Community Water Fluoridation: How It Works and What It Saves

Key points

• Community water fluoridation adjusts the fluoride in drinking water to the level recommended for preventing cavities.
• It benefits everyone in a community — preventing cavities, narrowing oral health gaps and saving money.
• CDC does not mandate it. The U.S. Public Health Service's recommended level is not an enforceable standard.

Fluoridation is a cornerstone of cavity prevention in the United States: a practical, cost-effective and equitable way to improve oral health regardless of age, education or income. CDC named it one of the 10 great public health achievements of the 20th century because cavities declined so dramatically after it began in 1945.

How it works

• Almost all water has some natural fluoride, but usually too little to prevent cavities.
• The recommended (optimal) level is 0.7 milligrams per liter — about 3 drops in a 55-gallon barrel.
• Water systems add fluoride to reach it — or remove some where natural levels are too high. In some places natural levels are already at the protective level.
• Fluoridated water bathes teeth in a little fluoride all day, strengthening the surface against decay.

Who decides: state and local governments — often voters themselves. Some states require fluoridation for water systems above a certain size.

The halo effect: food and drinks are often processed in fluoridated communities, spreading the benefit to people who live elsewhere.

What the research shows

• Fluoridated water reduces cavities by about 25% in children and adults — meaning less mouth pain, fewer fillings and extractions, and fewer missed days of school and work.
• Communities of 1,000 or more see an average return of about $20 for every $1 spent, rising with community size — though even small communities save.
• Fluoridated communities save an average of $32 per person a year in cavity treatment.

CDC promotes the effective use of fluoride products and community water fluoridation. More: Fast Facts on fluoridation and what CDC is doing.

What you can do

• Use fluoride toothpaste, and drink fluoridated water if it's available. Fluoride protects at all ages.
• If your water isn't fluoridated, ask your dentist, doctor or pediatrician whether your child should take a fluoride supplement (drops, tablets or lozenges).
• See a dentist regularly. More about fluoride.

Sources

Based on "About Community Water Fluoridation," Division of Oral Health, Centers for Disease Control and Prevention; a work of the United States government in the public domain.