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Tooth decay is one of the most common chronic diseases among American children with 1 of 4 children living below the federal poverty level experiencing untreated tooth decay. Untreated decay can cause pain, school absences, difficulty concentrating, and poor appearance—all contributing to decreased quality of life and ability to succeed.

Tooth decay and its complications are preventable, and several preventive and early treatment options are safe, effective, and economical. The CDC leads national efforts to improve oral health by using proven strategies such as community water fluoridation and school-based dental sealant programs that prevent oral diseases.

Community water fluoridation is “the controlled addition of a fluoride compound to a public water supply to achieve a concentration optimal for dental caries prevention.” In 2012, more than 210 million people, or 74.6% of the U.S. population served by public water supplies, drank water with optimal fluoride levels to prevent tooth decay. 

Evidence shows that water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride, ultimately reducing tooth decay by 25% in children and adults.5-8 Additional evidence shows that schoolchildren living in communities where water is fluoridated have, on average, 2.25 fewer decayed teeth compared to similar children not living in fluoridated communities.


The safety and benefits of fluoride are well documented and have been reviewed comprehensively by several scientific and public health organizations. Expert panels consisting of scientists from the United States and other countries, with expertise in various health and scientific disciplines, have considered the available evidence in peer-reviewed literature and have not found convincing scientific evidence linking community water fluoridation with any potential adverse health effect or systemic disorder such as an increased risk for cancer, Down syndrome, heart disease, osteoporosis and bone fracture, immune disorders, low intelligence, renal disorders, Alzheimer disease, or allergic reactions.

Professionally applied Topical fluoride for caries prevention:

A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs reported on the effects of topical fluoride for caries prevention.   The panel recommends the following for people at risk of developing dental cavities:

  • 2.26 percent fluoride varnish or 1.23 percent fluoride (APF) gel

  • or prescription-strength, home-use 0.5 percent fluoride gel or paste

  • or 0.09 percent fluoride mouthrinse for patients 6 years or older


Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from “in favor” to “expert opinion for.”


As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences.

n the February 2016 Journal of the American Dental Association.

researchers found Fluoride varnish may be an effective treatment for the reversal of incipient (beginning) cavity lesions in both baby and permanent teeth.


Community Water Fluoridation Facts

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