Community Water Fluoridation: What Dentists Can Do

By Johnny Johnson and Matt Jacob


Community water fluoridation is recommended by a long list of leading health and medical organizations, including the Centers for Disease Control and Prevention, American Dental Association and the American Academy of Pediatrics (AAP). Fortunately, 88 percent of Tennesseans who are served by public water systems receive drinking water that is fluoridated. But here’s the bad news: in recent years, several Tennessee communities have made hasty decisions to cease water fluoridation.

Dental professionals can play crucial roles to encourage their communities to continue fluoridation. A dentist in Jonesborough met one-on-one with city council members and shared important facts with them. His leadership and expertise led the city to reverse its decision and resume fluoridation.

Consider what is at stake when a community ends water fluoridation. A 2016 study compared two large cities in Canada. Calgary, the first city, ceased fluoridation in 2011. Edmonton, located 185 miles north of Calgary, provided fluoridated water throughout the study period. Researchers compared children’s cavity trends in Calgary and Edmonton both before and afterCalgary stopped fluoridation. The cavity rate for Calgary children jumped 146 percent — far higher than the rate for Edmonton kids.

Dental professionals can take concrete steps to educate their communities and encourage local officials to make informed decisions about fluoridation:

1. Tour your local water plant. If you live in a fluoridated community, contact your local water system and ask to tour the water plant. Better yet, ask others to join you. Consider inviting other dentists, a city council member, a school nurse or health services coordinator, and county health department officials. Taking a tour is a great learning opportunity. It also provides you with a chance to thank the water plant personnel who work there. Let them know they are playing a crucial role in keeping children and adults healthy by reducing tooth decay. Listen closely for any concerns they cite about operations or equipment — these may be worth sharing with your city council or local governing agency. 

2. Read your local water system’s consumer confidence report.
YOU are the most critical person to monitor whether fluoridation is being appropriately delivered as promised in your community water supply.  Read the Consumer Confidence Report every year.  If it isn’t 0.7ppm, inquire why.  Contact your water company to find out why it is not optimal.  Contact the state Department of Health.  The American Fluoridation Society may be able to help if you aren’t satisfied with what you’ve been told.
A few years ago, AFS was reviewing these reports from another state when — much to our surprise — we discovered that a city water system that was supposedly fluoridated was, in fact, not adding enough fluoride. We contacted state and local officials and shared what we had found. They were as shocked as we were and took the necessary steps to ensure this urban water system resumed fluoridation.
The CDC has an excellent resource where anyone can look up the fluoridation status by county and community.  This resource is called “My Water’s Fluoride”.  This website is intended for everyone, public and professionals, to quickly look up information on their fluoridation status.

3. Use your social media, website and physical space to post positive messages about fluoride. Posters and other materials can provide positive, accurate information about fluoride on the walls of your dental practice or clinic. If you have a Facebook or Twitter account, share graphics or videos that promote fluoride in toothpaste and water, as well as encouraging families to drink plenty of water (as opposed to sugary drinks). If your practice has a website, create a page or section called “What About Fluoride?” that provides information about fluoride. Feel free to draw information for your website from the “Water Fluoridation Basics” page of the Centers for Disease Control and Prevention.

Here’s where you can find resources to help you with social media as well as finding posters for your practice or clinic:

  • The AAP manages an oral health website providing samples of posters, videos and other materials about fluoride and water. Explore these materials at Contact Hollis Russinof at AAP ( if you would like a printed copy of these posters.

4. Monitor the letters published by your local newspaper. Read the letters to the editor (LTEs) in your local newspaper. If an LTE in your newspaper attacks fluoride or makes a misleading statement, write an LTE in response. In your letter, focus on the facts and avoid making any personal attacks. Many people who criticize fluoride or fluoridation are simply repeating what they read on a web page or Facebook post. Dentists are respected members of their communities. Residents will appreciate it when you weigh in to clarify what the evidence shows.
Dentists who lend their voice can make a powerful difference to improve oral health. Feel free to contact the American Fluoridation Society if you need technical assistance or other support.

Johnny Johnson, DMD, MS, is a Florida pediatric dentist who serves as president of the American Fluoridation Society (AFS). Matt Jacob is a communications and training consultant for AFS. For more information, visit