Date of Completion


Embargo Period



Dr. Scott Wetstone, Russell Melmed, MPH

Field of Study

Public Health


Master of Public Health

Open Access

Open Access


There is a bourgeoning controversy unknown to many surrounding one of the CDC’s top ten public health achievements of the 20th century. After more than 50 years of implementation, community water fluoridation may not have achieved the declines in caries rates we once thought or hoped for, especially in light of alternative approaches to preventing caries including but not limited to other sources of fluoride supplementation, changes in diet, and tooth brushing behavior.

In fact, a survey of past research highlights the fact that this policy decision may be based on out of date and/or a lack of research all together. With 92% of adults ages 20-64 having dental caries in 2004, caries rates continue to be an issue today.1 Dental caries are not just a cosmetic problem, they are a serious health condition that have many negative consequences in a person’s quality of life.2 The use of community water fluoridation has remained controversial in terms of the rights of the individual to make his/her own health care decisions versus the right of the state to make public health interventions, and it remains costly. Estimates in pre-2002 dollars put a town’s cost of community water fluoridation between $0.40 and $2.70 per person based on the size of the community.3 This paper explores the scientific discoveries and social factors influencing the decision to recommend community water fluoridation, highlighting conflicting information and timelines.

Major Advisor

Dr. David Gregorio