Fluoride and Community Water Fluoridation (CWF)

Fluoride Resources and Information

Stronger, healthier teeth may be as close as your kitchen sink. It is possible to prevent and even reverse dental decay and disease by drinking water that is fluoridated to optimal levels. Scroll down to learn more.

Fluoride & CWF




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  Recent Events & News About Fluoride

  •  Gloucester, MA : A majority of Gloucester residents vote to keep adding fluoride to its water system (November 2015)
  •  Rockport, MA Rockport to keep fluoride (May 2015)  
  •  How we learned to stop worrying and love fluoridated water: Boston Globe editorializes that community water fluoridation’s opponents’ “half-baked reasons for asking Rockport and Gloucester to end water fluoridation aren’t much more convincing than the Cold War-era conspiracy theories” a la the satire Dr. Strangelove. (April 2015)
  • Concord, MA: Concord voters flush plan to remove fluoride from drinking water (April 2015)
  • Topsfield, MA: MDS Members Drs. Grady, Collins, Carroll, McAllister, Keliher, Phoenix, Stozanski, Mattson, and Lawton team up with physician Dr. Norman Gaudrault for a compelling letter to the editor
  • Oak Bluffs, MA: Voters approved maintaining fluoridated water, thanks in part to an editorial from MDS members Dr. Golden, Orazem, Cullen, Nadelstein, Samuels, and Schaeffer




What Is Fluoride and Its Benefits?

Fluoride is an ion found in abundance in the earth's crust from the element fluorine. In its gas state, fluorine does not exist in its free state in nature. Rather, fluorine exists in the fluoride compound found in rocks and soil. Water becomes fluoridated in nature when water passes over the rocks and soil, releasing the fluoride ions. As a result of this process occurring in nature, all water contains varying amounts of fluoride. The varying fluoride levels found in nature can be attributed to the water depth and the quality of the fluoride ions in the area. For example, oceans have a fluoride level ranging from 1.2 - 1.4 parts per million (ppm). Most food and water contain varying levels of fluoride.

Fluoride is known as nature's cavity fighter and protects teeth when introduced both systemically and topically. Systemic fluorides are ingested into the body. These fluorides are necessary for children because they are incorporated into pre-eruptive dental structures. Teeth protected during this period enjoy longer lasting protection against decay and dental carries than teeth that receive topical fluoridation. Topical fluorides protect and strengthen post-eruptive teeth and can prevent decay and dental carries. 

Fluoride is one of the world's most studied substances. Thousands of studies have been conducted over the past 60 years to establish and confirm fluoride's benefits:

  • Fluoride is safe. Countless studies have been conducted proving fluoride's safety.
  • Fluoride is inexpensive. It costs between $.50 to $3.00 per capita per year to fluoridate a community's water supply. Every dollar spent on community water fluoridation (CWF) saved $38 in dental restoration costs.
  • Fluoride benefits everyone—regardless of age and socioeconomic status.


What Is CWF and Which Massachusetts Communities Are Fluoridated?

Community water fluoridation (CWF) is the adjustment of sub-optimally fluoridated water levels up to the levels recommended for optimal dental health. The United States Public Health Service determined the optimal fluoride concentration levels range from 0.7 - 1.2 ppm. 

One milligram per liter (mg/L) of fluoride in water equals one part per million (ppm). One ppm of fluoride is diluted in a million parts of water. The following comparisons give an idea of the amount of one part per million: 1 inch in 16 miles; 1 minute on 2 years; 1 cent in $10,000.

At this range, dental decay is effectively reduced while minimizing the risks of dental fluorosis. The optimal level for a location depends on the annual average maximum daily air temperature of the geographic area.

There are three types of additive options approved by the American Water Works Association and NSF International: sodium fluoride, sodium fluorosilicate, and fluorosilic acid. The benefits of community water fluoridation are the same regardless of the source.


What Do Others Have to Say About Community Water Fluoridation (CWF)?

Fluoride is one of the earth's most studied substances. Click on the resources and information below to learn more.


ADA Resources



Is Your Community Water Fluoridated?

Check the list of Massachusetts cities and towns.



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