Water Fluoridation

Fluoride is the thirteenth most abundant element in the earth’s crust, present in virtually all waters. However, levels of fluoride in drinking water are usually below the therapeutic levels necessary for good oral health. Fluoridation, the process of adding fluoride to the public water supply, has been responsible for a remarkable reduction in cavities and tooth loss and was named by CDC as one of 10 great public health achievements of the twentieth century. The importance of fluoride was originally identified by a series of studies comparing the difference in oral health between communities using groundwater with naturally high fluoride levels to the typical deficient fluoride levels observed in most surface water supplies (1,2). A brief overview of this study is included in CDC’s Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries (3).

Water fluoridation involves adjusting the fluoride content in drinking water to the optimum level. The United States Public Health Service recommends a concentration from 0.7 to 1.2 mg/L or parts per million (ppm). The value of fluoride has been shown to benefit all people of all ages, and the use of fluoride in dental care is now an accepted practice. In the United States, approximately 72.4% of the population on public water supplies uses fluoridated water.

For more information, please visit CDC’s Community Water Fluoridation page.

1. Dean HT. Endemic fluorosis and its relation to dental caries. Public Health Rep 1938;53:1443-52.
2. Dean HT. On the epidemiology of fluorine and dental caries. In: Gies WJ, ed. Fluorine in dental public health. New York, New York: New York Institute of Clinical Oral Pathology, 1945:19-30.
3. U.S. Centers for Disease Control and Prevention. Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. MMWR 1999;48(41):933-940. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm