Promoting Oral Health through Water Fluoridation

Adopted by the FDI General Assembly November, 2000 in Paris, France
Revised September, 2014 in New Delhi, India
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Water fluoridation is the adjustment of the fluoride concentration in fluoride-deficient water supplies to a level recommended for optimal oral health. More than 370 million people in over 27 countries receive the benefits of water fluoridation.

In recognition of the importance of promoting oral health through water fluoridation, FDI World Dental Federation states that:

  • Over 70 years of research and recent systematic reviews have shown that water fluoridation is an effective public health measure for the prevention of dental decay in children and adults.
  • Water fluoridation is particularly appropriate for populations demonstrating moderate to high risk of dental decay.
  • Water fluoridation confers positive health savings and contributes to reducing disparities in the rates of dental decay in communities.
  • At the fluoride concentrations recommended for the prevention of dental decay, scientific research and reviews show that human general health is not adversely affected.
  • The public health benefits of water fluoridation in the prevention of dental decay far outweigh the possible occurrence of very mild/mild dental fluorosis.
  • In establishing the recommended level of fluoride to be used in water to prevent dental decay, public health authorities should be cognisant of the balance between the prevention of dental decay and dental fluorosis. To do so, public health authorities should take into account the prevailing maximum ambient air temperature, the availability of other sources of fluoride and how they are used, as well as dietary and cultural practices in the community for individuals from infancy through childhood.
  • Water supplies to be fluoridated should be reliable and the necessary quality control measures, facilities and expertise available to implement and monitor water fluoridation should be available.
  • The dental profession, medical profession, health researchers and public health authorities should continue to research the effectiveness and safety of water fluoridation and other methods of delivering fluoride for the prevention of dental decay, and this information should be made available to the public in a transparent manner.

Other sources of fluoride are fluoride toothpaste, salt fluoridation, milk fluoridation, fluoride mouth rinses and a range of professionally applied fluoride products. FDI recommends a comprehensive preventive approach as the most appropriate method of reducing the heavy burden of dental decay worldwide and together with WHO supports the use of water fluoridation as an important public health measure.


  1. British Fluoridation Society (2012): One in a million - the facts about water fluoridation. Manchester, British Fluoridation Society.
  2. Cobiac L J, Vos T. Cost-effectiveness of extending the coverage of water supply fluoridation for the prevention of dental caries. Community Dent Oral Epidemiol 2012; 40:369-76.
  3. Griffin SO, Regnier E, Griffin PM, Huntley V. Effectiveness of fluoride in preventing caries in adults. J Dent Res 2007; 86:410-5.
  4. McDonagh M, Whiting P, Bradley M, Cooper J, Sutton A, Chestnutt I, Misso K, Wilson P, Treasure E, Kleijnen J. A systematic review of public water fluoridation. NHS Centre for Reviews and Dissemination, University of York, 2000.
  5. Health effects of water fluoridation: a review of the scientific evidence. Report on behalf of the Royal Society of New Zealand and the Office of the Prime Minister’s chief science advisor. August 2014
  6. National Fluoridation Information Service. Review of scientific reviews relating to water fluoridation between January 2000 and July 2010. Wellington, NZ: NFIS Advisory, 2011.
  7. National Health and Medical Research Council. A systematic review of the efficacy and safety of fluoridation. Canberra: Australian Government, 2007.
  8. Petersen PE. World Health Organization global policy for improvement of oral health – World Health Assembly 2007. Int Dent J 2008;58:115-21
  9. Rugg-Gunn AJ, Do L. Effectiveness of water fluoridation in caries prevention. Community Dent Oral Epidemiol 2012;40(Suppl.2):55-64.Tchouaket E, Brousselle A, Fansi A, Dionne PA, Bertrand E, Fortin C. The economic value of Quebec’s water fluoridation program. J Pub Health Dent 2013; 21; 523-37
  10. Water Fluoridation: Health Monitoring Report for England 2014. gateway 2013547
  11. UK Medical Research Council. Water fluoridation and health. London: MRC, 2002. fluoridation report.pdf.
  12. US Centres for Disease Control. Recommendations for using fluoride to prevent and control dental caries in the United States. Atlanta: CDC, 2001.
Public Health Committee

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