© 2025 American Dental Association l ix
American Dental Association
Executive Summary
Fluoridation Facts, 2025
As of the writing and publication of this document, the political and regulatory environment of community
water fluoridation is experiencing significant disruption.
There will be periodic electronic updates to this document as governmental regulations change and reviews
of sound science- and evidence-based studies are offered through peer-reviewed journals and periodicals.
• Fluoridation of community water supplies is the single most effective public health measure to prevent
tooth decay.
• Throughout more than 80 years of research and practical experience, the overwhelming weight of
credible scientific evidence has consistently indicated that fluoridation of community water supplies
is safe.
• Studies prove water fluoridation continues to be effective in reducing tooth decay by more than
25% in children and adults, even in an era with widespread availability of fluoride from other
sources, such as fluoride toothpaste.
• Because of the important role community water fluoridation has played in the reduction of tooth
decay, the US Centers for Disease Control and Prevention (CDC) has proclaimed it one of 10 great
public health achievements of the 20th century (along with vaccinations and infectious disease
control).
• Community water fluoridation is the controlled adjustment of fluoride that occurs naturally in all
water to optimal levels to prevent tooth decay (0.7 milligrams per liter).
• Community water fluoridation benefits everyone, especially those without access to regular dental
care. Fluoridation is a powerful tool in the fight for social justice and health equity.
• Simply by drinking water, people can benefit from fluoridation’s cavity protection whether they are
at home, work, or school.
• Water that has been fortified with fluoride is similar to fortifying salt with iodine, milk with vitamin D,
and orange juice with vitamin C—all of which are supplements, not medications.
• When compared to the cost of other prevention programs, water fluoridation is the most cost-
effective means of preventing tooth decay for both children and adults in the United States. The cost
of a lifetime of water fluoridation for one person is less than the cost of one filling.
• For community water systems that serve more than 1,000 people, the economic benefit of fluoridation
exceeds the cost. The benefit-cost ratio increases as the size of the population served increases (largely
due to economies of scale). Fluoridation is a cost-saving method to prevent tooth decay.
• According to data from 2022, 72.3% of the US population is served by public water systems that
are optimally fluoridated.
American Dental Association
Executive Summary
Fluoridation Facts, 2025
As of the writing and publication of this document, the political and regulatory environment of community
water fluoridation is experiencing significant disruption.
There will be periodic electronic updates to this document as governmental regulations change and reviews
of sound science- and evidence-based studies are offered through peer-reviewed journals and periodicals.
• Fluoridation of community water supplies is the single most effective public health measure to prevent
tooth decay.
• Throughout more than 80 years of research and practical experience, the overwhelming weight of
credible scientific evidence has consistently indicated that fluoridation of community water supplies
is safe.
• Studies prove water fluoridation continues to be effective in reducing tooth decay by more than
25% in children and adults, even in an era with widespread availability of fluoride from other
sources, such as fluoride toothpaste.
• Because of the important role community water fluoridation has played in the reduction of tooth
decay, the US Centers for Disease Control and Prevention (CDC) has proclaimed it one of 10 great
public health achievements of the 20th century (along with vaccinations and infectious disease
control).
• Community water fluoridation is the controlled adjustment of fluoride that occurs naturally in all
water to optimal levels to prevent tooth decay (0.7 milligrams per liter).
• Community water fluoridation benefits everyone, especially those without access to regular dental
care. Fluoridation is a powerful tool in the fight for social justice and health equity.
• Simply by drinking water, people can benefit from fluoridation’s cavity protection whether they are
at home, work, or school.
• Water that has been fortified with fluoride is similar to fortifying salt with iodine, milk with vitamin D,
and orange juice with vitamin C—all of which are supplements, not medications.
• When compared to the cost of other prevention programs, water fluoridation is the most cost-
effective means of preventing tooth decay for both children and adults in the United States. The cost
of a lifetime of water fluoridation for one person is less than the cost of one filling.
• For community water systems that serve more than 1,000 people, the economic benefit of fluoridation
exceeds the cost. The benefit-cost ratio increases as the size of the population served increases (largely
due to economies of scale). Fluoridation is a cost-saving method to prevent tooth decay.
• According to data from 2022, 72.3% of the US population is served by public water systems that
are optimally fluoridated.
