Promoting Community Water Fluoridation

Pew’s initiative for children’s dental policy promotes community water fluoridation as one of the most effective and least expensive strategies for improving oral health. Lauded by the Centers for Disease Control and Prevention (CDC) as one of 10 great public health achievements of the 20th century, the adjustment of fluoride levels in drinking water has dramatically improved oral health for millions of Americans over the past 70 years.

Fluoridation improves health. Drinking water with the optimal level of fluoride reduces tooth decay by about 25 percent for children and adults.  Our mouths contain bacteria that convert sugars in the foods and beverages we consume to acid, which harms tooth enamel and damages teeth. Drinking water with the recommended amount of fluoride protects teeth against that acid, making them stronger and more resistant to decay.

Fluoridation makes fiscal sense. Research shows that community water fluoridation offers the greatest return-on-investment of any decay prevention strategy. The Centers for Disease Control and Prevention estimates that every $1 invested in water fluoridation saves $38 in dental treatment costs.  The reduction in just the costs of filling and extracting diseased teeth (not counting lost work time and dental pain) far exceed the cost of fluoridation. The CDC reports that if all water was fluoridated, it would save over $1 billion annually.  

Too many communities in the U.S. are not fluoridated. While about three-quarters of Americans on public water systems have fluoridated water, there are still tens of millions of people who do not have access to this preventive health benefit. In eight states, less than half of the population on community water systems has fluoridated water.  In New Jersey, Hawaii, and Oregon less than one-quarter are receiving fluoridation’s benefits.  

There is broad support for community water fluoridation. We are building partnerships among state and local groups, philanthropic organizations, and national groups representing the broad-based support for water fluoridation. Through the Campaign for Dental Health, coordinated by the American Academy of Pediatrics, Pew supports efforts to protect and expand access to water fluoridation in communities throughout the nation.