July 7, 2020
CHIEF DENTAL OFFICERS’ STATEMENT OF SUPPORT OF COMMUNITY WATER FLUORIDATION COMMEMORATING THE 75TH ANNIVERSARY

In commemoration of the 75th anniversary of community water fluoridation (CWF), we, the undersigned, offer this statement of support.

Since the groundbreaking research on the effects of fluoride in water on dental caries in the 1930s by H. Trendley Dean, a U.S. Public Health Service (USPHS) dental officer who was head of the Dental Hygiene Unit at the National Institute of Health, the USPHS has been at the forefront of this issue. In 1945, the U.S. Surgeon General and the National Institute of Dental Research sponsored the first water fluoridation implementation in Grand Rapids, Michigan, and a study of data from that effort demonstrated a 60 percent drop in dental caries among Grand Rapids children after just 11 years.

Now we celebrate 75 years of CWF in the United States, described by the Centers for Disease Control and Prevention as one of 10 great public health achievements of the 20th century (along with vaccination, recognition of tobacco use as a health hazard, control of infectious diseases, and others). CWF has been hailed by numerous USPHS leaders, beginning with Surgeon General Leonard A. Scheele who in 1951, before the Senate Subcommittee on Appropriations, affirmed CWF as official policy of the USPHS (McClure, FJ, Fluoridation. 1970). In 2001, Surgeon General David Satcher, who commissioned the first-ever Surgeon General’s Report on Oral Health, stated that “more than 50 years of scientific research has found that people living in communities with fluoridated water have healthier teeth and fewer cavities…” In 2004, Surgeon General Richard Carmona added that CWF “continues to be the most cost-effective, equitable and safe means to provide protection from tooth decay in a community,” and in 2016 the immediate past Surgeon General, Vivek Murthy, said that “our progress on this issue has been undeniable.”

Indeed, our progress on CWF in the U.S. has resulted in fluoridation in 46 of the 50 largest cities in the country and for populations served by community water systems, over 70 percent benefit from having optimum levels of fluoride. Over seven decades of research have shown the dramatic decreases in dental caries as a result of CWF, not just in children but throughout the lifespan. As a result, CWF has been a cornerstone of the Nation’s Healthy People Priorities since their inception in 1980, and explains why almost every major medical, dental and public health organization supports CWF. The American Public Health Association, for example, has recommended “fluoridation of all community water systems as a safe and effective public health measure for the prevention of tooth decay,” while the American Academy of Pediatrics says that CWF “is beneficial for reducing and controlling tooth decay and promoting oral health in children and adults.”

Community water fluoridation is the great equalizer in prevention of dental caries because all individuals regardless of income or education are able to access their public tap water. In addition to being a safe and effective disease prevention measure, it also is low in cost. Prevention of dental caries through CWF provides “a lifetime of cavity prevention for less than the cost of one dental filling,” as then-Surgeon General Regina Benjamin stated in 2013, a statement that is still true today.

As the former chief dental officers of the USPHS, we have spent our entire careers dedicated to improving the Nation’s oral health. Continued efforts to support CWF anchors our efforts to achieve health equity. With the forthcoming release of the second-ever Surgeon General’s Report on Oral Health, and in commemoration of the 75th anniversary of CWF in Grand Rapids, we reaffirm our support and commitment to CWF. The first Surgeon General’s Report had as its major message that “oral health means much more than healthy teeth…it is integral to the general health and well-being of all Americans.” Please join us in resolving to support CWF, one of the greatest public health achievements and a cornerstone to the prevention of dental caries and improvement of both oral health and overall health.

RADM (Ret.) Nicholas S. Makrides, DMD, MPH
USPHS Chief Dental Officer, 2014-2018

RADM (Ret.) William D. Bailey, DDS, MPH
USPHS Chief Dental Officer, 2010-2014

RADM (Ret.) Christopher G. Halliday, DDS, MPH
USPHS Chief Dental Officer, 2006-2010

RADM (Ret.) Dushanka V. Kleinman, DDS, MScD
USPHS Chief Dental Officer, 2001-2006

RADM (Ret.) William R. Maas, DDS, MPH
USPHS Chief Dental Officer, 1997-2001

RADM (Ret.) Stephen B. Corbin, DDS, MPH
USPHS Chief Dental Officer, 1995-1997

RADM (Ret.) Robert J. Collins, DMD, MPH
USPHS Chief Dental Officer, 1991-1995

RADM (Ret.) Robert E. Mecklenburg, DDS, MPH
USPHS Chief Dental Officer, 1981-1987

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