The ADA supports water fluoridation as a safe, effective method for preventing dental cavities.
There are more than 90 national and international professional health organizations that support the safe and effective use of fluoride for preventing dental cavities. They include the ADA, Alberta Health Services, the Canadian Dental Association, the Canadian Medical Association, Health Canada, the Public Health Agency of Canada, the United States Centers for Disease Control and Prevention, and the World Health Organization.
Dental decay is the most common chronic disease in children, affecting five to eight times as many children as asthma. According to recent data from the Canadian Health Measures Survey, 56.8% of children in Canada aged six to 11 are affected by dental cavities and 58.8% of adolescents aged 12 to 19 have experienced decay in one or more permanent teeth. By adulthood, nearly 96% of dentate Canadians have experienced coronal decay, with a mean count of 10.7 DMFT (decayed, missing, and filled teeth).
Scientific support
The safety and efficacy of water fluoridation has been frequently studied and continues to be supported by current science. Over 60 years of research and recent systematic reviews have shown that water fluoridation is a safe, effective, and efficient public health measure for preventing dental decay. In fact, the United States Centers for Disease Control and Prevention has recognized water fluoridation as one of the 10 great public health achievements of the 20th century.
“When combined with healthy food and good oral health habits, fluoride is safe and effective whether it occurs naturally or is added to the optimal level in water. In this way fluoridation uniquely allows us to prevent disease and suffering and promote the wellness of all Albertans, equitably. It is pretty simple: adults and children from areas with water fluoridate have fewer cavities than people in communities where the water fluoride level is too low,” states Dr. James Talbot, former Chief Medical Officer of Health for Alberta.
Health Canada’s Chief Dental Officer states that “the safety and efficacy of water fluoridation has been frequently studied and continues to be supported by current science. Canadian and international studies agree that water that was fluoridated at optimum levels does not cause adverse health effects.”
Health Canada convened an expert panel to review fluoride. After an extensive toxicological review, it concluded that the weight of evidence from all currently available studies does not support a link between exposure to fluoride in drinking water and any adverse health effects, including those related to cancer, immunotoxicity, reproductive/developmental toxicity, genotoxicity, neurotoxicity, and/or intelligence quotient deficit.
Fluoridation of drinking water continues to be the most economical means of getting the proven protection that fluoride gives to teeth. Children need fluoride protection while their teeth are developing. Adults also benefit from fluoride since the risk of root decay increases with aging. A 2013 Canadian study estimates that for every dollar invested in water fluoridation, $71.05 to $82.83 is saved in dental costs.
Frequently Asked Questions: Fluoride
Fluoride is a mineral found in soil, water (both fresh and salt), and various foods.
An optimal level of water fluoridation is achieved by adjusting the level of fluoride in the water to achieve the right balance between the benefit of preventing tooth decay and the risk of developing dental fluorosis.
Dental fluorosis is an esthetic change in the appearance of teeth. It is caused when higher than optimal amounts of fluoride are ingested in early childhood. In its mildest and most common form, it affects the look of the tooth, with small white specks appearing.
The Canadian Health Measures Survey 2007-2009 found that dental fluorosis is not an issue of concern for the vast majority of children (84%). Some children (16%) have mild forms of fluorosis that often go unnoticed by both the children and their parents.
Water fluoridation is the process of adjusting the level of naturally occurring fluoride in a public drinking water supply to optimize the dental benefits of preventing tooth decay.
Municipal water treatment facilities monitor the level of fluoride. These municipalities rely on the Federal-Provincial Territorial Committee on Drinking Water, which makes recommendations about the optimal level of fluoride in public drinking water to prevent tooth decay.
With the exception of dental fluorosis, an esthetic condition, scientific studies have not found any credible link between water fluoridation and adverse health effects.
Your dentist can assess your child’s risk of developing tooth decay and advise you of an appropriate level of fluoride protection.
The Canadian Dental Association advises that the use of fluoridated toothpaste is determined by the level of risk of tooth decay for children up to three years old. Consult a health professional to determine whether your child who is under three years of age is at risk of developing tooth decay. If such a risk exists, the child’s teeth should be brushed by an adult using a minimal amount (a portion the size of a grain of rice) of fluoridated toothpaste. If your child is not considered to be at risk, the teeth should be brushed by an adult using a toothbrush moistened only with water.
For children from three to six years of age, use only a small amount of fluoridated toothpaste (a portion the size of a green pea). Children in this age group need an adult’s help brushing their teeth.
Fluoride has a positive effect on oral health by making teeth more resistant to decay. Fluoride can also prevent or even reverse tooth decay.
For many Albertans, fluoride is in public drinking water, which provides protection to the entire community. Fluoride toothpastes and rinses are available for purchase, and your dentist can provide professional fluoride products, such as gels and varnish.
Helpful links
- Health Canada’s Drinking Water Recommendations
- Guideline on Fluoride in Drinking Water (2010)
- Findings and Recommendations of the Fluoride Expert Panel (2007)
- Fluoride Information – American Dental Association
- Letter to the NIEHS-funded Green study on maternal fluoride exposure