and reckless move that disregards science, health equity, and the ability of communities to shape policies that impact their health.”

Community Preventive Services Task Force (CPSTF) “recommends community water fluoridation to reduce tooth decay (i.e., dental caries or cavities).”

Consumer Federation of America - "Only small minorities of respondents (albeit consistently more Republicans) agreed with what I would identify as “conspiracy theories,” i.e. 'getting the measles vaccine is more dangerous than becoming infected with measles,' 'Vitamin A can prevent measles infections,' 'the COVID-19 vaccine is the deadliest vaccine ever created,' 'including fluoride in the water supply reduces children’s IQs,' and 'vaccines have been shown to cause autism.'”

Council of European Dentists: 2015 Manual of Dental Practice states, “Fluoride is a substance which gives protection to teeth against tooth decay, if ingested in optimal quantities, or applied to the surface of the teeth by means of toothpaste or other methods. Fluoride may be found naturally at optimal or suboptimal levels in water supplies or in some countries (Hungary, Ireland, Spain and the UK by the addition of fluoride to the water supplies).” (P. 31)

Council of State and Territorial Epidemiologists (CSTE) - "The National Oral Health Surveillance System (NOHSS) is a collaborative effort between CDC's Division of Oral Health and the Association of State and Territorial Dental Directors (ASTDD) designed to monitor the burden of oral disease, use of the oral health care delivery system, and the status of community water fluoridation on both a national and state level. CSTE and the state Chronic Disease Directors were instrumental in developing the framework for chronic disease surveillance indicators, including these oral health indicators."

Dale Foundation signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Dear Doctor - A Patient Education Company: “Extensive scientific evidence conclusively shows that water fluoridation and fluoride toothpastes substantially reduce dental caries, tooth decay, and are cost-effective. In fact, the Centers for Disease Control and Prevention has named water fluoridation as one of the ten most important public health measures of the 20th century.”

Delta Dental Plans Association signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD
Raise a glass to fluoridated water - "Water fluoridation is a proven community benefit – it helps reduce cavities, tooth loss, and tooth decay, straight from the tap! Keep reading to learn how it works, other benefits of hydration, and how you can make sure you’re getting enough fluoride to keep your smile healthy." Search

Dental Advancement through Learning and Education (DALE) Foundation signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Dental Assisting National Board signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Dental Trade Alliance signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

DentaQuest: “Teeth are covered with a sticky film called plaque. Plaque uses the food we eat to make acids that cause cavities. But fluoride fights acids in the mouth and makes teeth stronger. Even before your baby’s teeth come in, fluoridated water will make their teeth stronger. After teeth come in, keep guarding against cavities with fluoridated water and fluoride toothpaste, plus fluoride treatments at the dentist. Avoid bottled water because it usually doesn’t include fluoride.”

Dentistry UK: "Key messages … Prevention isn’t solely the patient’s duty – it also falls under the purview of governmental bodies and policymakers to safeguard patients’ health. For World Oral Health Day, please join us in targeting politicians with pressure to support preventive oral health policies such as community water fluoridation and expansions to the soft drinks levy."
“We fully support UK-wide water fluoridation at the Oral Health Foundation. During week four, we want to raise awareness about the benefits of fluoride and encourage people to write to their local MP to adopt water fluoridation in the local area.”
National Smile Month – everyone deserves a healthy smile - Dentistry

Dentistry.One signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Delta Dental: "Why is fluoride in tap water? Because it works! Community water fluoridation has done so much to reduce tooth decay that it has been named one of 10 great public health achievements of the 20th century." Search

Department of Health & Social Care, UK –– Advancing our health: prevention in the 2020s. "Water fluoridation schemes such as this have been used for over 70 years internationally, and in England for over 55 years." In its 2022 report, PHE concluded, that "The findings of the 2022 health monitoring report are consistent with the view that water fluoridation at levels prescribed within the UK regulatory limit (<1.5mg/l) is an effective, safe, and equitable public health intervention to reduce the prevalence, severity, and consequences of dental caries. It supports previous findings that these benefits are greatest in the most deprived areas, thereby contributing to reducing dental health inequalities."
9/23/21 Statement on water fluoridation from the UK Chief Medical Officers: "Conclusion - As with all things in medicine and public health there is a balance of risk and benefit. There is unquestionably an issue with tooth decay in the UK and an entrenched inequality which needs to be addressed. Fluoridation of water can reduce this common problem.
On balance, there is strong scientific evidence that water fluoridation is an effective public health intervention for reducing the prevalence of tooth decay and improving dental health equality across the UK. It should be seen as a complementary strategy, not a substitute for other effective methods of increasing fluoride use." Dr Frank Atherton, Chief Medical Officer, Wales, Dr Michael McBride, Chief Medical Officer, Northern Ireland, Dr Gregor Smith, Chief Medical Officer, Scotland, Professor Chris Whitty, Chief Medical Officer, England

DrBicuspid article, Increasing water fluoridation will reduce childhood caries (June 2024) states, "Expanding community water fluoridation (CWF) coverage may effectively lower the incidence of caries among children, according to a study published on June 21 in the Journal of the American Dental Association."

Drinking Water Inspectorate (DWI) - England and Wales: "Fluoridation is the term used to describe the dosing of water supplies to bring the fluoride level up to 1 milligram per litre as a public health measure intended to prevent tooth decay."

Elevate Oral Care signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Enable Dental signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Environmental Protection Agency (EPA): Q&A on Fluoride recognizes “Fluoride can also be added to public drinking water supplies as a public health measure for reducing cavities among the treated population." and "The HHS recommended optimal level of 0.7 milligrams per liter is set to promote public health benefits of fluoride for preventing tooth decay while minimizing the chance for dental fluorosis."
EPA and HHS Announce New Scientific Assessments and Actions on Fluoride: “One of water fluoridation’s biggest advantages is that it benefits all residents of a community—at home, work, school, or play,” said HHS Assistant Secretary for Health Howard K. Koh, MD, MPH. “Today’s announcement is part of our ongoing support of appropriate fluoridation for community water systems, and its effectiveness in preventing tooth decay throughout one’s lifetime.”

European Academy of Paediatric Dentistry (EAPD) “reaffirms its support [2019] for the use of community water fluoridation as a safe, effective, relevant and costsaving public health measure for the prevention and control of dental caries. The Academy recognises that CWF alone is not a panacea but should be seen as an important element in a multi-faceted approach to caries prevention and control, which includes oral health promotion and access to affordable care.” (p. 514)

European Food Safety Authority (EFSA): “Although fluoride is not essential for tooth development, its role in the prevention of dental caries has been known for many years. Epidemiological studies have shown an inverse correlation between the presence of fluoride in drinking water and the prevalence of dental caries in children.”

European Scientific Committee on Health and Environmental Risks (SCHER) – summary of 2010-2011 report, Critical Review of Any New Evidence on the Hazard Profile, Health Effects, and Human Exposure to Fluoride and the Fluoridating Agents of Drinking Water: “Fluoride, either naturally present or intentionally added to water, food and consumer products, e.g. toothpaste, is generally considered beneficial to prevent dental caries.” (p. 39) There were no health risks listed for exposure to optimally fluoridated water.

FACTS.NET - 30 Facts About Fluoride In Water (2/28/2025) - "Key Takeaways: Fluoride occurs naturally and helps prevent cavities, but ingesting too much can harm the brain and bones. Public health policies aim to balance its benefits and risks for optimal oral health. Fluoride in water prevents tooth decay, but too much can cause dental fluorosis. Understanding its benefits and risks is crucial for maintaining healthy teeth and overall well-being."
40 Facts About Fluoridation (12/1/2024) - Key Takeaways: -“Fluoridation adds fluoride to water, reducing tooth decay. It's safe, endorsed by health organizations, and benefits everyone, but some people have concerns about overexposure and environmental impact. - Fluoridation has a rich history and continues to evolve. New technologies and research may shape its future, while global health organizations are likely to continue supporting it as a key public health measure.”

Faculty of Dental Surgery of the Royal College of Surgeons - "The Faculty of Dental Surgery supports the introduction of water fluoridation. It is a safe and effective public health measure to reduce dental decay and inequalities in dental health. Today’s report (2022) provides further evidence for this. It finds that children and young people in areas in England with higher fluoride concentrations were up to 63% less likely to be admitted to hospital for tooth extractions due to decay than those in areas with low fluoride concentrations. In the most deprived 20% of areas, the chance of five-year old children having cavities - or holes in their teeth - was 25% lower in areas with a fluoridation scheme than in areas without." Search

Faculty of Public Health - Message stated, "I can confirm that FPH does support community water fluoridation. Please see attached a press release to this effect from BACD, who our Oral Health SIG are linked to through an MoU.

Families USA: “The Surgeon General’s report on oral health notes that community water fluoridation is one of the most notable public health achievements of the 21st century. It levels the playing field, improving the oral health of both high-income and low-income families. Fluoridation is both easy to administer and is cost effective. According to Pew, ‘Community water fluoridation can reduce tooth decay in children by up to 60 percent and it costs as little as $1 per person, per year.’ And NASHP notes that the ‘estimated savings range from $7 to $42 for every dollar spent on water fluoridation.’ Despite the fact that water fluoridation has been proven to increase health outcomes for children across the country, there are campaigns spreading misinformation about the effects of fluoride. While public health officials believe water fluoridation should be expanded to cover more communities throughout the country, some counties are scaling back on this important initiative.”

FDI World Dental Federation: Promoting Oral Health through Water Fluoridation: "Water fluoridation is the adjustment of the fluoride concentration in fluoride-deficient water supplies to a level recommended for optimal oral health. More than 370 million people in over 27 countries receive the benefits of water fluoridation. In recognition of the importance of promoting oral health through water fluoridation, FDI World Dental Federation states that:
* Over 70 years of research and recent systematic reviews have shown that water fluoridation is an effective public health measure for the prevention of dental decay in children and adults.
* Water fluoridation is particularly appropriate for populations demonstrating moderate to high risk of dental decay.
* Water fluoridation confers positive health savings and contributes to reducing disparities in the rates of dental decay in communities.
* At the fluoride concentrations recommended for the prevention of dental decay, scientific research and reviews show that human general health is not adversely affected. * The public health benefits of water fluoridation in the prevention of dental decay far outweigh the possible occurrence of very mild/mild dental fluorosis.
2021 Global strategy on tackling oral diseases: "... the role that adequate exposure to fluoride plays in the prevention of tooth decay (dental caries) – the most prevalent disease worldwide. It mentions different fluoride delivery mechanisms and recognizes them as essential prevention methods, including community based fluoridation where appropriate - for instance, water fluoridation is an effective and safe way to systematically protect oral health in populations with a moderate to high risk of dental caries, thus reducing oral health inequalities." 65 dental organizations worldwide were cosignatories.

First Focus on Children: November 2024, "First Focus on Children expresses grave concern over the nomination of Robert F. Kennedy Jr. by President-elect Donald Trump to serve as Secretary of Health and Human Services (HHS). Kennedy’s well-documented positions on key public health issues, including his opposition to vaccines and water fluoridation, raise significant red flags, particularly concerning the health and safety of children."
August, 2016 “The good news is that community fluoridation is a solution that protects everyone – especially kids – against at least 25% of tooth decay. … The cost-benefit ratio makes one thing obvious – community fluoridation is a cost saver. In most places, every $1 invested in water fluoridation saves $38 in dental treatment – money that would otherwise come from CHIP, Medicaid, or other government resources. … The research is clear: Community fluoridation is an easy, affordable solution to a disease that adversely affects our most at-risk children. How can we say no to such an easy solution for such a common problem?” Search

Fluoride Exposed: "If you also wanted to call us a couple of pro-fluoridationists, we can't deny it. We both proudly support community water fluoridation. And we have each advocated for fluoridation in our beloved city of Portland.… Our goal here is not to ask you to support fluoridation like we do. Our goal is for everyone to learn more about science, regardless of your values-based beliefs about fluoridation.” (DentalTown, Dentistry article, Who We Are)
Fluoride Science is dedicated to balanced reviews of fluoride studies and communicating the qualities and summaries of the scientific evidence for professional communities that may engage in patient care and/or public health services.

Food and Drug Administration: 2019 “The U.S. Food and Drug Administration (FDA) announced today that it is proposing to revise the quality standard for bottled water to specify that bottled water to which fluoride is added by the manufacturer may not contain fluoride that exceeds 0.7 milligrams per liter (mg/L). If finalized, the proposed rule would amend the allowable levels of fluoride in domestically packaged and imported bottled water to which fluoride is added. This proposal is based on findings from evolving research on optimal concentrations of fluoride that balances fluoride’s benefits in preventing tooth decay with its risk of causing dental fluorosis…”
Health Claim Notification for Fluoridated Water and Reduced Risk of Dental Caries: "Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. All U.S. residents are likely exposed to some degree of fluoride, which is available from multiple sources."

Food Safety Authority of Ireland (FSAI) stated, “In Ireland … public water supplies are required to be fluoridated. Since 2007, the level of fluoride in public water supplies in the Republic of Ireland has been set at between 0.6 and 0.8 mg/L. … The objective (of the study) was to evaluate possible risk, if any, to the health of children aged 1–12 years and adults resident in Ireland arising from exposure to fluoride from foods and beverages, including fluoridated water. … These estimates are based on fluoride content of foods and beverages, including fluoridated water. … Based on the results of this study, the FSAI Scientific Committee concluded that there is currently no scientific basis for concerns about the safety of children and adults in Ireland from exposure to fluoride from foods and beverages."
Safety of Fluoride Exposure for the Developing Foetus in Ireland: "The available evidence indicates that exposure to fluoride during foetal development in Ireland is not excessive and does not give rise to moderate or severe fluorosis of primary teeth. Therefore, there is currently no scientific basis for concerns about the safety of the developing foetus arising from exposure to fluoride in Ireland."

General Dental Council response to the Department of Health and Social Care consultation, Water fluoridation: seeking views on future consultation process. "The General Dental Council (GDC) is the UK regulator of dental professionals. Our primary purpose is to protect, promote and maintain the health, safety and wellbeing of the public. Thank you for the opportunity to respond to the consultation. As part of our core objective of public protection, we support broader system efforts to increase dental access, improve oral health and reduce oral health inequalities. We are aware of evidence which shows that water fluoridation, at levels recommended in the UK, can safely and effectively reduce tooth decay and oral health inequalities."

Gerontological Society of America
10/4/24 - “Individuals at all ages, and especially older adults who are prone to root caries, should adopt and perform regular preventive oral health behaviors, avoid foods with added sugar and fermentable carbohydrates, drink fluoridated water, brush with fluoridated toothpaste, use dental floss or interdental brushes daily, and chew sugar free gum. ... GSA recommends increased access to fluoridated water supplies, with an encouraged investment of $20 for every $1 spent on water fluoridation.”

Green Facts: “The "optimum" level of fluoride in drinking water, associated with the maximum level of dental caries protection and minimum level of dental fluorosis, is considered to be approximately 1 mg/litre. …. Fluoridated drinking water is one of the most cost-effective means of delivering fluoride to large numbers of individuals. It requires a suitable community-wide drinking water delivery system along with a reasonable level of technological development. About 210 million individuals throughout the world consume such water.” Search

Health Canada: We support Community Water Fluoridation as an effective way to prevent tooth decay. It is universally accessible and provides benefits to all members of a community, regardless of their: age, gender, income, ethnicity. education, access to oral health services, or ability to afford oral hygiene supplies. Community Water Fluoridation has been proven to be a safe, effective and equitable way to prevent and reduce tooth decay (including root decay) for people of all ages - from children to seniors.” (Position Statement, Fluoridation Fact Sheet)

Health Forward Foundation signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Health Research Board, Ireland: 11/10/2022 - "New HRB report reviews health effects of community water fluoridation Review finds no definitive evidence that community water fluoridation has negative health effects."
2015: Health Effects of Water Fluoridation, An Evidence Review: “In summary the literature found no strong evidence that CWF is definitively associated with negative health effects.” Search

Health Resources and Services Administration (HRSA): “Fluoride helps to prevent dental decay. Most effectiveness is shown with systemic exposure to very low concentrations during tooth development via community water fluoridation or supplements, in combination with higher topical concentrations, which should not be swallowed.
Remember that fluoride, when properly used, is safe. Like all other medications and supplements, more is not better. Many scientific studies showed the benefits of fluoride on dental caries, as well as documented its safety.” (p. 31)
Oral Health and Nutrition: “Fluoride is a mineral that is often found naturally in water in various amounts. For about 75 years, community water systems have been checking and safely adjusting fluoride levels to protect people's teeth from dental cavities. Drinking water that has fluoride reduces cavities by about 25% in children and adults. Fluoride, along with calcium and other minerals in saliva (spit), can reverse early stages of tooth decay.”

Healthy Children “Is fluoride in drinking water safe for my children? Yes. America has been preventing tooth decay with fluoridated water for over 80 years. Is fluoride linked to IQ? Fluoride in drinking water at the recommended level has not been linked to lower IQ scores. Some studies, including from the U.S. government, have noted a possible link between very high fluoride levels in drinking water—more than twice the level of fluoride in U.S. drinking water—and lower IQ scores in children. The findings were based on studies in non-U.S. countries where some pregnant women and children were exposed to total amounts higher than 1.5 mg of fluoride per liter of drinking water.” 4/24/2025
4/9/2025 - "Adding fluoride to water is safe and benefits everyone. As more and more communities have added fluoride to water supplies, the U.S. has seen a major decline in cavities and other dental problems. Fluoridation has been identified as the most practical and cost-effective method of delivering fluoride to all members of a community, regardless of age, education or income. The average lifetime cost per person to fluoridate a water supply is less than the cost of one dental filling."

Healthy Teeth Healthy Children: “What is Fluoride? -- "Fluoride is a naturally occurring mineral that can help prevent tooth decay.”

Indian Dental Association (India): “Fluoride helps prevent tooth decay by a) Conversion of hydroxyapatite to a fluoridated hydroxyapatite, b) Increased rate of post eruptive maturation, c) Inhibits the micro-organism. ... In the event that water fluoridation is not feasible, school water fluoridation can be an alternative.”

Indian Health Service (U.S.) states, “The Indian Health Service (IHS) Dental Program has the broad mission to support American Indian individuals and groups as they strive to improve their oral health. … IHS Dental Program objectives address: reducing dental decay in children; reducing periodontal disease in children and adults; and fluoridating community water systems. … Fluoride use is cornerstone upon which dental disease prevention programs are built. Sources of fluoride promoted include: Fluoridated water supply, Topical fluoride and varnish application, Fluoridated toothpaste.”

Institute for Evaluation of Labour Market and Education Policy (Sweden): “Fluoridation of the drinking water is a public policy whose aim is to improve dental health. Although the evidence is clear that fluoride is good for dental health, concerns have been raised regarding potential negative effects on cognitive development. We study the ef effects of fluoride exposure through the drinking water throughout life on cognitive and non-cognitive ability, math test scores and labor market outcomes in a large-scale setting. ... Conclusion: We have investigated the effects of fluoride on outcomes related to the central nervous system and more long-term labor market outcomes. Taking all together, we find a zero effect of fluoride on cognitive ability, non-cognitive ability and points on the national test in math. For income and employment status we find evidence of a positive effect of fluoride, which is in line with the explanation that better dental health is a positive factor on the labor market.”

Institute for Science in Medicine states, “One of the top public health achievements has been community water fluoridation (CWF), which now provides a safe, effective and economical way to help prevent tooth decay. ... Community water fluoridation (CWF) is the adjustment of the naturally-occurring fluoride content in drinking water for optimal health benefit. ... Needed Policy: In order to optimize the dental health of citizens, all communal water systems need to implement CWF as recommended by recognized public health authorities.”
The Anti-Fluoridationist Threat To Public Health: "Tactics of the Anti-fluoridation Movement:
Misrepresenting the Conclusions of Valid Research, Citing Strange, Far-Fetched Case Studies to Attack Fluoridation, Engaging in Misleading Spin about Europe and Fluoride, Misrepresenting the Positions of Governmental or Health Organizations, Painting an Inaccurate Picture of Dental Fluorosis, Leaving Out Critical Facts, Using a “Rhetorical Question” to Create Fear, Holding Extreme Views About Health and Medicine. ... The anti-fluoridationists’ fake scientific controversy has resulted in reduced dental health, needless pain, suffering, and lost productivity, with substantially increased financial burdens on individuals and our health care system."

International Association for Dental, Oral, and Craniofacial Research (IADR): Position Statement on Community Water Fluoridation - 2022 update: “IADR supports community water fluoridation as a safe and effective, evidence-based intervention for the prevention of dental caries. This public health measure has a high benefit/cost ratio and benefits deprived communities the most thus reducing health inequalities. While fluoride occurs naturally in water, levels vary depending on regions and sources of water. Fluoridation is the controlled addition of a precise amount of fluoride to community water systems to the level beneficial for dental health, without systemic health side-effects. The practice of adding fluoride to community water supplies began after Dr. H. Trendley Dean observed a dose response relationship between naturally occurring fluoride levels in water with dental fluorosis and caries in his famous 21-city study. Community water fluoridation began in Grand Rapids, Michigan, USA in 1945 and reached 63.4% of the United States population in 2018. Globally, over 400 million people in 25 countries have access to community water fluoridation. The 75-year history of community water fluoridation as a public health measure has been summarized in an IADR Centenary Review.” Search

International Association of Paediatric Dentistry signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

International Dental Journal
4/13/25 - Facts Facts and Fallacies of the Fluoride Controversy: A Contemporary Perspective “Conclusions Fluoride has played a pivotal role in the prevention and management of dental caries through its well-established mechanisms of action, including enamel remineralization, inhibition of demineralization, and antimicrobial properties. Various fluoride delivery methods, such as water, milk, and salt fluoridation, and toothpastes have demonstrated significant public health benefits, particularly in reducing caries prevalence. … While controlled exposure to fluoride is essential for maximizing its dental benefits, unregulated consumption poses rare risks such as dental and skeletal fluorosis. ,,, for children with developing permanent dentition, there is no substitute for systemic fluoridation as it provides lifelong benefits by incorporating fluoride into the enamel structure whereas topical fluorides do not reach systemic circulation” Search

Ireland Dental Health Foundation states, “The dramatic improvement seen in the oral health of Ireland since the introduction of water fluoridation in the mid-1960s – particularly among children and young adults with lifetime exposure to water fluoridation (labeled “Full Fl” in charts) – has been mainly attributed to the caries-preventive effect of fluorides in water and in toothpaste.” Search

Irish Dental Association Position Paper: “TThe Irish Dental Association (IDA) strongly endorses water fluoridation as the most practical, cost effective and safe, public health measure to control the occurrence of tooth decay in Ireland. Community water fluoridation is endorsed by the World Health Organization (WHO) as the first choice method of providing fluoride to communities. The US Centers for Disease Control and Prevention (CDC), and the EU Scientific Committee on Health and Environment Risks (SCHER) have also endorsed water fluoridation. The US Surgeon General described water fluoridation as one of the top ten greatest public health measures of the twentieth century. ... The Irish Dental Association recognises that water fluoridation is a contentious issue and is regularly debated in the media. The Irish Dental Association recommends that policymakers be guided by high quality, peer-reviewed evidence.”

Irish Expert Body on Fluorides and Health Position Statement: "Water Fluoridation and the use of appropriate fluorides is a major plank of public health policy in Ireland in the prevention and management of tooth decay. ... Conclusion: The Expert Body is of the opinion that there continues to be overwhelming evidence that water fluoridation significantly benefits dental health. The Expert Body is satisfied, having studied current peer reviewed scientific evidence worldwide, that water fluoridation, at the optimal level, does not cause any ill effects and continues to be safe and effective in protecting the oral health of all age groups. These views are supported by reputable international agencies and valid scientific articles and reviews.”
Answers from Irish Expert Body on Fluorides and Health

Israeli Ministry of Health: "The fluoridation of drinking water is considered an achievement of the public health system, through its beneficial influence on dental health. It can spare people pain, suffering and hospitalizations, and constitutes a part of the basic human right for health."
"The decision by Yael German of the Yesh Atid party /to end fluoridation/, amazed experts at Israel’s schools of dentistry and public health because it contravened a year of recommendations and attempts by professionals and the ministry to change German’s mind."
The effect of community water fluoridation cessation on children's dental health: a national experience: "After CWF cessation in Israel [2014], rates of dental treatments significantly increased."

Journal of the American Medical Association (JAMA)
5/30/25 - “This cost-effectiveness analysis simulating the results of ceasing PWS [public water system] fluoridation, per the proposed policy change, projects an increase in tooth decay among children of 7.5 pp and costs of approximately $9.8 billion over 5 years. Subsequent increases in dental costs and disproportionate harms would affect publicly insured and uninsured children. These findings suggest that, despite the potential harms of excessive fluoride exposure, fluoridation at safe levels offers both individual and societal benefits that would be at risk.” Search

Justice in Aging signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

KidsHealth: "Fluoride is a mineral found in water sources and soil. Fluoride is added to the water in the United States and other countries. It is also found in some toothpastes, mouth rinses, and vitamin supplements. Fluoride strengthens teeth enamel. The enamel is the hard outer covering of the teeth. By keeping the enamel strong, fluoride helps prevent cavities. Cavities are caused by tooth decay. Tooth decay is caused by some types of bacteria (germs) in the mouth. These bacteria make acid that can break down tooth enamel. Fluoride prevents the acid from breaking down the enamel. It also helps teeth damaged by acid to repair themselves. Fluoride cannot repair cavities, but it can reverse some tooth decay and prevent new cavities."

KFF - Formerly known as The Kaiser Family Foundation
12/24 - Water Fluoridation in the U.S.: The Federal Role in Policy and Practice: “Trump’s announced nomination of Robert F. Kennedy Jr. to be the Secretary of Health and Human Services has raised questions about the potential for the federal government to influence water fluoridation practices across the country. Kennedy has long been critical of water fluoridation and has said the incoming Trump administration will recommend that fluoride be removed from public water on day one. Meanwhile, key professional associations, public health experts, and many policymakers continue to support fluoridation as an important tool for improving dental health in the U.S., and perhaps one of the most important public health interventions ever implemented.” KFF Search, KFF Health News

Linus Pauling Institute: “The use of fluoridated dental products and adequate intakes of fluoride reduce the occurrence of caries throughout life by promoting tooth mineralization and re-mineralization. … The major sources of systemic and topical fluoride are drinking water, foods and beverages made with fluoridated water, infant formulas, and fluoride-containing oral care products. Fluoridated salt and milk are currently available outside the US in Europe, Latin America, and Southeast Asia.” Linus Pauling's statement supporting fluoridation.

Malaysian Dental Association (MDA): Questions and answers, 12. Fluoride in Water - "Extensive experimental, clinical and epidemiological research undertaken for more than 60 years have attested to the safety and effectiveness of water fluoridation. No other public health measure has had the scientific endorsement and broad base of research which supports its use as dose fluoridation. The legality of fluoridation has been tested and upheld in the highest courts since the early 1950s."."

Mayo Clinic states, “By 6 months, children should have fluoride in their water, and children of brushing age should use soft brushes and fluoridated toothpaste.”

MCNA Dental signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Medicaid Medicare CHIP Services Dental Association signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

MouthWatch, Inc. signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

National Academy of Medicine, 2023 Discussion Paper: "Additionally, incorporating non-health sector policies that benefit oral health would demonstrate to communities the importance of oral health while also creating partnerships within and outside the health sector. Cross-sector policies could be operationalized by intensifying and expanding upstream and midstream actions on the social and commercial determinants of oral health. Examples include implementing sugar taxes, ensuring that optimal fluoridation systems are in place, ..."

National Academy of Sciences on Fluoride in Drinking Water: - positive fluoridation reports, 1951, 1977, 1993, 2006, 2007

National Academies of Sciences Engineering Medicine (NASEM): "In 2019, the National Toxicology Program (NTP) released the draft monograph Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects (NTP 2019a). The draft monograph summarized the findings of the systematic review and concluded that 'fluoride is presumed to be a cognitive neurodevelopmental hazard to humans.' NTP asked the NASEM to review the draft monograph. National Academies of Sciences, Engineering, and Medicine. The committee provided many suggestions for improvement and concluded that NTP had not adequately supported its conclusions."
NTP released its revised draft monograph on 9/16/2020. The NASEM reviewed the revised draft and concluded, “the committee is still concerned about the presentation of the data, the methods, and the analyses in the revised monograph and finds that the monograph falls short of providing a clear and convincing argument that supports its assessment. ... Much of the evidence presented in the report comes from studies that involve relatively high fluoride concentrations. Little or no conclusive information can be garnered from the revised monograph about the effects of fluoride at low exposure concentrations (less than 1.5 mg/mL). NTP therefore should make it clear that the monograph cannot be used to draw any conclusions regarding low fluoride exposure concentrations, including those typically associated with drinking-water fluoridation. ... Given the substantial concern regarding health implications of various fluoride exposures, comments or inferences that are not based on rigorous analyses should be avoided.” (p. 14)

National Association of County and City Health Officials policy: “NACCHO recognizes the public health benefits of community water fluoridation as a safe and cost-effective measure for preventing tooth decay and encourages communities to fluoridate water systems at levels optimal for protection against tooth decay. ”
CWF Online Resources - "Community water fluoridation adjusts the amount of fluoride in drinking water to the level known to reduce tooth decay and promote good oral health. Water fluoridation’s biggest advantage is that it is the best method of delivering fluoride to all members of the community, regardless of age, education, income level, or access to routine dental care." Search

National Association of Local Boards of Health, Oral Health Guide: Community Water Fluoridation: “Water fluoridation is the most effective way of delivering the benefits of fluoride to all members of a community, regardless of age, education, or income level. ... This document specifically addresses prevention of tooth decay through community water fluoridation. NALBOH’s goal is to inform BOHs about this effective public health intervention.”

National Association of Pediatric Nurse Practitioners signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

National Association of School Nurses: Links to fluoridation support

National Cancer Institute: “Water fluoridation is the process of adding fluoride to the water supply so the level reaches approximately 0.7 ppm, or 0.7 milligrams of fluoride per liter of water; this is the optimal level for preventing tooth decay. ... Since those extensive reviews, several additional epidemiologic studies have been conducted, with no credible evidence of an association between fluoride levels and osteosarcoma or Ewing sarcoma. Most studies relied on historical estimates of exposure. However, in 2011, researchers examined the possible relationship between fluoride exposure and osteosarcoma in a new way: they measured fluoride concentration in samples of normal bone that were adjacent to a person’s tumor. …The analysis showed no difference in bone fluoride levels between people with osteosarcoma and people in a control group who had other malignant bone tumors." Search

National Dental Association: “It is therefore, the position of the National Dental Association that Community Water Fluoridation is safe, beneficial and cost effective and should be encouraged and supported under the following conditions:
• Community water supplies should contain the optimal fluoride levels as recommended by the U.S. Public Health Service (a range from 0.7 – 1.2 parts per million)
• Local communities and dental societies should be in agreement with and support the fluoridation project in their communities.
• Appropriate resources monitoring capabilities should be available to ensure that the appropriate water fluoride monitoring infrastructures are in place at all times in the impacted communities.”
Auxiliary Organizations: National Dental Assistants’ Association, National Dental Hygienists' Association, Student National Dental Organization: Auxiliary Associations

National Drinking Water Alliance lists fluoridation policies of the AWWA, ASTDD and ADA and links to a CfDH poster on the benefits of fluoridated water.

National Governors Association: "Three oral health interventions—placement of resin-based dental sealants on permanent molars in children at high risk for dental caries, community water fluoridation, and routine application of fluoride varnish by primary care providers—meet the criteria of improving health outcomes and demonstrating cost saving and, in the case of community water fluoridation, a return on investment (ROI) within three years."

National Health and Medical Research Council (Australia) - "In Australia, community water fluoridation programs are considered a safe and effective way of reducing tooth decay across the population. Tooth decay is one of the most common health problems in Australia. It can cause pain, difficulty eating and sleeping, and may make people feel unhappy about their appearance. In Australia, dental health has improved since water fluoridation began in the 1950s. Compared to their parents’ generation, Australians born after 1970 (when the majority of water fluoridation programs commenced in Australia) have about half the level of tooth decay." Search

National Health Service, England, “Statement of support for water fluoridation by the Chief Dental Officer for England: As the robust international evidence shows, water fluoridation is another public health tool that can reduce the incidence of tooth decay amongst adults and children – saving potentially thousands of teeth and improving oral health inequality in the process. fluoridation schemes. Recent large reviews that have been carried out. ... Overall, these reviews found that water fluoridation appears to contribute to reduced tooth decay levels and doesn't seem to be associated with any significant health risks.” Search

National Institute of Dental and Craniofacial Research (NIDCR): “We know today that fluoride can prevent, stop, and reverse the early stages of tooth decay. If left untreated, tooth decay can lead to cavities, pain, tooth loss, missed days of school or work, the need for dental procedures, and potentially deadly infections elsewhere in the body. Prior to community water fluoridation, tooth decay was widespread and severe. Missing and decaying teeth were the most common reasons for World War II recruits to be rejected from military service. After the introduction of water fluoridation, tooth decay was dramatically reduced in both children and adults.”
Fluoride & Dental Health: "For the past several decades, fluoride levels have been adjusted in community water supplies to improve oral health. Fluoride is also used in oral care products such as toothpaste and mouth rinse.6,7,8 Fluoride works by strengthening the tooth’s hard outer surface, called enamel and helps reverse early decay by replenishing lost minerals." Search

National Kidney Foundation: Although the NKF does not formally endorse CWF, the organization states, “The benefits of water and dental products containing fluoride is the prevention of tooth decay and dental cavities in people of all ages.”

National League for Nursing signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

National Network for Oral Health Access (NNOHA): “Community water fluoridation is a population health program that is in a unique position to equitably prevent dental caries across all socioeconomic groups). While dental caries is still the most prevalent chronic disease that disproportionately effects lower socioeconomic status communities, community water fluoridation continues to decrease cavities by 25% at the population level.” Advocacy Partners, ADA, ADHA, AIDPH, CareQuest Institute for Oral Health, Community Catalyst, Families USA, Hispanic Dental Association, NACHC, National Conference of State Legislatures, National Dental Association, OPEN, Pew Charitable Trusts, Society of American Indian Dentists. Search
National Science Foundation "Most people know that adding fouoride to public water systems helps promote healthy teeth and prevent tooth decay." (MD&A-8)
National Toxicology Program - Fluoride Exposure: Neurodevelopment and Cognition: “The NTP review was designed to evaluate total fluoride exposure from all sources and was not designed to evaluate the health effects of fluoridated drinking water alone. It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ. The NTP found no evidence that fluoride exposure had adverse effects on adult cognition.”
Network for Public Health Law: State Laws and Regulations Addressing Fluoridation in Water “Community water fluoridation is recommended by nearly all health organizations, including the American Dental Association, American Academy of Pediatrics, U.S. Public Health Service, and World Health Organization. Many studies have illustrated the benefits of a fluoridated community water supply, particularly in preventing tooth decay. According to the Centers for Disease Control and Prevention, community water fluoridation is a cost-effective, efficient way to deliver fluoride to all members of a community. Because of its effectiveness at reducing dental caries, water fluoridation is known as one of the ten great public health achievements of the 20th century. This resource provides a summary of the laws and regulations regarding water fluoridation in each U.S. state and select jurisdictions.”
New Zealand College of Public Health Medicine (NZCPHM) was established as an incorporated society in 2008 to represent the medical specialty of public health medicine in New Zealand. Water Fluoridation Policy Statements (clicking downloads the pdf file) - Water Fluoridation "The NZCPHM supports community water fluoridation as an effective and safe approach to prevent tooth decay and reduce inequities in oral health. These benefits are most pronounced for those at higher risk of poor oral health, including Māori and Pacific people and people living in more deprived areas."
New Zealand Dental and Oral Health Therapists Association (NZDOHTA) provides fluoridation support on both its regular and business Facebook pages.
New Zealand Dental Association (NZDA) “continues to strongly support and promote community water fluoridation as a safe and effective preventative measure to improve public oral health. It is the NZDA's position that all New Zealanders who could have access to optimally fluoridated water do so have access. Fluoride works in two ways: systemically and topically.
Systemic: Fluoride builds into the developing tooth structure making them more resistant to decay. It is most effective when teeth get exposed to small levels of fluoride as they erupt through the gums.
Topical: Fluoride helps repair the early stages of decay by replacing the minerals lost on the surface of the teeth.”

New Zealand Medical Association “supports the expanded use of community water fluoridation to reduce the burden of oral disease and reduce health inequities in New Zealand.”
New Zealand Ministry of Health: “The current review supports that conclusion on the basis that:
* The evidence that has been published since 2021 indicates ongoing clear benefits from CWF even during the period when alternative forms of fluoride (such as fluoride toothpaste) are available and
* CWF promotes equity by decreasing the incidence and severity of dental caries in individuals in areas of high socioeconomic deprivation as much as, or more than individuals in areas of less deprivation and
* there has been no high-quality evidence published since those 2014 and 2021 reports to suggest a causal link between fluoride exposure at the levels used in Aotearoa New Zealand for CWF and significant harm to health."
About community water fluoridation policy, and how it is a safe, effective, and affordable way to prevent and reduce tooth decay for everyone.
New Zealand Nurses Organization states, “The benefits of water fluoridation on dental health are widely accepted as the safest, most effective intervention in reducing the level of dental caries (World Health Organization 1994). However, there are still many areas in New Zealand where public water supplies are not fluoridated and where the protection it offers – estimated at 2.4 and 12 fewer decayed teeth per person in New Zealand - is not available.” (Discussion point #3)
NHS Wales, "Community water fluoridation: All water supplies contain varying small amounts of naturally occurring fluoride. Community water fluoridation is the process of adjusting the level of fluoride in drinking water to optimal levels to prevent tooth decay. There have been effective water fluoridation schemes worldwide for over 70 years. Community water fluoridation has consistently been found to be safe and effective in reducing tooth decay. There is no evidence of any significant health risks associated with water fluoridation. Over 400 million people worldwide receive fluoridated drinking water."
NIH - National Library of Medicine - Examining the Mistrust of Science: "On the right, we see anti-science arguments by legacy industry and religion around issues such as climate change, evolution, reproductive technology, and vaccination; these are largely pro-corporate, anti-regulatory, anti-reproductive control positions. On the left, we see anti-science arguments about hidden dangers to health and the environment, with objections centering on issues like vaccines, GMOs, fluoridation, and EMF pollution—none of them supported by the evidence. These arguments are largely pro-choice, pro-regulation, and anti-corporate.” These days the President and RFK Jr. are anti-fluoridation.
NSF.ORG - "Water fluoridation is the practice of adjusting the fluoride content of drinking water. Fluoride is added to water for the public health benefit of greatly reducing the incidence of tooth decay and therefore improving the health of the community." Fluoridation Products and Fluoride
OFFOR Health signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Oral Health Alliance: “Preventive oral healthcare starts good oral hygiene practices, such as brushing with fluoridated toothpaste, drinking fluoridated water, flossing daily, chewing sugar free gum, and avoiding excess sugar and fermentable carbohydrates, and not smoking.”
Oral Health Connections signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD
Oral Health Foundation (UK) states, “Local authorities from across the United Kingdom should add fluoride to water supplies, following new research confirms it has no negative effects. That is the message from the Oral Health Foundation, which is calling for the introduction of widespread community fluoridation schemes, a move they believe will help protect millions of Brits from tooth decay. The extensive research, carried out by the National Toxicology Program in the US where 80% of water is fluoridated, states that following years of analysis, there is ‘no link between elevated levels of fluoride and cognitive learning deficits.’" 2024 Oral Health Manifesto: “Prevention is Prevention is our first line of defence, by instilling strong daily routines at home. These practices, such as water fluoridation, regular check-ups and fluoride treatments, are not only cost-effective but vital for early disease detection and management. ... (Policy) Universal water fluoridation: Implement widespread water fluoridation across the UK to prevent tooth decay and reduce inequalities." Search

Oral Health Group, Canada – News on oral health, including support of fluoridation issues.

Paediatric Society of New Zealand (KidsHealth): “Community water fluoridation is an effective, safe and affordable way to prevent and reduce tooth decay for everyone. What are the facts about community water fluoridation? : 1) Numerous studies have shown that children and adults living in areas with community water fluoridation have significantly less tooth decay than those living in non-fluoridated areas. 2) Evidence based on decades of community water fluoridation shows it is safe. 3) There is strong evidence that community water fluoridation is cost-effective. It saves much more in dental costs for individuals than it costs to run fluoridation programmes.”

Pathwaves Partnership signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Pan American Health Organization: “Although water fluoridation had been highly effective, the lack of adequate water distribution systems in the Region, especially in rural areas, made it difficult to implement nationwide water fluoridation programs. In 1994, the program began to develop a strategy by evaluating experiences of countries that had launched salt fluoridation programs from the mid-1980s to the early 1990s.”

Pew Charitable Trusts “supports water fluoridation because it’s one of the most cost-effective strategies for states and communities to improve the oral health of their residents.” Fluoridation Advocacy

Platform for Better Oral Health in Europe: “BEST PRACTICES IN ORAL HEALTH PROMOTION AND PREVENTION FROM ACROSS EUROPE – EXAMPLES: COMMUNITY WATER FLUORIDATION -- The aim of community water fluoridation (a well recognised strategy globally) is to reduce the prevalence of dental caries through the adjustment of naturally occurring fluoride in public water supplies to the optimum level of oral health. Existing schemes in England were introduced progressively between 1964 and 1995. They serve approximately 6 million people living in 26 different local authority areas in various parts of the country. Overall, the annual cost of supplying fluoridated water to 6 million people in England is around £2.1 million (an investment of £0.35 per person per annum)."

Public Health Agency of Canada: Position Statement on Community Water Fluoridation: “Community water fluoridation is an important and often overlooked public health measure that has contributed over the last 70 years to the health of Canadians by preventing tooth decay and thereby improving oral health. … The big advantage of community water fluoridation is that it benefits all residents in a community, regardless of age, socioeconomic status, education, oral hygiene practices, employment or access to routine dental care, making it a truly equitable public health practice. Canadian and international studies agree that properly fluoridated water is safe. The likeliest adverse effect is an increased risk of mild dental fluorosis, which causes white specks to appear on the teeth and is usually unnoticeable. There is also no scientific evidence to suggest that children should avoid drinking fluoridated water at the accepted levels in Canadian drinking water.” Search
Public Health Association of New Zealand (PHANZ): “Scientific Evidence: Decades of research support the safety and effectiveness of fluoride at recommended levels. The World Health Organization (WHO) has also published guidelines to help communities control fluoride exposures to establish the important balance between caries prevention and protection against adverse effects, and water fluoridation is listed as one of the fluoride delivery methods by WHO’s recent Global Oral Health Action Plan (2024).” PHANZ Policy Position Statement on Community Water Fluoridation

Public Health Communications: Collaborative (PHCC): May 28, 2025 - Fluoride: What it is, and Why it Matters for Individual and Community Health: "Safe levels of water fluoridation make a big difference in individual and community health outcomes. Share this resource with your community members to increase understanding of the benefits of fluoride and additional ways to maintain oral health."
Public Health England -- Conclusion: “The findings of this report agree with the view that water fluoridation is an effective and safe public health measure to reduce the frequency and severity of dental decay, and narrow differences in dental health between more and less deprived children and young people.” (P. 8) Search GOV.UK

Quackwatch -- Fluoridation search
Robert Wood Johnson Foundation funded Healthy Drinks. Healthy Kids which includes the recommendation, "Drinking fluoridated water is one of the best ways to reduce a child’s chances of having cavities. Fluoride is a naturally occurring mineral that helps prevent cavities. Fluoridation refers to how much fluoride is added to drinking water. The recommended level of fluoride in drinking water is 0.7 parts per million.” These recommendations were developed by experts at the Academy of Nutrition and Dietetics (AND), the American Academy of Pediatrics (AAP), the American Academy of Pediatric Dentistry (AAPD), and the American Heart Association (AHA) under the leadership of Healthy Eating Research (HER).

Royal Australasian College of Physicians New Zealand (RACP) “and the Paediatric Society of New Zealand (PSNZ) support water fluoridation as a highly effective, safe, cost-saving and equitable measure to prevent dental caries and improve oral health across all sectors of society. ... Fluoridation of community water supplies is the single most effective public health measure to prevent dental decay. Community water fluoridation programmes have directly reduced the rate of dental caries in New Zealand and throughout the world, including Australia, Canada, the USA, Chile, Columbia, Britain and Ireland.”

Royal College of Paediatrics and Child Health (UK) “Areas with higher levels of fluoride in drinking water have lower rates of tooth decay and general anaesthetics for dental extraction. Department of Health and Social Care recommends water fluoridation as a safe and effective evidence-based public health measure to reduce the prevalence and severity of tooth decay, and reduce dental health inequalities.” Search

The Royal Society is a Fellowship of many of the world's most eminent scientists and is the oldest scientific academy in continuous existence. A report by the Royal Society of the impact of the internet on our information environment, and on misinformation relating to scientific issues - including historic misinformation about water fluoridation

Royal Society for Public Health (RSPH): Chief Executive Shirley Cramer said: “There are huge inequalities in oral health in the UK and this report highlights an important measure in tackling these inequalities. The report addresses concerns with the fluoridisation of water which have previously been unanswered and we must ensure that public health specialists and the general public understand that fluoridisation is something to be embraced.” Treasurer and Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, said: "Although water fluoridation schemes have been in place in the UK for more than 40 years, only around five-and-a-half million people have been drinking water from a fluoridated area. There is a continued need for water fluoridation to help tackle remaining inequalities, particularly in the more deprived areas of the country. Fluoridation is the most important single measure that the UK Government can take to bring a substantial change in the nation’s dental health.”

Royal Society of New Zealand and Office of the Prime Minister’s Chief Science Advisor report stated, “A large number of studies and systematic reviews have concluded that water fluoridation is an effective preventive measure against tooth decay that reaches all segments of the population, and is particularly beneficial to those most in need of improved oral health. Extensive analyses of potential adverse effects have not found evidence that the levels of fluoride used for community water fluoridation schemes contribute any increased risk to public health, though there is a narrow range between optimal dental health effectiveness and a risk of mild dental fluorosis. ... This analysis concludes that from a medical and public health perspective, water fluoridation at the levels used in New Zealand poses no significant health risks and is effective at reducing the prevalence and severity of tooth decay in communities where it is used. Communities currently without CWF can be confident that this is a safe option that is cost saving and of significant public health benefit – particularly in those communities with high prevalence of dental caries. ”” (p. 10)

Salud America! “Community water fluoridation is the practice of adjusting the level of fluoride in the local water supply so there is just enough to help protect teeth from decay. It’s called ‘community’ water fluoridation because the whole community benefits. But Latino kids and families with low incomes, who suffer more than others from tooth decay, benefit the most. For every $1 invested in community water fluoridation we save as much as $38 in money that CHIP, Medicaid, insurance companies, and individuals would have to spend to treat unhealthy teeth.”

Schuyler Center for Analysis and Advocacy signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD Focus on fluoridation

Singapore Ministry of Health recommends, “Make sure that your children's drinking water is fluoridated. If your water supply does not contain fluoride, your dentist or pediatrician may prescribe daily fluoride supplements. … Fluoride is often added to drinking water to help reduce tooth decay. In the 1930s, researchers found that people who grew up drinking naturally fluoridated water had up to two-thirds fewer cavities than people living in areas without fluoridated water. Studies since then have repeatedly shown that when fluoride is added to a community's water supply, tooth decay decreases.”

Singapore’s National Water Agency, PUB: “Frequently Asked Questions: Why is fluoride added to our drinking water? PUB has implemented fluoridation of drinking water as part of our water treatment process since 1957. This is a requirement by the Ministry of Health (MOH) to prevent dental cavities. The fluoride levels in Singapore’s drinking water are lower than the maximum level of 0.7 mg/L stipulated in the Environmental Public Health (Water Suitable for Drinking) (No.2) Regulations 2019 and is well within World Health Organisation's guideline of 1.5 mg/L.”
#7 - Post Chemical Treatment: “The water is dosed with lime to balance the pH of water and fluoride to prevent tooth decay. Chlorine disinfected water is dosed with ammonia while ozone disinfected water is dosed with chlorine and ammonia, to maintain water quality in the distribution system.”
Water Quality -- Clean and Safe Water Supply – “Why is fluoride added to our drinking water? PUB has implemented fluoridation of drinking water as part of our water treatment process since 1957. This is a requirement by the Ministry of Health (MOH) to prevent dental cavities.”

Smiles for Life: “Fluoride Use Recommendations Summary of Fluoride Modalities [a method of therapeutic approach] for Low- and High-Risk Patients Community water fluoridation – Yes, for both Low and High Caries Risk Patients.”

SmileMD signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Society for Public Health Education, 2020 Call for increased awareness of the importance of oral health, "Whereas, the CDC recommends the promotion of community water fluoridation to reduce cavities as it is one of the greatest public health achievements of the 20th century (CDC, 2019a). People living in communities with fluoridated water have 25% fewer cavities than those living in communities without fluoridated water, and it is cost-effective." Search

Society of American Indian Dentists
2024 Public Policy Priorities: "The Society of American Indian Dentists (SAID) is dedicated to promoting and improving the oral health of American Indian/Alaska Native (AI/AN) communities and engaging in advocacy to support AI/AN dental professionals across the U.S. SAID’s primary goals are to:
• Community water fluoridation: AI/AN communities are less likely than the general population to have access to a safe water supply. Clean, safe, fluoridated water is important for good oral health and SAID supports expanding access to community water fluoridation.”

Society of Pediatric Cardiovascular Nurses signed the April 15, 2025 Community Water Fluoridation document sent to U.S. Representatives and Senators - “We, the undersigned organizations, are proud to affirm the safety and effectiveness of community water fluoridation. What has been lauded as one of the ten greatest public health achievements of the 20th century has recently become politicized and gravely misrepresented.” AAPD

Special Care Dentistry Association - “Oral Health Policies & Clinical Guidelines: Fluoride Use & Fluoride Therapy - Links to the American Academy of Pediatric Dentistry: Policy on Use of Fluoride: “Community water fluoridation is recognized as one of the 10 greatest public health achievements of the twentieth century because it is a beneficial and inexpensive population-based approach that can reach the entire community.“ Fluoride Therapy: "Fluoridation of community drinking water is the most equitable and cost-effective method of delivering fluoride to all members of most communities."

State of Israel Ministry of Health: “The fluoridation of drinking water is considered an achievement of the public health system, through its beneficial influence on dental health. It can spare people pain, suffering and hospitalizations, and constitutes a part of the basic human right for health. ... Drinking water fluoridation is the most efficient, safest, simplest, cheapest, and most equal measure, by a significant margin, among all methods for preventing dental diseases in the general public." Search

UK Chief Medical Officers - Water fluoridation: statement: "Water fluoridation schemes involve adding fluoride to community drinking water supplies in areas of low natural fluoride, increasing the level to that known to reduce tooth decay. This happens in approximately 25 countries internationally, covering an estimated 400 million people[footnote 8]. Evidence from observational and interventional studies shows that appropriate levels of fluoride can reduce the prevalence and severity of dental decay in both adults and children." Search

UK Parliament: 12/10/2024 - Water fluoridation and dental health: "There is high quality scientific evidence that shows that water fluoridation is a safe and effective public health intervention that can improve overall dental health. Fluoridating water helps to strengthen dental enamel, which prevents dental decay (caries)".

U.S. Department of Defense: The Assistant Secretary of Defense stated: "Providing optimally fluoridated water is a proven disease prevention program that improve and sustain the military readiness and health of military personnel. With the current scientific evidence supporting the benefits of fluoride in preventing dental decay for all ages, to include adults, it is critical that the DoD provide this proven public health benefit. This will ensure improved dental readiness and health for Active Duty personnel.”

U.S. Department of Health and Human Services report states, “Through this final recommendation, the U.S. Public Health Service (PHS) updates and replaces its 1962 Drinking Water Standards related to community water fluoridation—the controlled addition of a fluoride compound to a community water supply to achieve a concentration optimal for dental caries prevention.1 For these community water systems that add fluoride, PHS now recommends an optimal fluoride concentration of 0.7 milligrams/liter (mg/L). In this guidance, the optimal concentration of fluoride in drinking water is the concentration that provides the best balance of protection from dental caries while limiting the risk of dental fluorosis.”
Head Start: CWF: "Drink fluoridated water throughout the day. Fluoride in drinking water helps prevent tooth decay. Most bottled water does not contain fluoride.”
Head Start: CWF: "Fluoride is the safest and best way to prevent tooth decay. For generations, many communities have added fluoride to their public water (tap) supply to prevent tooth decay." Head Start Search
Community Preventive Services Task Force: "Community water fluoridation is the controlled adjustment of fluoride in a public water supply to help prevent tooth decay (i.e., dental caries or cavities) in the community. Fluoride prevents tooth decay by preventing demineralization and enhancing remineralization of tooth enamel. Although fluoride occurs naturally in water across the U.S., it is usually lower than the optimal concentration needed to prevent dental caries. "

U.S. National Institutes of Health (and U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research) 2021 report, Oral Health in America, states "Decreasing health disparities depends in large part on programs and policies aimed at providing more equitable distribution of evidence-based, health-promoting interventions. Generally, this means programs that are not dependent on individual behavior change or compliance, such as community water fluoridation programs. Increasing the proportion of the population served by community water fluoridation not only benefits the entire population but disproportionally benefits economically vulnerable groups, producing a flatter socioeconomic gradient in dental caries among children ... and reducing the need for expensive dental treatment." (p. 1-39)
“Although the efficacy of water fluoridation to prevent caries is well known, the number of people with access to this preventive measure remains low in some areas of the country. In fact, some communities have discontinued optimal water fluoridation. While budgetary concerns may contribute to these decisions, community water fluoridation has been discontinued in some locations as the result of organized opposition based on false and unscientific arguments. Unfortunately, communities not fluoridating their water supplies will usually have higher rates of dental caries (McLaren et al. 2016; Meyer et al. 2018).” (p.2A-16)
Fluoride Fact Sheet: "Adequate fluoride intakes reduce the risk of dental caries in its initial stages by inhibiting demineralization and the activity of bacteria in dental plaque and by enhancing tooth remineralization. Water fluoridation protects teeth in two main ways—by preventing the development of caries through ingestion of drinking water during the tooth-forming years and through direct contact of fluoride with teeth throughout life."

National Institute of Dental and Craniofacial Research states, “Fluoride (said like floor-eyed) is a mineral that occurs naturally in soil, water, and air that has been shown to prevent cavities, or tooth decay. For the past several decades, fluoride has been added to community water supplies and oral care products such as toothpaste and mouth rinse. Fluoride works by strengthening the tooth’s hard outer surface called enamel. ... Fluoride can prevent tooth decay across the lifespan; both children and adults benefit from it." 2024 "Big Hopes for Little Teeth: Over the past seven decades, extensive national and international research, including NIDCR-supported studies, have added to evidence that fluoride use for caries prevention is safe and effective. Today, over 200 million people in the U.S., or 73% of the population, have access to fluoridated drinking water, and almost every toothpaste on the market contains fluoride as its active ingredient."

Office of Dietary Supplements (ODS) states, “Water fluoridation protects teeth in two main ways—by preventing the development of caries through ingestion of drinking water during the tooth-forming years and through direct contact of fluoride with teeth throughout life.”

U.S. Preventive Services Task Force (USPSTF): “All children are at potential risk of dental caries; those whose primary water supply is deficient in fluoride (defined as < 0.6 parts per million) are at particular risk. … the Community Preventive Services Task Force recommended fluoridation of community water sources based on strong evidence of effectiveness in reducing dental caries.”

U.S. Public Health Service Statement July 7, 2020 from eight former Chief Dental Officers of the USOHS, “Community water fluoridation is the great equalizer in prevention of dental caries because all individuals regardless of income or education are able to access their public tap water. In addition to being a safe and effective disease prevention measure, it also is low in cost. Prevention of dental caries through CWF provides “a lifetime of cavity prevention for less than the cost of one dental filling,” as then-Surgeon General Regina Benjamin stated in 2013, a statement that is still true today. … As the former chief dental officers of the USPHS, we have spent our entire careers dedicated to improving the Nation’s oral health. Continued efforts to support CWF anchors our efforts to achieve health equity. With the forthcoming release of the second-ever Surgeon General’s Report on Oral Health, and in commemoration of the 75th anniversary of CWF in Grand Rapids, we reaffirm our support and commitment to CWF.”

U.S. Surgeons General’s statements on CWF: “Since the 1950s, U.S. Public Health Service Surgeons General have committed his or her support for community water fluoridation. Below are endorsements supporting community water fluoridation from various Surgeons General:” 2001 statement, 2004 statement, 2016 statement

WebMD states, “Fluoride is a mineral that occurs naturally in many foods and water. … Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. It also reverses early decay. In children under 6 years of age, fluoride becomes incorporated into the development of permanent teeth, making it difficult for acids to demineralize the teeth. Fluoride also helps speed remineralization as well as disrupts acid production in already erupted teeth of both children and adults. … Approximately 62% of the U.S. population served by public water supplies has access to adequate levels of fluoride in their water, and 43 of the 50 largest U.S. cities have water fluoridation systems.”
May 21, 2025 — “Fluoride Is Under Fire. Should You Be Concerned? Activists have warned for decades about potential risks of fluoride, even though research shows harmful effects only at very high doses. With the Trump administration, those voices have been amplified, starting with Secretary of Health and Human Services Robert F. Kennedy Jr. Before the election in November, he called fluoride an “industrial waste” linked to numerous health risks — claims that have been widely discredited by scientific research. His campaign against fluoride follows similar uproars over vaccines and autism.”

Wikipedia, Water fluoridation by country

FDI World Dental Federation Policy Statement: “In recognition of the importance of promoting oral health through water fluoridation, the FDI World Dental Federation states that: Over 70 years of research and recent systematic reviews have shown that water fluoridation is an effective public health measure for the prevention of dental decay in children and adults. Water fluoridation is particularly appropriate for populations demonstrating moderate to high risk of dental decay. Water fluoridation confers positive health savings and contributes to reducing disparities in the rates of dental decay in communities. At the fluoride concentrations recommended for the prevention of dental decay, scientific research and reviews show that human general health is not adversely affected. The public health benefits of water fluoridation in the prevention of dental decay far outweigh the possible occurrence of very mild/mild dental fluorosis”

World Health Organization (WHO) states, “The appropriate use of fluoride for the prevention of dental caries has been a major dental public health strategy. Methods of delivering fluoride are well known, and those appropriate for the prevention of Early Childhood Caries (ECC) were considered in more detail. These included fluoride delivered through either water, salt or milk, fluoridated toothpaste and intra-oral topical fluoride application. Exposure to optimum fluoride concentration in drinking water from birth not only benefits the primary dentition, helping to control ECC, but also provides some pre-eruptive effect for the permanent teeth.” (p. 284) Search
2022 WHO Guidelines for drinking-water quality "There are few chemicals for which the contribution from drinking-water to overall intake is an important factor in preventing disease. One example is the effect of fluoride in drinking-water in protecting against dental caries." (p. 7) "In some countries, fluoride may also be added to table salt or drinking-water in order to provide protection against dental caries. The amounts added to drinking-water are such that final concentrations are usually between 0.5 and 1 mg/l. The fluoride in final water is always present as fluoride ions, whether from natural sources or from artificial fluoridation." (p.402) "Low concentrations provide protection against dental caries, both in children and in adults. The protective effects of fluoride increase with concentration up to about 2 mg of fluoride per litre of drinking-water; the minimum concentration of fluoride in drinking-water required to produce it is approximately 0.5 mg/l. However, fluoride can also have an adverse effect on tooth enamel and may give rise to mild dental fluorosis (prevalence: 12–33%) at drinking-water concentrations between 0.9 and 1.2 mg/l, depending on drinking water intake and exposure to fluoride from other sources. Mild dental fluorosis may not be detectable except by specialist examination." (p.404)
2022 WHO Global oral health status report: 3.3.2 Water Fluoridation: "Adjusting the level of fluoride in drinking water is a safe, cost-effective public health measure for the prevention of caries. This includes adding fluoride in areas where the natural fluoride levels of drinking water are too low as well as eliminating fluoride from drinking water in areas where natural fluoride concentrations are too high. As a population-based health strategy, water fluoridation does not discriminate by social class and provides universal health benefit to all groups within a community, thereby reducing inequalities. The estimated reduction rates for caries range between 25% and around 60% depending on the study, location and population. WHO and other public health agencies recommend that appropriate fluoride levels range between 0.5 mg/l and 1.0 mg/l of water, depending on average water consumption and climate as well as the population’s exposure to other sources of fluorides." (p.69) Download Report
Fluoride and Oral Health: "At the 2007 WHO World Health Assembly, a resolution was passed that universal access to fluoride for caries prevention was to be part of the basic right to human health."
Inadequate or excess fluoride: "It is estimated that caries of the permanent teeth is the most prevalent of all conditions assessed, with 2.4 billion people globally suffering from caries of permanent teeth and 486 million children from caries of primary teeth. Public health actions are needed to provide sufficient fluoride intake in areas where this is lacking, so as to minimize tooth decay. This can be done through drinking-water fluoridation or, when this is not possible, through salt or milk fluoridation or use of dental care products containing fluoride, and by advocating a low-sugar diet."