Study of decade of data backs argument for community water fluoridation

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at

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Children living in counties with fluoridated water have significantly less tooth decay than those living in counties that lack water fluoridation programs, according to a newly published large-scale study.

Reduced decay rates were most pronounced in the primary teeth of children living in fluoridated counties. Yet community water fluoridation (CWF) also was credited with conferring a meaningful level of protection to the permanent teeth of children and adolescents.

“These findings confirm a substantial caries-preventive benefit of CWF for U.S. children and that the benefit is most pronounced in primary teeth,” wrote the authors of the study, which was published in the Journal of Dental Research.

To reach their conclusions, researchers merged county-level fluoridation data from the Centers for Disease Control and Prevention’s Water Fluoridation Reporting System with dental examination data gleaned from 10 years of National Health and Nutrition Examination Surveys (NHANES).

According to the study, U.S. counties in which more than 75 percent of the population had access to community water fluoridation showed a 30 percent reduction in tooth decay in children’s primary teeth and a 12 percent reduction in permanent teeth compared with counties in which fewer than 75 percent of the population had access to publicly fluoridated water.

As the report noted, the fluoridation of America’s drinking water has been hailed as one of the great public health achievements of the 20th century.

Yet when community fluoridation took off in the years after World War II, conspiracy theorists branded the initiative a communist plot. In spite of years of research supporting its safety and efficacy, fluoridation continues to be viewed with suspicion in some quarters.

Just this month, for example, the Republican Party of Texas included a plank in its new platform calling for a ban on fluoride in the state water supply.

The 331-plank platform, written at the state party’s annual convention in San Antonio and approved in a vote by delegates also calls for measures including the abolition of daylight savings time and the protection of Confederate monuments, Lauren McGaughy reported June 18 in a story for the Dallas Morning News.

In addition to water fluoridation, the platform challenges a number of other public health efforts: it calls for the outlawing of sex education in public schools, the ending of needle exchange programs, the defunding of Planned Parenthood, the repeal of the Affordable Care Act. It seeks a requirement that the state inform parents that they may opt their children out of vaccinations.

The platform, which is accompanied by a list legislative priorities, does not have the force of law, McGaughy wrote. Still, the document has the power to shape and influence policymaking, she noted.

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