© 2025 American Dental Association l v
Table of Contents
37. Does fluoride, at the levels found in drinking water that is fluoridated to the recommended
levels, alter immune function or produce an allergic reaction (hypersensitivity)? . . . . . . . . . . . . . . . . 66
38. Is fluoride, as provided by community water fluoridation, a genetic hazard?. . . . . . . . . . . . . . . . . . . . 67
39. Does fluoride at the levels found in water fluoridation affect human reproduction,
fertility, or birth rates?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
40. For women, does drinking water fluoridated at the recommended level create a risk
for their children to be born with Down syndrome?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
41. Does ingestion of water fluoridated at recommended levels have an adverse effect on
neurodevelopment or intelligence (IQ) or behavioral disorders in children? . . . . . . . . . . . . . . . . . . . . . 70
42. Does drinking fluoridated water increase the level of lead in the blood or cause lead
poisoning in children?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
43. Does drinking water fluoridated at recommended levels cause Alzheimer’s disease?. . . . . . . . . . . . . 75
44. Does drinking water fluoridated at recommended levels cause or contribute to heart disease? . . . 76
45. Is the consumption of water fluoridated at recommended levels harmful to the kidneys? . . . . . . . . 77
46. What are some of the erroneous health claims made against water fluoridation?. . . . . . . . . . . . . . . . 79
Section 3: Fluoridation Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
47. Who regulates drinking water additives in United States?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
48. What standards have been established to ensure the safety of fluoride additives
used in community water fluoridation in the United States? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
49. Does fluoridating the community water supply raise concerns about lead, arsenic,
and other toxic contaminants to the water supply?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
50. Have fluoride additives been tested for safety?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
51. What is the source of the additives used to fluoridate water supplies in the United States?. . . . . . . 85
52. Does the process of water fluoridation present unusual safety concerns for water
systems and water facility operators? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
53. Does fluoridation present difficult engineering problems?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
54. Does fluoride at levels used in fluoridation corrode water pipes?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
55. Does fluoride at levels used in water fluoridation corrode glass, concrete, or other
surfaces in water plants?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
56. Does fluoridated water harm the environment?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Section 4: Public Policy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
57. What is public health?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
58. Is water fluoridation a valuable public health measure?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
59. Does water fluoridation reduce disparities and improve health equity in dental health? . . . . . . . . . . 94
60. Along with the ADA, who supports community water fluoridation?. . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
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