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Frequently Asked Questions

What are fluoride and fluoridation?
Fluoride is a mineral that exists naturally in most water sources, including lakes, rivers and the ocean. It also exists in varying levels in the food and beverages we drink. Through the process known as “water fluoridation,” public water systems balance the amount of fluoride to the optimum level for preventing tooth decay.
How does fluoride prevent tooth decay?
Fluoride works in two ways. In people of all ages, it works topically on tooth surfaces by mixing with saliva, neutralizing the acids produced by bacteria in the mouth and strengthening the enamel. In children, water with a good balance of fluoride supports the development of teeth that are resistant to decay. When someone drinks water, fluoride combines with the calcium and phosphate in developing teeth – making the teeth more resistant to cavities and decay.
Why do some people oppose fluoridation?
The internet has its share of websites that contain inaccurate and misleading information that aim to cast doubt and confusion. In fact, every major health entity in the United States, including the Centers for Disease Control and Prevention (CDC), the American Dental Association, the Surgeon General, and the American Academy of Pediatrics, support fluoridation. Leading health experts and researchers who have studied fluoridation for decades in the US overwhelmingly conclude that drinking water with fluoride is safe, effective and essential to maintaining good oral health.
How about fluorosis? Isn’t that caused by drinking water with fluoride?
Fluorosis is mostly a cosmetic condition that leaves faint white streaks on teeth. It does not cause pain or affect the health of the teeth. Excessive amounts of fluoride naturally occurring in drinking water could cause fluorosis, but not when the levels are adjusted to the government’s recommendation. In fact, medical experts believe that in many cases, fluorosis occurs because young children consume too much toothpaste when brushing their teeth.
Is fluoridation still necessary?
Yes. Although Americans’ dental health has improved over the last decades, tooth decay is still widespread and affects more than 90 percent of Americans by the time they reach their adult years. Water fluoridation is the most efficient and cost-effective way of getting the health benefits of fluoride.
What about fluoride in toothpaste? Isn’t that sufficient?
No. Years after toothpaste with fluoride became widely available, an independent panel of experts looked at the specific impact of water fluoridation and determined that it reduces tooth decay by about 25%. Medical experts consider water fluoridation the most effective source of fluoride.
If fluoridation is effective, why do people still get cavities?
Fluoride alone cannot guarantee a person will enjoy a full life without cavities. Other factors play a role, such as a person’s diet and nutrition, and the frequency with which they visit the dentist for routine treatment. Nevertheless, research proves that fluoridation does reduce the rate of tooth decay and provides an important benefit to all individuals.
Is fluoridation only good for children or does it also benefit adults?
Tooth decay is an issue that people must address throughout their lifetime, and fluoridation helps people of all ages. In seniors, it helps prevent decay on the exposed root surfaces of teeth—a condition that affects older adults. This is especially good news, since Medicare does not cover most dental care.
Who decides about water fluoridation in communities?
State laws and city ordinances determine the process for how a community decides whether to begin water fluoridation or not. It’s important to ensure that those making this decision—whether they are elected officials or the voting public—are relying on sound, scientifically accurate information.

More resources

There is power in knowledge. The more we know, the better decisions we can make about our health care and wellbeing. Here are some reliable sources of information about water fluoridation:
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