4 l © 2025 American Dental Association
Introduction
community water fluoridation program, under the direction of Dr. Dean, began in Grand Rapids, Michigan,
in January 1945 with Muskegon, Michigan, as the non-fluoridated control community. The other three studies
were conducted in the following three pairs of cities with the fluoridated city listed first: Newburgh and
Kingston, New York (May 1945) Brantford and Sarnia, Ontario, Canada (June 1945) and Evanston and
Oak Park, Illinois (February 1947).20–22
In the 1940s, four pioneering community trials, were carried out to evaluate the effects
of the controlled addition of sodium fluoride to fluoride-deficient water supplies.
The astounding success of these comparison studies firmly established the practice of water fluoridation as
a practical, safe, and effective public health measure to prevent tooth decay, and it was embraced quickly by
other communities. After 10 years of fluoridation, the decay rate in Grand Rapids, Michigan had significantly
decreased by 54% in deciduous teeth and 60% in permanent teeth.23
The history of water fluoridation is a classic example of a curious professional making exacting clinical
observations that led to epidemiologic investigations and eventually to a safe and effective community-
based public health intervention, which even today remains the cornerstone of communities’ efforts to
prevent tooth decay.
In addition to these studies noted, reviews on fluoride in drinking water have continued to be issued over
the years. Beginning in 1951, the National Research Council (NRC) of the National Academies issued its first
report stating fluoridation was safe and effective. The NRC has continued to issue reports on fluoride in
drinking water (197724 and 199325), with the most recent review published in 2006.26 Additional reviews
completed over the 17-year period from 2007 to 2024 include:
2024 Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny
A-M, O’Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst
Rev. 2024, Issue 10. Art. No.: CD010856. DOI: 10.1002/14651858.CD010856.pub3.27
2023 Fiore G, Veneri F, Di Lorenzo R, Generali L, Vinceti M, Filippini T. Fluoride exposure and ADHD:
A systematic review of epidemiologic studies. Medicina. 2023 59(4), 797.28
2023 Kumar JV, Moss ME, Liu H, Fisher-Owens S. Association between low fluoride exposure and
children’s intelligence: a meta-analysis relevant to community water fluoridation. Public Health.
2023, 219: 73-84. DOI:10.1016/j.puhe.2023.03.011.29
2022 Belotti L, Frazão P. Effectiveness of water fluoridation in an upper-middle-income country:
a systematic review and meta-analysis. Int J Paediatr Dent. 2022, 32(4), 503-13.30
2019 Cury J, Ricomini-Filho AP, Perecin Berti FL, Tabchoury CPM. Systemic Effects (Risks) of Water
Fluoridation. Brazilian Dent J. 2019, 30(5), 421-428.31
2018 Ajiboye AS, Dawson DR, Fox CH. American Association for Dental Research Policy Statement
on Community Water Fluoridation. J Dent Res. 2018, 97(12),1293-1296.32
Introduction
community water fluoridation program, under the direction of Dr. Dean, began in Grand Rapids, Michigan,
in January 1945 with Muskegon, Michigan, as the non-fluoridated control community. The other three studies
were conducted in the following three pairs of cities with the fluoridated city listed first: Newburgh and
Kingston, New York (May 1945) Brantford and Sarnia, Ontario, Canada (June 1945) and Evanston and
Oak Park, Illinois (February 1947).20–22
In the 1940s, four pioneering community trials, were carried out to evaluate the effects
of the controlled addition of sodium fluoride to fluoride-deficient water supplies.
The astounding success of these comparison studies firmly established the practice of water fluoridation as
a practical, safe, and effective public health measure to prevent tooth decay, and it was embraced quickly by
other communities. After 10 years of fluoridation, the decay rate in Grand Rapids, Michigan had significantly
decreased by 54% in deciduous teeth and 60% in permanent teeth.23
The history of water fluoridation is a classic example of a curious professional making exacting clinical
observations that led to epidemiologic investigations and eventually to a safe and effective community-
based public health intervention, which even today remains the cornerstone of communities’ efforts to
prevent tooth decay.
In addition to these studies noted, reviews on fluoride in drinking water have continued to be issued over
the years. Beginning in 1951, the National Research Council (NRC) of the National Academies issued its first
report stating fluoridation was safe and effective. The NRC has continued to issue reports on fluoride in
drinking water (197724 and 199325), with the most recent review published in 2006.26 Additional reviews
completed over the 17-year period from 2007 to 2024 include:
2024 Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny
A-M, O’Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst
Rev. 2024, Issue 10. Art. No.: CD010856. DOI: 10.1002/14651858.CD010856.pub3.27
2023 Fiore G, Veneri F, Di Lorenzo R, Generali L, Vinceti M, Filippini T. Fluoride exposure and ADHD:
A systematic review of epidemiologic studies. Medicina. 2023 59(4), 797.28
2023 Kumar JV, Moss ME, Liu H, Fisher-Owens S. Association between low fluoride exposure and
children’s intelligence: a meta-analysis relevant to community water fluoridation. Public Health.
2023, 219: 73-84. DOI:10.1016/j.puhe.2023.03.011.29
2022 Belotti L, Frazão P. Effectiveness of water fluoridation in an upper-middle-income country:
a systematic review and meta-analysis. Int J Paediatr Dent. 2022, 32(4), 503-13.30
2019 Cury J, Ricomini-Filho AP, Perecin Berti FL, Tabchoury CPM. Systemic Effects (Risks) of Water
Fluoridation. Brazilian Dent J. 2019, 30(5), 421-428.31
2018 Ajiboye AS, Dawson DR, Fox CH. American Association for Dental Research Policy Statement
on Community Water Fluoridation. J Dent Res. 2018, 97(12),1293-1296.32
