Fluoride

Fluoridation

What is Water Fluoridation?

Fluoride is a natural mineral that is shown to protect against tooth decay. Almost all water has some naturally occurring fluoride, but usually not enough to prevent tooth decay. Fluoridation is the adjustment of the fluoride in public drinking water to a level that is optimal for reduction of tooth decay. Fluoride is not added to water from a private well. It is a decision made at the state and local level to add it to community/public drinking water systems.

Frequently asked questions and Fluoridation according to the CDC

Why is water fluoridation important to oral health?

According to the CDC Office of Oral Health, fluoride benefits children and adults throughout their lives. For children younger than age 8, fluoride helps strengthen the adult (permanent) teeth that are developing under the gums. For adults, drinking water with fluoride supports tooth enamel, keeping teeth strong and healthy. The health benefits of fluoride include having:

Fewer cavities.
Less severe cavities.
Less need for fillings and removing teeth.
Less pain and suffering because of tooth decay.

Research proves that water fluoridation is safe, effective and the best way to improve oral health in a community. Fluoride is added to community water systems. It can also be found in some bottled water that is labeled that fluoride has been added, and tooth paste in smaller amounts.

Given the large decrease in tooth decay during the past 60 years, the Centers for Disease Control and Prevention (CDC) named water fluoridation one of Ten Great Public Health Achievements of the 20th Century.

Source: The Centers for Disease Control & Prevention

How have requirements for water fluoridation changed in CT over time?

Since 1962, the optimal level varied in the U.S. from 0.7-1.2 parts per million. At that time, drinking water, food and beverages prepared with fluoridated watet were nearly the only sources for an individual’s fluoride intake.

Fluoridation became a law (CGS Sec. 19a-38) in Connecticut on May 18, 1965, initiated by Public Act 156. PWSs serving 50,000 or more were required to begin fluoridation on January 1, 1967, and PWSs serving 20,000 to 49,999 people were required to begin fluoridation on October 1, 1967.

On January 7, 2010, the United States Department of Health and Human Services (HHS) and the EPA announced a change to the guidelines on fluoridation of drinking water. The recommendation, based on a review of scientific evidence regarding the safety and health benefits associated with community water fluoridation, establishes a single level of 0.7 mg of fluoride per liter of water. (0.7mg/L).

In May 2016, legislation was signed keeping Connecticut’s fluoridation levels in line with the federal recommendations on the optimal fluoride level for preventing tooth decay. The current requirement for PWSs to adjust the fluoride level of the water is listed in Connecticut General Statutes Section 19a-384:

A water company, as defined in section 25-32a, shall add a measured amount of fluoride to the water supply of any water system that it owns and operates and that serves twenty thousand or more persons so as to maintain an average monthly fluoride content that is not more or less than 0.15 of a milligram per liter different than the United States Department of Health and Human Services' most recent recommendation for optimal fluoride levels in drinking water to prevent tooth decay.

Fluoridation Timeline in Connecticut
1962-1965	The optimal fluoridation level varied in the U.S. from 0.7-1.2 parts per million.
1965	On May 18^th fluoridation became law in CT (CGS Sec. 19a-38). PWSs serving 50,000 or more people required to begin fluoridation on January,1,1967 and PWSs serving 20,000 to 49,999 people required to begin on October 1, 1967.
2010	On January 7^th the U.S. Dept. of Health & Human Services (HHS) & the EPA announced a change to the guidelines on fluoridation of drinking water. The recommendation establishes a single level of 0.7 mg of fluoride per liter of water. (0.7mg/L).
2016	In May, legislation was signed keeping Connecticut’s fluoridation levels in line with the federal recommendations on the optimal fluoride level for preventing tooth decay (CGS Sec. 19a-384).

Fluoridation in Connecticut Public Water Systems

Thirty-two (32) Public Water Systems in Connecticut adjust for fluoride to their drinking water and report daily fluoride levels to the DPH Drinking Water Section per Connecticut Regulation Section 19-13-B102 (12).

As of 2022, an estimated 2.2 million people (90%) in Connecticut receive optimally fluoridated drinking water from PWSs – exceeding the level of fluoridation set forth by Healthy People 2020 (Objective 0H-13) to increase the proportion of the U.S. population served by community water systems with optimally fluoridated water to 79.6 percent. It also exceeds the target (77.1%) established by Healthy People 2030 (Objective OH-11).

Connecticut’s Public Water Supply Service Area

What the Office of Oral Health (OOH) is Doing to Support Community Water Fluoridation

With a support from a federal grant from the Centers for Disease Control the OOH in partnership with DPH’s Drinking Water Section offers training to community water operators about the importance of water fluoridation as it relates to overall health and wellness, assists monitoring fluoridation levels in community water systems, and conducts ongoing public messaging on the importance of fluoride and water fluoridation for public awareness.

Resources

Connecticut:

Other:

American Academy of Pediatric Dentistry