Fluoride Action Network

Water Fluoridation

"Fluoridation goes against all principles of pharmacology. It’s obsolete." -- Dr. Arvid Carlsson, Nobel Laureate in Medicine/Physiology.


Fact 1:

Fluoride Is Not a Nutrient. 

The National Academy of Sciences has confirmed that fluoride is not an essential nutrient. Humans, therefore, do not need fluoride for the prevention of any human disease. This distinguishes the practice of fluoridating water from the practice of adding iodine to salt; humans need iodine, they do not need fluoride.

Fact 2:

Not a Single “Randomized Controlled Trial” Has Ever Proven Fluoridation Works. 

Despite over 60 years of water fluoridation, there has yet to be a single randomized controlled trial (RCT) to demonstrate its benefits (or safety). An RCT is the gold standard for medical treatments and, under current medical standards, most drugs are not allowed to enter the market without one. Were fluoridated water defined as a medical treatment (which, logically, it is), it would not have sufficient evidence to gain approval from licensing bodies.

Fact 3:

Fluoride Works Topically, Not Systemically. 

Water fluoridation began in the 1940s under the premise that swallowing fluoride is the most effective way to strengthen teeth. It is now known, however, that fluoride’s main benefit comes from topical contact with teeth, not from ingestion. Even if fluoridated water has a benefit, therefore, there is no need to swallow it.

Fact 4:

No Difference in Tooth Decay Between Fluoridated and Non-Fluoridated Countries.

The CDC’s Oral Health Division has called water fluoridation one of the “top 10 public health achievements of the twentieth century.” Yet, according to comprehensive data compiled by the World Health Organization, there is no discernible difference between the few western countries that fluoridate their water, and the majority that do not. WHO’s data also shows that, over the past 40 years, non-fluoridated countries have experienced the same large decline in tooth decay as fluoridated countries.

Fact 5:

Fluoridation Prevents Cavities in Less than 1 out of 100 Tooth Surfaces. 

In 1986 and 1987, the National Institute of Dental Research (NIDR) conducted the largest study on dental health ever conducted in the United States, examining over 39,000 children in 84 areas of the country. When the results of the study were later obtained under a Freedom of Information Act request, it was shown that children who lived their whole lives in fluoridated areas had no less decayed teeth (“Decayed, Missing, or Filled Teeth,” DMFT) than children from non-fluoridated areas. This finding has never been refuted. However, when a more sensitive measure of tooth decay (DMFS) was used, a difference of 0.6 tooth surfaces was found between the fluoridated and non-fluoridated areas. A difference of 0.6 tooth surfaces, however, represents less than 1% of the 100+ tooth surfaces in a child’s mouth! Other large, modern studies have found similar results:  very small differences in DMFS, and no difference in DMFT.

Fact 7:

Fluoridated Does Not Prevent Oral Health Crises in Low Income Communities. 

Despite some claims and insinuations to the contrary, water fluoridation does not prevent the oral health crises that result from rampant poverty, lack of access to dental care, and lack of access to healthy food. This is evident by the fact that oral health crises are occurring in major urban areas. As but one of many examples, the Dental Director in Cincinnati (a city that has been fluoridated since 1978) described the oral health situation as follows:

‘We cannot meet the demand. It’s absolutely heartbreaking and a travesty. We have kids in this community with severe untreated dental infections. We have kids with self-esteem problems, and we have kids in severe pain and we have no place to send them in Cincinnati. People would be shocked to learn how bad the problem has become.’”

This raises the obvious question: If fluoridation in America’s urban areas has failed to prevent the current oral health crisis, why should anyone believe it can prevent the next one?

Fact 8:

Fluoridation Does Not Prevent Baby Bottle Tooth Decay (Early Childhood Caries). 

Published research has also found that fluoridation is ineffective at preventing the most serious oral health problem facing poor children, namely “baby bottle tooth decay,” otherwise known as early childhood caries (Barnes 1992; Shiboski 2003). Low-income communities need dental care, not cheap industrial chemicals in their water.


Tooth decay does not go up when fluoridation is stopped.

Where fluoridation has been discontinued in communities from Canada, the former East Germany, Cuba and Finland, the rate of tooth decay did not increase. Instead, the rate of tooth decay continued to decline.

FACT 10:

Fluoridation Is Much More Likely to Cause Dental Fluorosis than Reduce Decay 

When the water fluoridation program was endorsed by U.S. health authorities in the 1950s, proponents argued that fluoride intake in fluoridated communities would produce a very sharp reduction in tooth decay with only a very minimal effect on dental fluorosis. Proponents argued that fluoridated water would reduce tooth decay by over 60% while limiting dental fluorosis to only about 10% of children. This prediction did not prove true. The failure of the prediction is readily apparent when comparing the predicted relationship with the actual relationship observed in the NIDR’s national survey.

The failure of the prediction has also been highlighted by a multi-million dollar, decades long NIH-funded study that investigated the relationship between daily fluoride intake, tooth decay, and dental fluorosis from birth through adolescence. In 2009, the investigators reported that they could detect no significant association between tooth decay and total fluoride intake, but that a clear association existed between total fluoride intake and dental fluorosis.  In other words, the daily intake of fluoride had little relationship with beneficial tooth outcomes (prevention of cavities), but a significant relationship with detrimental tooth outcomes (dental fluorosis). This was not the risk-benefit trade-off on which the water fluoridation program was sold.

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