Water Fluoridation

Oral Health, Information for Health Professionals

Community Water Fluoridation

Fluoride is a naturally occurring mineral found in soil, water and air. Over one hundred years ago, dentists discovered that people who lived in communities with naturally occurring fluoride in the water had less tooth decay. This observation led to health authorities introducing community water fluoridation as a public health measure to prevent tooth decay.  Community water fluoridation adjusts the amount of fluoride in public water supplies to a safe and effective level. Health Canada recommends fluoridation to a level of 0.7 mg/L or ppm.

Research on community water fluoridation addresses a wide array of subjects for example, the health benefits and risks, implementation, costs, the environment and the ethics of fluoridation. Research consistently shows that community water fluoridation is safe, effective, economical and poses no risk to human health. Health Canada and more than 90 other healthcare organization worldwide endorse fluoridation.

Learn more about Community Water Fluoridation in Alberta.

Research in Alberta

In Alberta, research is being conducted on the impact of cessation of community water fluoridation. In May 2011 the city of Calgary stopped water fluoridation after being in place since 1991. This provided an opportunity to compare children’s caries rates in Calgary to those in the city of Edmonton where fluoridation started in 1967 and remains to date. The research confirms that fluoride cessation in Calgary has had a negative impact on children’s oral health. This change occurred quickly, within 3 years after cessation of CWF. You can review the research here:

In 2019, the city of Calgary asked the O’Brien Institute for Public Health to provide a scholarly analysis to enhance city councils and the public’s understanding of the debate surrounding community water fluoridation. The analysis addressed benefits, harms, integrated approaches to preventing tooth decay and the community water fluoridation debate.

Research in Canada

Ethical and effective public policy must be based on the best scientific evidence available. Systematic reviews about fluoridation deliberately search for all studies, including ones about possible adverse effects. Findings from a systematic review provide a broader assessment of the evidence and its application to general population. Therefore, they provide quality, reliable information for public health recommendations.

In 2019, The Canadian Agency for Drugs and Technologies in Health (CADTH) completed a Health Technology Assessment on Community Water Fluoridation Programs. CADTH concluded that “there is consistent evidence that CWF protects against dental caries in children and adults and leads to improved oral health outcomes with very uncommon and minor side effects, and that CWF programs are cost saving from a societal perspective.”

Canadian research into sources of fluoride, mechanism of action, health impact and risks for the Canadian population are available in Guidelines for Canadian Drinking Water Quality: Guideline Technical Document - Fluoride.

Research Around the World

Water fluoridation is practiced around the world. Countries regularly conduct and update their information, including systematic reviews.

Position Statement

“Alberta Health and Alberta Health Services recognize that community water fluoridation effectively prevents tooth decay, especially among people who are most vulnerable. It offers significant benefits with very low risk and reaches all residents who are connected to a municipal water supply. Therefore, Alberta Health and Alberta Health Services endorse community water fluoridation as a foundational public health measure to prevent tooth decay and improve oral health.”

Read the full document: Alberta Health and Alberta Health Services Position Statement on Community Water Fluoridation.