We, the undersigned organizations, stand firmly in support for community water fluoridation. Recognized as one of the greatest public health accomplishments of the 20th century, community water fluoridation is a safe and effective way to improve oral health for all, regardless of age, education, income and access to dental care. We are concerned about recent divisions over community water fluoridation and worry about potentials impacts on the oral health of Wisconsin residents if this program were discontinued.
Fluoride is a naturally occurring mineral that works to improve oral health in two important ways. Small amounts of fluoride in drinking water are absorbed by growing teeth, building the foundation for a healthy smile for life. Community water fluoridation also supports healthy teeth for adults by coating the teeth with a small amount of fluoride throughout the day, suppressing cavity causing bacteria. Through these two crucial mechanisms, community water fluoridation can reduce cavities by at least 25%[1]. Healthy teeth are more than just teeth – research continues to find they play a crucial role in overall health and well-being. Tooth pain is a leading reason children miss school across the nation, resulting annually in 34 million lost school hours to emergency dental care[2]. Furthermore, poor oral health plays a role in heart disease, diabetes, low birth weight and can even lead to life-threating infections and death.
Safety has always been a priority for community water fluoridation. Fluoride exists naturally in all drinking water sources, however often not at the level shown to reduce dental disease. In the U.S., water is fluoridated at 0.7 parts per million (ppm), a level carefully selected based on a large body of evidence, to provide the maximum benefits and minimal risk. As advocates for evidence-based practices, we welcome new research that challenges current thinking, provided it meets scientific standards. This includes, but is not limited to: transparency, reproducibility, low to minimal bias and peer review. To date, no credible scientific evidence, including the National Toxicology Program’s (NTP) recent report on fluoride, has found this level to be dangerous[3].
The NTP report explicitly states, “Higher estimated fluoride exposures” may be associated with neurological effects in children. Higher fluoride exposures are defined as above 1.5 ppm – more than double the level used in community water fluoridation in the U.S. The NTP report also notes that studies suggesting a possible correlation between high levels of fluoride and intelligence quotient scores in children had significant bias. No credible study included in the NTP report found the small amount of fluoride added to drinking water to be dangerous. Meanwhile, credible studies continue to find community water fluoridation safe and effective, such as a recently published study from Australia including more than 2,000 children, finding no link between intelligence and recommended levels of water fluoridation[4]. Most notably, neither the NTP report nor the recent lawsuit involving the U.S. Environmental Protection Agency recommended ending water fluoridation, due to a lack of strong evidence against the practice.
Calgary, Alberta, serves as a strong reminder of the preventive power of community water fluoridation. In 2011, Calgary’s City Council chose to discontinue community water fluoridation. As a result, dental disease has increased significantly, with a 700% increase in the number of children receiving IV antibiotics for dental infections, half of whom were under 5 years old[5]. The increase in dental disease has been so severe the city must now invest nearly $20 million to reintroduce fluoride into tap water and combat the oral health crisis it created[6].
As longtime advocates for the health and well-being of children in Wisconsin, we are deeply concerned about families losing access to preventative oral health care with the discontinuation of community water fluoridation happening statewide. For every dollar invested into community water fluoridation, there is a savings of $38 per person in dental care costs[7] – totaling nearly $6.1 million across Wisconsin. Families from underserved populations, including Wisconsin’s rural communities, who already face significant dental professional shortages will be most impacted. We also know waitlists for dental offices can be incredibly long, ranging from months to years. There is genuine concern that Wisconsin will not be able to meet increased demand for dental services that will inevitably result from ending community water fluoridation.
While communities statewide engage in important discussions about community water fluoridation, we encourage families, advocates and local leaders to consult their trusted oral health care providers to learn more about the strong evidence on the safety and efficacy of fluoride. Independent, nonpartisan organizations that have long been champions of children’s health, including the American Academy of Pediatrics and the American Dental Association, continue to support community water fluoridation. Discontinuing this effective, evidence-based program would negatively impact community well-being and represent a significant setback in prevention.
[1] https://www.ada.org/about/press-releases/community-water-fluoridation-at-optimal-levels-is-safe-and-effective
[2] https://www.cdc.gov/nccdphp/priorities/oral-disease.html
[3] https://ntp.niehs.nih.gov/publications/monographs/mgraph08
[4] https://pubmed.ncbi.nlm.nih.gov/36214232/
[5] https://www.cbc.ca/news/canada/calgary/fluoride-water-calgary-edmonton-cavity-children-1.6162686
[6] https://calgaryherald.com/news/fluoride-restored-drinking-water-calgary-march-2025#:~:text=Shortly%20after%20they%20were%20elected,returned%20to%20Calgary's%20drinking%20water.
[7] https://www.cdc.gov/fluoridation/about/?os=bingquiz.com%2Fbing-weekly-quiz-answers%2Fy0VZMAqv&ref=app
As longtime advocates for the health and well-being of children in Wisconsin, we are deeply concerned about families losing access to preventative oral health care with the discontinuation of community water fluoridation happening statewide. For every dollar invested into community water fluoridation, there is a savings of $38 per person in dental care costs[7] – totaling nearly $6.1 million across Wisconsin. Families from underserved populations, including Wisconsin’s rural communities, who already face significant dental professional shortages will be most impacted. We also know waitlists for dental offices can be incredibly long, ranging from months to years. There is genuine concern that Wisconsin will not be able to meet increased demand for dental services that will inevitably result from ending community water fluoridation.
While communities statewide engage in important discussions about community water fluoridation, we encourage families, advocates and local leaders to consult their trusted oral health care providers to learn more about the strong evidence on the safety and efficacy of fluoride. Independent, nonpartisan organizations that have long been champions of children’s health, including the American Academy of Pediatrics and the American Dental Association, continue to support community water fluoridation. Discontinuing this effective, evidence-based program would negatively impact community well-being and represent a significant setback in prevention.
[1] https://www.ada.org/about/press-releases/community-water-fluoridation-at-optimal-levels-is-safe-and-effective
[2] https://www.cdc.gov/nccdphp/priorities/oral-disease.html
[3] https://ntp.niehs.nih.gov/publications/monographs/mgraph08
[4] https://pubmed.ncbi.nlm.nih.gov/36214232/
[5] https://www.cbc.ca/news/canada/calgary/fluoride-water-calgary-edmonton-cavity-children-1.6162686
[6] https://calgaryherald.com/news/fluoride-restored-drinking-water-calgary-march-2025#:~:text=Shortly%20after%20they%20were%20elected,returned%20to%20Calgary's%20drinking%20water.
[7] https://www.cdc.gov/fluoridation/about/?os=bingquiz.com%2Fbing-weekly-quiz-answers%2Fy0VZMAqv&ref=app