Fluoride, Water and Health: What You Need to Know

For most people in the United States, fluoride has been in their local tap water for decades—for good reasons.

Fluoride has been shown to strengthen tooth enamel against cavities and save Americans money on dental treatments.

But questions come up periodically:

• What is fluoride?
• Why do so many communities add it to their water?
• What are its health benefits?

Now is a good time to review the facts.

Fluoride 101: The What and Why

Fluoride is a natural mineral that protects teeth. By reinforcing the enamel—the hard outer layer of the tooth—it helps prevent cavities and decay. Where teeth have been weakened, fluoride can help repair the damage. At the same time, it helps combat acids and bacteria, which can erode teeth.

For these reasons, the American Dental Association calls fluoride “nature’s cavity fighter. When drinking water is fluoridated to recommended levels, children and adults experience 25% fewer cavities on average.

The Right Amount of Fluoride is a Good Thing

Why is fluoride considered “nature’s” fighter? Because it originates in the Earth’s subsurface rocks and is released into soil, water and air. As a result, most tap water naturally contains some level of fluoride. Many foods and beverages contain fluoride as well.

However, these natural levels often fall short of the amounts scientists have found optimal for delivering health benefits. That’s why municipal water systems across America add fluoride to their drinking water to bring it up to effective levels, a practice called Community Water Fluoridation (CWS). The practice dates back to the end of World War II.

The U.S. Public Health Services recommends that the amount of fluoride needed in water to help prevent tooth decay is 0.7 mg/L. 

These current fluoridation levels are way below the maximum allowable level of fluoride in public drinking water set by the US Environmental Protection Agency (EPA).

Other Sources of Fluoride

Fluoridated water is a strong foundation for fighting tooth decay and improving oral health. However, fluoride is also found in other sources, such as

• Toothpaste: Almost all commercial, anti-cavity toothpaste sold in the United States contains fluoride. If you prefer non-traditional toothpaste, such as natural, charcoal or DIY options, be aware they may not have fluoride. You’d miss out on the enamel-strengthening key ingredient that helps protect teeth.
• Mouthwash: Not all mouthwashes contain fluoride, so check the label.
• Tablets or liquids: Children at high risk for cavities may receive special fluoride treatments from their dentists in the form of tablets or liquids.
• Topical solutions: In some cases, dentists may apply fluoride varnish, gel or silver diamine fluoride to children's teeth at risk for cavities. Dental plans often cover these treatments for kids but not for adults. Check your dental plan to see what’s covered.

Bottled Water Falls Flat on Fluoride

DYK: Bottled water actually reduces our exposure to fluoride. Generations ago, we all drank from the tap, and that water usually contained fluoride. However, if much of your water intake comes from purchased bottles, you get much less fluoride to protect your teeth.

Fluoride in the Water is a Public Health Bargain

The cost of providing public water fluoridation is small, often less than a dollar per person per year. Yet the communities served by fluoridated water save an average of $32 per person a year by avoiding the need to treat cavities.

Fluoride in the Water is a Success Story

The U.S. Centers for Disease Control and Prevention named community water fluoridation one of the “Ten great public health achievements of the 20th century,” alongside others like vaccination and food safety.

Today, 75% of Americans have access to fluoridated tap water. In Arkansas, the number is even higher, almost 90%. That’s the result of a multi-year CWF funding effort by Delta Dental of Arkansas during the 2010s.

Drinking optimally fluoridated water is one of the most effective ways to keep teeth healthy, along with brushing, flossing, a healthy diet, and regular dental visits. Realizing its benefits is as easy as turning on the tap.