General Questions: Water Fluoridation

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What is fluoride?

Fluoride is a natural mineral found in soil, water (both salt and fresh), plants and various foods. In addition to natural sources, fluoride can be found in toothpastes, mouthwashes, supplements (tablets or drops), gels and rinses.

What is water fluoridation?

Water fluoridation is the process of adjusting the level of fluoride in public drinking water to the optimal level to protect against tooth decay. Approximately 45% of Canadians benefit from fluoridated water.

What are the benefits of water fluoridation?

Fluoride protects teeth from decay by strengthening the outer layer of the tooth (enamel).

Water fluoridation delivers the benefits of fluoride to an entire population, providing both a systemic and topical effect. It is particularly beneficial during tooth development as it is incorporated into the enamel, making the teeth stronger. Topical applications, such as fluoridated toothpaste, work hand-in-hand with water fluoridation to further strengthen tooth enamel.

Why is water fluoridation needed when it is available from other sources?

Water fluoridation is a cost effective and far reaching preventive public health measure. Water fluoridation ensures that all members of the community, regardless of age, education, and social-economic status, are protected against tooth decay. It can be particularly beneficial to children, seniors and other vulnerable individuals who may not have access to other preventive measures, such as regular dental care.

Is water fluoridation safe?

The safety and effectiveness of water fluoridation has been frequently studied and continues to be supported by current science. Canadian and international studies agree that water that is fluoridated at optimum levels does not cause adverse health effects.

Water fluoridation is monitored by health professionals to ensure the continued safe and effective use of fluorides. In 2007, Health Canada commissioned an independent expert panel to review scientific studies available on fluoride and its possible effects on health. The panel addressed five specific areas including: total daily intake of fluoride; dental fluorosis (discolouration of tooth enamel caused by too much fluoride); other health effects; risk assessment and the risks and benefits of drinking water fluoridation. The report from the panel reinforced Health Canada's position that water fluoridation is important from a public health perspective.

Who is responsible for fluoride in water?

Each municipality makes the decision to fluoridate water in collaboration with the appropriate provincial or territorial authority. The Federal-Provincial-Territorial Committee on Drinking Water makes recommendations about optimal fluoride levels. Health Canada has determined optimal concentration of fluoride in drinking water to promote dental health to be 0.7 mg/L.

What is dental fluorosis and should I be concerned?

Dental Fluorosis is a condition caused by a child receiving too much fluoride during tooth development, i.e. under the age of six. In its mildest and most common form, fluorosis may affect the look of a tooth, but will not affect its function.
The prevalence of dental fluorosis was studied in the 2010 Canadian Health Measure Survey. Health Canada notes that 'so few Canadian children have moderate to severe fluorosis that, even combined, the prevalence is too low to permit reporting. This finding provides validation that dental fluorosis remains an issue of low concern in this country.'

What are the cost benefits for fluoridating the water supply?

A US Center for Disease Control study estimated that every $1US invested in community water fluoridation saved $38US in avoided costs for dental treatment. 1

1.    US Department of Health and Human Services. Cost Savings of Community Water Fluoridation. Atlanta, GA. Centers for Disease Control and Prevention Division of Oral Health website, August 2007. Available online