Oral Health Program: Fluoride and Community Water Fluoridation

Community Water Fluoridation, P-40111 (PDF) is the process of adjusting the fluoride level in water to 0.7 milligrams per Liter of water (mg/L) of water or the amount that protects teeth from developing cavities.

Starting in the 1930’s, the relationship between fluoridated water and tooth decay was studied. It was discovered that children drinking fluoridated water had less tooth decay. Now, water fluoridation has been around for more than 80 years in the United States! It continues to be widely researched and studied as one of the 10 top great public health interventions of the 20th century. It is safe, effective, and supported by public health, medical, and dental organizations worldwide. The scientific consensus continues to support water fluoridation at the recommended level of 0.7 mg/L as safe and effective for preventing cavities.

In public health, interventions that work to keep entire communities and populations healthy are examined. Adding fluoride to water is an effective intervention at the population level to widely reduce cavities. Water fluoridation benefits everyone, especially those without access to regular dental care.

Additional resources

• I Like My Teeth American Academy for Pediatrics (AAP): You may have a lot of questions about fluoridation, and rightly so. We all have questions about things that impact the health of our families. Here's where to get answers without the technical talk, to make finding what you need quick and easy.
• Community Water Fluoridation FAQs CDC (Centers for Disease Control and Prevention): Read frequently asked questions about fluoridated water and infant formula, bottled water and more.
• Fluoride Myths and Facts AAP: You may have heard the myths, here is the correct information on the safety and effectiveness of fluoridation.

Tooth decay is caused by certain bacteria in the mouth. When you eat sugar and other refined carbohydrates, these bacteria produce acid that removes minerals from the surface of the tooth.

Fluoride in drinking water is absorbed by the teeth, strengthening the tooth's surface and protecting it from acid produced by bacteria. With fluoridated water, the teeth are bathed in a low concentration of fluoride throughout the day. The water you drink passes over your teeth and stays in your saliva during the day, so your teeth are always being bathed in fluoride. Brushing your teeth with fluoridated toothpaste is different. Fluoride is only applied twice per day to your tooth's surface without staying in your saliva.

Fluoride helps to remineralize tooth surfaces and prevents cavities from forming. Fluoride in the body is necessary when teeth are forming under the gums to make teeth strong. Fluoride on the surface works after teeth have erupted to continue to keep teeth strong. In children younger than age 8, fluoride helps strengthen the adult (permanent) teeth that are developing under the gums.

Fluoride benefits children and adults throughout their lives.

Water fluoridation is the best way to get fluoride, but not the only way. Natural fluoride is found in food, plants, animals, and ground water, but the amounts received in this way are usually too low to protect teeth from decay. Water fluoridation is a proven way to prevent dental decay throughout life. It’s cost-effective, doesn’t require a change in habits, and provides those without access to dental care some protection.

In people of all ages, fluoride supports tooth enamel, keeping teeth strong and healthy. Fluoridated toothpaste, fluoride rinses, and fluoride varnish lower the risk for tooth decay, especially for people who are at higher risk for decay. Although these products reduce tooth decay, combined use with fluoridated water offers protection greater than any of these products used alone.

Fluoride varnish treatments can be received in a dental office, pediatrician's office, through a local health department, or Wisconsin Seal-A-Smile programs.

Learn more about fluoride varnish.

Fluoride varnishes are a safe, simple, and effective treatment that benefits people of all ages. Fluoride varnish must be painted on teeth by health professionals, such as physicians, nurses, dental hygienists, and physician assistants. Fluoride varnish is not meant to be a replacement for fluoridated water.

What is fluoride varnish?
Fluoride varnish is a protective coating that is painted on teeth to help prevent new cavities and stop cavities that have already started.

Why is fluoride varnish recommended?

• Tooth decay (cavities) is one of the most common preventable diseases seen in children.
• Children as young as 12-18 months can get cavities.
• Cavities in baby teeth cause pain and can prevent children from being able to eat, speak, sleep, and learn properly.
• Children do not lose all their baby teeth until they are about 11 or 12 years old.
• Adults often get cavities at the gum line.
• People with certain health care needs or who are unable to brush their own teeth are at higher risk of getting cavities.

Is fluoride varnish safe?

Yes, fluoride varnish can be used on people of all ages from babies with their first tooth to adults. Only a very small amount of fluoride varnish is used.

How is fluoride varnish put on the teeth?

The varnish is painted on the teeth. It is quick and easy to apply. It stays on the teeth for many hours, but does not permanently stick to the tooth.

How often should I receive a fluoride varnish?

Your health care professional will recommend what is best for you. Typically, it is painted on the teeth two to four times per year at regular intervals.

Where can I get a fluoride varnish treatment?

Fluoride varnish treatments can be offered at a pediatrician's office, local health department, school-based dental program (Wisconsin Seal-A-Smile), long-term care facility, or dental office.

How much does a fluoride varnish treatment cost?

Fluoride varnish treatments for children are often a covered service under medical and dental insurance plans, including Wisconsin Medicaid and grant programs. Varnish treatments may be expensive for families if uninsured. Adults should ask their health care professional about charges.

Where can I learn more about fluoride varnish?

Fluoride Varnish for Adults Q+A National Maternal and Child Oral Health Resource Center publication, Fluoride Varnish for Adults Q+A in Spanish: Provides information for adults, including pregnant women, about how fluoride varnish can make teeth more resistant to tooth decay.

Fluoride is a mineral and in the right amount, fluoride in drinking water strengthens teeth.

The Wisconsin Department of Health Services follows the scientific consensus that supports 0.7 mg/L of fluoride in your drinking water as a safe and effective way to prevent tooth decay and promote good oral health.

It is important to Know Your Water's Fluoride Level, P-03442 (PDF)

Public or city water systems are tested and maintained by water operators for citizens. You can find out if your city fluoridates by visiting the CDC website, My Water's Fluoride. It allows consumers to learn about the fluoride level in their drinking water and the number of people served by the system and water source.

When a public water system fluoridates, the Wisconsin Department of Natural Resources (DNR) regulates the process through monitoring requirements and inspections to ensure the proper safety measures are being followed. At the municipal level, water operators are responsible for monitoring the fluoride level in water daily.

Fluoride found naturally in private wells is not regulated. Fluoride is present in virtually all waters but the amount varies across the state. It is important to know the fluoride content of your water.

Private well-owners are responsible for regularly testing and maintaining their well. You can test for fluoride at least once or before the water will be used by someone who is pregnant or young children. You can find more information on testing and how to interpret results in Fluoride in Private Well Water, P-03521. Fluoride levels less than 0.7 mg/L are too low for oral health protection. Parents should talk with their child's medical or dental professional about supplementing with additional fluoride sources to ensure adequate oral protection.