Community Water Fluoridation Facts and Strategy

Community water fluoridation is the most effective public health measure to prevent tooth decay. The Centers for Disease Control and Prevention has proclaimed community water fluoridation as one of 10 great public health achievements of the 20th century. As of 2014,approximately 74.4% of the U.S. population served by public water systems receive the benefit of optimally fluoridated water.

Fluoridation of community water supplies is the adjustment of the existing, naturally occurring fluoride levels in drinking water to an optimal fluoride level recommended by the Center for Disease Control (0.7 parts per million) for the prevention of tooth decay. Water that has been fortified with fluoride is similar to fortifying milk with Vitamin D, table salt with iodine, and bread and cereals with folic acid.

Studies conducted throughout the past 65 years have consistently shown that fluoridation of community water supplies is effective and safe in preventing dental decay in both children and adults. Simply by drinking water, children and adults can benefit from fluoridation's cavity protection whether they are at home, work, or school. Today, studies prove water fluoridation continues to be effective in reducing tooth decay by 25 – 40%, even in an era with availability of fluoride from other sources, such as fluoride toothpaste.  Studies show that an average of $32.19 (ADA) is saved in dental treatment. Fluoridating community water systems reduces pain and suffering from tooth decay and related ills per person per year.

The American Dental Association endorses fluoridation of community water supplies as safe and effective for preventing tooth decay.  The ADA, along with state and local dental societies, continues to work with federal, state and local agencies to increase the number of communities benefiting from water fluoridation.

Source: American Dental Association

• Link to Studies
• Link to ADA Fluoride Facts

In communities or municipal water districts that are currently fluoridating, it is VERY important to attend council/local government meetings and publicly commend the elected or appointed officials for continuing to fund and support water fluoridation.

The Texas Dental Association has a standard form, which can be accessed through this link. The commendation can then be filled in with your local component details, printed on dental society/office letterhead and presented to community officials during one of their meetings. It can be accompanied by a brief statement on the benefits of community water fluoridation and the oral health of the entire community.

The intention of this commendation is to establish a relationship with local officials that may serve the community if/when community water fluoridation questions arise. The commendation shall be presented to community officials on an annual basis by every incoming component society president where applicable. 

Local component societies should be aware of the local or governmental entity responsible for water fluoridation.  Usually, it will be either the city council or a municipal water district board.  

Local component societies should regularly monitor meeting agendas of the entity for water fluoridation topics.  Meeting notices/agendas should be posted 72 hours prior to meetings.   

The yearly budget line items for the entity should include funds for purchase of chemicals for water fluoridation.  

The Texas Department of State Health Services/Texas Fluoridation Project provides information on communities that fluoridate.  

For more information regarding this matter click ​HERE.

When a component society is made aware of an issue in the community they should immediately contact the Texas Dental Association (TDA) and speak with Staci Rives at 512-443-3675 or by email. The Community Fluoride Committee (CFC) will be notified and contact will be made with the component society or member.  The Committee will provide all information and contacts necessary to deal with the issue.

After contacting TDA the local component will need to mobilize:

Arrange for several members to discuss different talking points during the meeting (note: each member is usually permitted 3 minutes for discussion)

Members should make contact with individual city council or board members, specifically those who may be patients, to discuss the benefits of water fluoridation and the consequences of water fluoridation cessation.  This contact should be personal and away from the formal meeting.

NOTE: “The Fluoride Action Network (FAN) is dedicated to protecting public health by ending water fluoridation and other involuntary exposures to fluoride.”[1]

[1] “FAN's Mission Statement.” Fluoride Action Network, fluoridealert.org/about/ accessed 29 July 2019.)

Hydrofluorosilicic acid, also known as FSA or HFS, is a transparent, colorless, aqueous solution that is used in a variety of applications.  It is a biproduct of the phosphate fertilizer industry. One of its most common uses is in the fluoridation of community water supplies. FSA is produced during the concentration of phosphoric acid in an evaporation process unique to the phosphate industry. The vapor stream from the phosphoric acid reaction is scrubbed with water to form FSA from the naturally occurring silica and fluorine in the phosphoric acid. The final product is collected, stored and tested prior to release for shipment. Hydrofluorosilicic acid must meet ANSI/AWWA Standards for purity. Two other chemicals also used are sodium fluoride and sodium fluorosilicate.  

Hydrofluorosilicic acid is the most common product used in water fluoridation and is added to the water by metering pump, thus titrating to the optimum therapeutic level recommended by the Centers for Disease Control and Prevention (CDC).  This optimum level is equivalent to one drop of hydrofluorosilicic acid in a bathtub full of water.  

Studies have shown that when the fluorosilicic acid enters the water stream, it immediately dissociates into fluoride ion and silica.  Studies also show that the fluoride ion from hydrofluorosilicic acid is the same as naturally occurring fluoride.

Source:  Mosaic

Use the resources below to learn more:

• Link to ADA Fluoride Facts
• Link to Texas Fluoridation Project
• Link to CDC

To determine if your community fluoridates, refer to the Centers for Disease Control and Prevention (CDC) website. To determine the concentration of fluoride in your community drinking water supply, you can contact your city government or by checking water quality reports that can be accessed online at the Texas Commission on Environmental Quality (TCEQ). 

If your community does not fluoridate, in order to encourage them to do so, you should take the following steps:

1.  Contact the Texas Dental Association (TDA) Community Fluoride Committee (CFC)
2.  Contact elected or appointed officials in your community to begin the process of educating them as to the benefits of water fluoridation

There are many myths regarding water fluoridation, they include:  

• Fluoride is detrimental to human health
• Fluoride is toxic waste
• Fluoride is mass medication
• Fluoridating water is an expensive burden to communities

The facts rather than the myths regarding water fluoridation can be addressed by referring to the following links:

• https://www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation/5-reasons-why-fluoride-in-water-is-good-for-communities
• https://americanfluoridationsociety.org/debunking-anti-claims/
• https://americanfluoridationsociety.org/debunking-anti-claims/myths/
• https://americanfluoridationsociety.org/debunking-anti-claims/what-critics-say/