National Institute of Detal and Craniofacial Reseach [NIDCR]

Statement on Water Fluoridation

Community water fluoridation is a public health effort that benefits millions of Americans. For more than half a century, water fluoridation has helped improve the quality of life in the U.S. through reduced pain and suffering related to tooth decay, reduced tooth loss, reduced time lost from school and work, and less money spent on dental care.

The National Institute of Dental and Craniofacial Research continues to support water fluoridation as a safe and effective method of preventing tooth decay in people of all ages. One significant advantage of water fluoridation is that anyone, regardless of socioeconomic level, can enjoy its benefits during their daily lives -- at work, school, and play -- simply by drinking fluoridated water or beverages prepared with fluoridated water. Within the U.S., fluoridated drinking water is also the most cost-effective method for preventing tooth decay.

Efficacy. The effectiveness of water fluoridation has been well documented in the scientific literature. Even before the first community fluoridation program began in 1945, epidemiologic data from the 1930s and 1940s revealed a lower prevalence of tooth decay in children who consumed naturally occurring fluoridated water, compared to children who had consumed fluoride-deficient water. Since that time, numerous studies have proven fluoride's effectiveness in decay prevention in the primary teeth of infants and children, as well as in the permanent teeth of children, adolescents and adults, including senior citizens.

Safety. As with other nutrients, fluoride is safe and effective when used and consumed properly. After more than 50 years of research and practical experience -- as well as data evaluation by the U.S. government, committees of experts, and national and international health organizations -- the verdict remains the same: fluoridating community water supplies, at optimal levels, is an effective and safe method for preventing tooth decay. Moreover, no credible scientific evidence supports an association between fluoridated water and conditions such as cancer, bone fracture, Down's syndrome, or heart disease as claimed by some opponents of water fluoridation.

Cost-effectiveness.Community water fluoridation is presently the most cost-effective method for preventing tooth decay. On average, it costs less than $1 annually per person to fluoridate community water systems serving most people in this country. The costs range from an average of 68 cents per person annually in communities with populations larger than 50,000, to an average of $3.00 per person annually in communities of fewer than 10,000 (1999 dollars).

Equity. Despite a decrease in overall decay rates during the past two decades, tooth decay is still a significant oral health problem, especially in certain segments of the population. People of low socioeconomic status suffer from a disproportionate burden of tooth decay. They also have less access than those with higher incomes to professional oral health services and other sources of fluoride, like gels and tablets. Water fluoridation helps reduce such oral health disparities.