Fluoride Action Network

Anti-Fluoridation Efforts Threaten Oral Health Protections for Children in Washington State

Source: Northwest Bulletin (University of Washington, School of Public Health) | March 30th, 2019 | By Kristopher A. Kerns, MPH-D

Guest Author / Kristopher A. Kerns, MPH-D will complete his Graduate Certificate in Maternal and Child Health in 2019 and his Doctoral Degree in Oral Health Sciences in 2021 at the University of Washington School of Public Health and School of Dentistry. He is currently investigating dysbiotic shifts in the oral microbiome in relation to oral diseases, focusing on dental caries and its etiology in children.

Public health interventions are no strangers to misinformation, alternative facts, and debate. Similar to the public discourse on vaccination programs, community water fluoridation has been a hot topic since its initial promotion more than 70 years ago. Water fluoridation is shown to be relatively inexpensive, provide blanket coverage to all children regardless of race, language, ethnicity, culture, or income levels, and reduce new decay by up to 25% by doing nothing more than drinking water from your sink.1

But campaigns that misconstrue the role and history of water fluoridation and its impact on human health put increasing pressure on local jurisdictions all over the state to discontinue the program. These threats present a risk to the oral health of young children and adolescents who otherwise may not have any access to other preventative or essential oral health care services.


The Washington Smile Survey measures the oral health of children and adolescents in the state every 5 years

Communities like Port Angeles and Woodland have recently stopped fluoridating their community water supplies due to these ongoing anti-fluoridation campaigns, says Shelley Guinn, Oral Health Program Coordinator and Consultant for the Washington State Department of Health (DOH). Although Washington is currently meeting or exceeding national goals set by the Healthy People 2020 initiative for reducing tooth decay in children and adolescents, the percentage of Washingtonians who live in communities with optimum fluoridated drinking water dropped from 64% in 2014 to 56% most recently, well below the national average of 75%. 2

More than half the state’s third-grade aged children, 8-10 years old, suffer from tooth decay, noted Guinn, the lead author of the 2016 Washington State Smile Survey. Even more concerning is that these rates of decay are disproportionate among children of color and those from a low socioeconomic status background. It is no doubt that fluoride varnish and sealant programs in combination with community water fluoridation are behind preventing even higher rates of tooth decay.


Re-educating local governments, community leaders, and the general public about the importance of water fluoridation and its role in oral health is critical in protecting vulnerable children and adolescents, says Guinn. Along with and the pursuit of stakeholder support.Although one of the primary goals of the Washington DOH is to promote the benefits of community water fluoridation, the Oral Health Program is currently funding-challenged and operates with a staff of 1.

Without essential resources, volunteers, and the capacity to pursue stakeholder support the department is unable to take action to prevent water fluoridation roll-back efforts; leaving Washington’s residents who currently benefit from fluoridated water at risk of losing this essential dental public health service.

This is largely concerning for Washington’s children and adolescent populations who are often unable to make family decisions about diet, oral hygiene, or access to oral health care services. Where access to community water fluoridation may be a child’s only oral disease prevention modality, this public health benefit is more important than ever to protect.


1. Community Preventive Services Task Force. Improving Oral Health: Community Water Fluoridation. 2017. https://www.thecommunityguide.org/sites/default/files/assets/OnePager-Or…

2. Washington State Department of Health. Washington State Smile Survey: A Report on the Oral Health of Washington’s Children. 2017. https://www.doh.wa.gov/Portals/1/Documents/Pubs/340-309-2016SmileSurvey.pdf