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Sixty years ago, Grand Rapids, Michigan became the world’s first city to adjust the level of fluoride in its water supply. Since that time, fluoridation has dramatically improved the oral health of tens of millions of Americans. Community water fluoridation is the single most effective public health measure to prevent tooth decay. Additionally, the Centers for Disease Control and Prevention proclaimed community water fluoridation as one of 10 great public health achievements of the 20th century.

Fluoridation of community water supplies is simply the precise adjustment of the existing naturally occurring fluoride levels in drinking water to an optimal fluoride level recommended by the U.S. Public Health Service (0.7–1.2 parts per million) for the prevention of dental decay. Based on data from 2002, approximately 170 million people (or over two-thirds of the population) in the United States are served by public water systems that are fluoridated.

Studies conducted throughout the past 60 years have consistently indicated that fluoridation of community water supplies is safe and effective in preventing dental decay in both children and adults. It is the most efficient way to prevent one of the most common childhood diseases—tooth decay (5 times as common as asthma and 7 times as common as hay fever in 5- to17-year-olds).

Early studies, such as those conducted in Grand Rapids, showed that water fluoridation reduced the amount of cavities children get in their baby teeth by as much as 60 percent and reduced tooth decay in permanent adult teeth nearly 35 percent. Today, studies prove water fluoridation continues to be effective in reducing tooth decay by 20–40 percent, even in an era with widespread availability of fluoride from other sources, such as fluoride toothpaste.

The average cost for a community to fluoridate its water is estimated to range from approximately $0.50 a year per person in large communities to approximately $3.00 a year per person in small communities. For most cities, every $1 invested in water fluoridation saves $38 in dental treatment costs.

The American Dental Association continues to endorse fluoridation of community water supplies as safe and effective for preventing tooth decay. This support has been the Association’s position since policy was first adopted in 1950. The ADA’s policies regarding community water fluoridation are based on the overwhelming weight of peer-reviewed, credible scientific evidence. The ADA, along with state and local dental societies, continues to work with federal, state, local agencies and community coalitions to increase the number of communities benefiting from water fluoridation.

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(Posted 12/22/05)