Public Policy l Fluoridation Facts 91 • American Association of Dental Research • American Association of Public Health Dentistry • American Water Works Association • Association of State and Territorial Dental Directors • Centers for Disease Control and Prevention • International Association of Dental Research • National Institute of Dental and Craniofacial Research Many organizations in the United States and around the world recognize the benefits of community water fluoridation. The ADA has developed a list of “National and International Organizations that Recognize the Public Health Benefits of Community Water Fluoridation for Preventing Dental Decay.” Please see the ADA website at www.ADA.org/fluoride for the most current listing as well as information on reproduction and distribution of the list. However, support for fluoridation doesn’t end with a list of organizations. In many cases, local newspaper editorial boards support fluoridation. Perhaps the most notable of these efforts occurred when the 2013 Pulitzer Prize for Journalism — Editorial Writing56 was awarded to Tim Nickens and Daniel Ruth of the Tampa Bay Times, St. Petersburg, Florida, for their diligent campaign that helped reverse a decision to end fluoridation of the water supply for the 700,000 residents of the newspaper’s home (Pinellas) county. Copies of their 10 editorials from 2012 can be viewed at http://www.pulitzer.org/ winners/tim-nickens-and-daniel-ruth. 61. Has the legality of water fluoridation been upheld by the courts? Answer. Yes. Fluoridation has been thoroughly tested in the United States’ court system, and found to be a proper means of furthering public health and welfare. No court of last resort has ever determined fluoridation to be unlawful. Moreover, fluoridation clearly has been held not to be an unconstitutional invasion of religious freedom or other individual rights guaranteed by the First, Fifth or Fourteenth Amendments to the U.S. Constitution. And while cases decided primarily on procedural grounds have been won and lost by both pro- and anti- fluoridation interests, to ADA’s knowledge, no final ruling in any of those cases has found fluoridation to be anything but safe and effective. Fact. The legality of fluoridation in the United States has been thoroughly tested in our court systems. Fluoridation is viewed by the courts as a proper means of furthering public health and welfare.57 No court of last resort has ever determined fluoridation to be unlawful. The highest courts of more than a dozen states have confirmed the constitutionality of fluoridation.58 In 1984, the Illinois Supreme Court upheld the constitutionality of the state’s mandatory fluoridation law, resolving 16 years of court action at a variety of judicial levels.59 Moreover, the U.S. Supreme Court has denied review of fluoridation cases thirteen times, citing that no substantial federal or constitutional questions were involved.58 Fluoridation is viewed by the courts as a proper means of furthering public health and welfare. No court of last resort has ever determined fluoridation to be unlawful. It has been the position of the American courts that a significant government interest in the health and welfare of the public generally overrides individual objections to public health regulation.58 Consequently, the courts have rejected the contention that fluoridation ordinances are a deprivation of religious or individual freedoms guaranteed under the Constitution.58,60 In reviewing the legal aspects of fluoridation, the courts have dealt with this concern by ruling that: (1) fluoride is a nutrient, not a medication, and is present naturally in the environment (2) no one is forced to drink fluoridated water as alternative sources are available and (3) in cases where a person believes that fluoridation interferes with religious beliefs, there is a difference between the freedom to believe, which is absolute, and the freedom to practice beliefs, which may be restricted in the public’s interest.61,62 Fluoridation is the adjustment of the level of a naturally occurring mineral found in water in order to prevent tooth decay. Courts have consistently ruled that water fluoridation is not a form of compulsory mass medication or socialized medicine.58,61,63 In fact, water that has been fortified with fluoride is similar to fortifying salt with iodine, milk with vitamin D and orange juice with calcium — none of which are medications.