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Fluoridation Facts
66. Is community water fluoridation accepted by other countries?
Answer
Yes. According to the British Fluoridation Society, as of 2020, approximately 380 million people
in 25 countries worldwide were supplied with water fluoridated by adjustment.465 Additionally,
more than 57.4 million receive naturally fluoridated water at the optimum level. Worldwide, the
estimated number of people with access to optimally fluoridated water equates to more than
400 million people.35
According to the British Fluoridation Society, as of 2020, approximately 380
million people in 25 countries worldwide were supplied with water fluoridated
by adjustment.465
Fact
The value of water fluoridation is recognized internationally. Countries and geographic regions with
water fluoridated by adjustment include the United States, Argentina, Australia, Brazil, Brunei, Canada,
Chile, China (Special Administrative Region of Hong Kong), Fiji, Guatemala, Guyana, the Irish Republic,
Malaysia, New Zealand, Panama, Papua New Guinea, Peru, South Korea, Serbia, Singapore, Spain, the
United Kingdom, and Vietnam.466 Major cities outside the United States with fluoridated water include
Adelaide, Auckland, Bilbao, Birmingham, Brisbane, Buenos Aires, Cork, Dublin, Edmonton, Ho Chi
Minh City (Saigon), Kuala Lumpur, Melbourne, Newcastle upon Tyne, Perth, Rio de Janeiro, San Paolo,
Santiago, Seville, Sydney, Toronto, Wellington, and Winnipeg.466
Thorough investigations of fluoridation conducted in a number of countries in addition to the United
States, including Australia, England, Ireland, New Zealand, as well as by the European Commission and
the WHO, support the safety and effectiveness of water fluoridation.34,35,38,40,41,43
Considering the extent to which fluoridation has already been implemented throughout the world,
the lack of documentation of adverse health effects is remarkable testimony to its safety.34,38-41 The
WHO has endorsed the practice of water fluoridation since 1969.428 In 1994, an expert committee of
the WHO published a report that reaffirmed its support of fluoridation as being safe and effective in
the prevention of tooth decay, and stated that “provided a community has a piped water supply, water
fluoridation is the most effective method of reaching the whole population, so that all social classes
benefit without the need for active participation on the part of individuals.”429 In 2004, the WHO once
again affirmed its support.430 In 2007, the 60th World Health Assembly recommended that countries
without access to optimal levels of fluoride or systemic fluoridation programs should consider
initiating fluoridation programs.431
A scientific evaluation of fluoride was conducted by the Scientific Committee on Health and
Environmental Risks (SCHER) upon request by the European Commission (EC).462 The EC is the
European Union’s (EU) executive body with responsibility to manage EU policy. The Committee was
asked to critically evaluate any new evidence on the hazard profile, health effects, and human exposure
to fluoride. The final report, Critical review of any new evidence on the hazard profile, health effects,
and human exposure to fluoride and the fluoridating agents of drinking water, was released in 2011.43
It stated that exposure to levels of fluoride used for fluoridation of drinking water does not lead
Fluoridation Facts
66. Is community water fluoridation accepted by other countries?
Answer
Yes. According to the British Fluoridation Society, as of 2020, approximately 380 million people
in 25 countries worldwide were supplied with water fluoridated by adjustment.465 Additionally,
more than 57.4 million receive naturally fluoridated water at the optimum level. Worldwide, the
estimated number of people with access to optimally fluoridated water equates to more than
400 million people.35
According to the British Fluoridation Society, as of 2020, approximately 380
million people in 25 countries worldwide were supplied with water fluoridated
by adjustment.465
Fact
The value of water fluoridation is recognized internationally. Countries and geographic regions with
water fluoridated by adjustment include the United States, Argentina, Australia, Brazil, Brunei, Canada,
Chile, China (Special Administrative Region of Hong Kong), Fiji, Guatemala, Guyana, the Irish Republic,
Malaysia, New Zealand, Panama, Papua New Guinea, Peru, South Korea, Serbia, Singapore, Spain, the
United Kingdom, and Vietnam.466 Major cities outside the United States with fluoridated water include
Adelaide, Auckland, Bilbao, Birmingham, Brisbane, Buenos Aires, Cork, Dublin, Edmonton, Ho Chi
Minh City (Saigon), Kuala Lumpur, Melbourne, Newcastle upon Tyne, Perth, Rio de Janeiro, San Paolo,
Santiago, Seville, Sydney, Toronto, Wellington, and Winnipeg.466
Thorough investigations of fluoridation conducted in a number of countries in addition to the United
States, including Australia, England, Ireland, New Zealand, as well as by the European Commission and
the WHO, support the safety and effectiveness of water fluoridation.34,35,38,40,41,43
Considering the extent to which fluoridation has already been implemented throughout the world,
the lack of documentation of adverse health effects is remarkable testimony to its safety.34,38-41 The
WHO has endorsed the practice of water fluoridation since 1969.428 In 1994, an expert committee of
the WHO published a report that reaffirmed its support of fluoridation as being safe and effective in
the prevention of tooth decay, and stated that “provided a community has a piped water supply, water
fluoridation is the most effective method of reaching the whole population, so that all social classes
benefit without the need for active participation on the part of individuals.”429 In 2004, the WHO once
again affirmed its support.430 In 2007, the 60th World Health Assembly recommended that countries
without access to optimal levels of fluoride or systemic fluoridation programs should consider
initiating fluoridation programs.431
A scientific evaluation of fluoride was conducted by the Scientific Committee on Health and
Environmental Risks (SCHER) upon request by the European Commission (EC).462 The EC is the
European Union’s (EU) executive body with responsibility to manage EU policy. The Committee was
asked to critically evaluate any new evidence on the hazard profile, health effects, and human exposure
to fluoride. The final report, Critical review of any new evidence on the hazard profile, health effects,
and human exposure to fluoride and the fluoridating agents of drinking water, was released in 2011.43
It stated that exposure to levels of fluoride used for fluoridation of drinking water does not lead
