ADEA’s Support for Community Water Fluoridation

April 9, 2025 —In 2015, the Surgeon General of the United States recognized community water fluoridation as one of the “10 great public health achievements of the 20th century.” Fluoridation is a powerful tool for disease prevention, particularly in combating dental caries—commonly known as cavities—which remain the most prevalent chronic disease among children.

The 2000 Surgeon General’s report, Oral Health in America, highlighted that oral health disparities are especially pronounced among individuals with special health care needs, those with low incomes, members of underrepresented groups and people living in underserved rural, urban and frontier communities. These populations experience higher rates of dental disease, more missing teeth and greater barriers to accessing oral health services than the general population.¹

Such oral health gaps underscore the urgent need to invest in a robust dental public health infrastructure—one that extends beyond the traditional, economically driven model of care. Because underrepresented and underserved populations are less likely to have access to affordable quality oral health services, fluoride plays an important role in supporting better oral health in these communities, which in turn leads to better overall health. Additionally, while the current health care model may serve many Americans, it falls far short of ensuring affordable, universal access to oral health for all persons.

Not only are the health benefits of fluoridation immense, but they also positively impact community economics: 

• Residents, both children and adults, of communities with community water fluoridation benefit as it helps reduce cavities by 25%.^2,3
 
• Taxpayers benefit as providing optimally fluoridated water to U.S. communities for one year saves $6.5 billion in dental treatment costs and offers an average return on investment of $20 for every $1 spent.⁴
 
• Employers, workforces and students also benefit as on average, communities with water fluoridation experience 25% fewer cavities, saving $32 per person annually by avoiding dental treatment costs and leading to fewer missed work and school days.⁵

In light of current scientific evidence, the American Dental Education Association strongly opposes any changes to the recommended optimal fluoride level of 0.7 milligrams per liter in community drinking water. This standard, as endorsed by the Centers for Disease Control and Prevention, remains a safe and effective means of preventing tooth decay and promoting oral health nationwide. 

Sincerely,

Karen P. West, D.M.D., M.P.H.
ADEA President and CEO

References

1. American Dental Education Association. Exhibit 10. ADEA policy statement on health care reform: oral health care: essential to health care reform. (As approved by the 2009 ADEA House of Delegates. J Dent Educ. July 2024;88(S2):S124–6.
2. Griffin SO, Regnier E, Griffin PM, Huntley VN. Effectiveness of fluoride in preventing caries in adults. J Dent Res. 2007;86(5):410–14.
3. Iheozor-Ejiofor Z, Worthington HV, Walsh T, et al. Water fluoridation for the prevention of dental caries. Cochrane Database of Syst Rev. 2015;(6). Art. No.: CD010856. doi: 10.1002/14651858.CD010856.pub2.
4. Centers for Disease Control and Prevention. CDC Oral Health. Return on Investment: Optimally Fluoridated Water. Accessed Apr. 8, 2025; U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation. U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries. Public Health Rep. 2015 Jul-Aug;130(4):318-31. doi: 10.1177/003335491513000408.
5. Ibid.