Community water fluoridation (CWF) is the single most important step a community can undertake to reduce tooth decay and the Centers for Disease Control and Prevention (CDC) named fluoridation of drinking water to prevent tooth decay as one of Ten Great Public Health Interventions of the 20th Century and recommended by the Community Preventive Service Task Force and U.S. Surgeon General. Fluoride is a naturally occurring mineral that is an effective way to prevent and protect teeth from tooth decay. Fluoride stops or can even reverse the tooth decay process, keeping tooth enamel strong and solid, for both children and adults. CWF is the controlled adjustment of fluoride in a public water supply to reach to optimal  level needed to improve oral health and reduce dental tooth decay. CWF represents a population-based intervention that reaches all members of the community regardless of age, education attainment, income level and access to preventive service.

California’s fluoridated drinking water act, Assembly Bill 733, became law in 1995, requiring water systems with 10,000 or more service connections to fluoridate their water supply when funding becomes available. Metropolitan Water District of Southern California (MWD) and the San Francisco Public Utilities Commission (SFPUC) have joined many of the nation’s public water suppliers in adding fluoride to its water supply. MWD began providing fluoridated water to Cal Water’s service areas in November 2007, and SFPUC has fluoridated most of its water supplies since the 1950s.

Restricting Factors:

• Opposition to fluoridation
• Multiple sources (natural, adjusted, multiple sources/well sources)

Contributing Factors:

• Most sources of drinking water naturally contain some fluoride.
• CWF is the process of adjusting the national occurring fluoride levels to optimal levels for good oral health.
• Existence of the state laws and policies

Anticipatory Factors:

• Availability of funds
• Water Quality testing

• California State Water Resources Control Board
• Local Oral Health Programs
• American Dental Association
• American Academy of Pediatric Dentistry
• Center for Diseases Control and Prevention

• Having champions and building community support for CWF.
• Support water operators through CDC resources to maintain compliance with reporting and to enhance performance.