© 2025 American Dental Association l 7
Water Fluoridation as a Public Health Measure
Established by the HHS, Healthy People 203055 provided an evidence-based, comprehensive set of
ambitious, achievable, national objectives for improving public health and reducing health disparities over
10 years, from 2020 to 2030. Healthy People 2030 recognizes the importance of water fluoridation in
promoting oral health and reducing disparities. Healthy People 2030 aims to increase the proportion of
people whose water systems have the recommended amount of fluoride.55 The target is to have 77.1%
of people served by community water systems with optimally fluoridated water to reduce oral health
disparities.56 In 2022, the CDC indicated that 72.3% of the US population on public water systems, or
a total of 209.1 million people, had access to fluoridated water.57
Fluoridation of community water supplies is the single most effective public health measure to prevent tooth
decay. Fluoridation helps prevent and, in some cases, reverse tooth decay across the lifespan. Increasing
numbers of adults are retaining their teeth throughout their lifetimes due in part to the benefits they receive
from water fluoridation. Dental costs for these individuals have been reduced and many hours of needless
pain and suffering due to untreated tooth decay have been avoided. By preventing tooth decay, community
water fluoridation has been shown to save money, both for families and the health care system. The return on
investment for community water fluoridation varies with the size of the community, and in general, increases
as the community size increases. Community water fluoridation is cost saving, even for small communities.
Additional information about this topic can be found in the Cost Section, Question 68.
Fluoridation of community water supplies is the single most effective public health
measure to prevent tooth decay. Studies show that community water fluoridation
prevents about 25% of tooth decay in children and adults, even in an era with
widespread availability of fluoride from other sources, such as fluoride toothpaste.
Community water fluoridation is an extremely valuable public health measure because:
Optimally fluoridated water is accessible to the entire community regardless of socioeconomic
status, educational attainment, or other social variables.58
Individuals do not need to change their behavior to obtain the benefits of fluoridation.
Frequent exposure to small amounts of fluoride over time makes fluoridation effective through the
lifespan in helping to prevent tooth decay.59
Community water fluoridation is more cost effective and cost saving than other forms of fluoride
treatments or applications.60,61
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