Should Portland provide fluoridated water to its residents?

Written by Gary T. Chiodo, D.M.D., F.A.C.D.

Community water fluoridation has been named by the Centers for Disease Control as one of the top 10 public health measures of all time. Now, Portland has the opportunity to join with other major cities and provide fluoridated water to its residents.

Currently, 74 percent of Americans are connected to fluoridated water systems and, with the advent of fluoridation in Portland, that percentage will increase. With 65 years of fluoridation history and more than 3,000 published studies supporting this primary prevention measure, the safety and efficacy of community water fluoridation is clear. Some persuasive facts about fluoridation include:

  • For every dollar spent on fluoridation, $38 are saved in dental care.
  • 35 percent of Oregon kids have untreated tooth decay.
  • A decayed tooth restored in childhood will cost about $2000 to preserve over the lifetime of the child.
  • On average, community water fluoridation reduces dental caries (also know as tooth decay or cavities) rate by 25 percent. The reduction is much greater in areas where access to dental care is decreased due to economics or other factors.
  • There have been 20 studies that demonstrated a substantial decrease in adult caries rates in fluoridated communities.

The time is here for Portland to implement this important public health approach.


Dr. Chiodo is the Interim Dean of the School of Dentistry at Oregon Health & Science University. Dr. Chiodo is also a professor of Community Dentistry, and Senior Scholar in the Center for Ethics in Health Care.  During the first 21 years of his career, he practiced at the Russell St. Dental Clinic, a 14 operatory, public health dental clinic in Portland, Oregon that treats the majority of identified HIV-positive persons in Oregon and southwest Washington.

Dr. Chiodo received his Certificate in Health Care Ethics from the University of Washington School of Medicine in 1992.  He has served on several state and national committees related to public health, ethics, and infectious diseases; has lectured internationally on these issues; and has published over 100 peer reviewed articles related to these topics.  In 2002, he was elected to fellowship in the American College of Dentists.

Dr. Chiodo is currently on the editorial board of “Medical Research Law & Policy.”

16 responses to “Should Portland provide fluoridated water to its residents?

  1. Modern science indicates that ingesting fluoride is ineffective at reducing tooth decay and harmful to health, While topical application of fluoride may harden teeth, swallowing fluoride, neither a nutrient nor essential for healthy teeth, will cause adverse drug effects that can range from skin rashes to broken bones.

  2. There are no scientifically sound, credible studies that have demonstrated any harm due to water fluoridated at 0.7 PPM. To the contrary, over 3000 studies have demonstrated the benefits and absence of harm of community water fluoridation. It is also not correct to state that the fluoride ion has only a topical effect relative to caries prevention. During the time of tooth formation and calcification, the ion is incorporated into the apatite structure of the tooth and makes it much more resistant to acid dissolution. One demonstration of this is that children who are born and raised in a fluoridated community and who then move to a non-fluoridated community, have a reduced caries rate.

  3. I support community water fluoridation. At a time when more than 100 million Americans lack dental insurance, fluoridation offers an easy, inexpensive preventive strategy that everyone benefits from simply by turning on their tap.

  4. Fluoridation is a benefit – the harm is caused by not having community water fluoridation – in dental costs, lost school days, lost work days, and unnessary pain.

    Did you know that pregnant women with cavities are more likely to have pre-term births?

    I’m so happy that Portland will have this opportunity

  5. Contrary to NYSCOF, recent research has reaffirmed the importance of the systemic effect caused by swallowing fluoridated water in childhood.

    Iida and Kumar (2009) showed that teeth with mild fluorosis, the type associated with fluoridation, are more cavity resistant. To produce the same level of protection sealants would need be placed and maintained on “four to 15 permanent first molars, a process that would cost a great deal more.”

    Neidell (2010) found that children who swallowed fluoridated water became adults with more teeth.

    Carefully conducted epidemiological studies on humans, not simply test tube experiments, show fluoridation provides both systemic and topical benefits. The best oral health is associated with life long fluoridated water consumption

  6. I was born and raised in Norway for the first 13 years of my life and was supplied with fluoride in our drinking water and I am proud to say that today, at 28 years old, I have never had a single cavity or tooth decay of any kind! I contribute this to having fluorinated water during childhood and believe it’s important to incorporate fluoride in our tap water in the hopes of helping uninsured families in our communities!
    I think it’s a great idea and am in full support!

  7. If Portland begins to fluoridate its water I and many other residents will be quite upset. Please listen to our voice, we the majority are against fluoridation of our drinking water.
    We do not want to be forced to drink a toxic chemical EVEN IF it is claimed to be beneficial to our dental health.
    will take care of my teeth and gums with my own actions and responsibility!

  8. In most European countries, fluoride added to the water has been banned for quite some time. In the countries where it is not banned, it still isn’t added. It is unethical to medicate an entire population without consent. In addition, I would take the educated guess that European children do not have more decay than fluoridated American children.
    Regarding the poster who said that water is fluoridated in Norway, it was actually decided 30 years ago that drinking water should not be fluoridated there. Denmark has never fluoridated their water supply and neither have Sweden, Austria, or Belgium. In 2003, Basel, Switzerland stopped their fluoridation program and now there are no cities in Switzerland that fluoridate.
    It is important too see this issue from an international perspective and not only from within the context of the United States. All of the governments that have banned fluoridation have access to and have examined the same scientific studies that the American cities are citing as a reason to implement fluoridation.

  9. Norway does not fluoridate its water and neither does the rest of Europe. It is uethical to medicate the masses without consent. Also. evidence suggests that fluoride helps tp leach lead out of pipes and this leads to blood-lead level increases. The “precautionary principle” should be top priority.

  10. Fluoride is a naturally occuring mineral. It is present to some extent in all water, including the ocean, and most foods. Fluoridation simply adjusts the level of this mineral so that it is effective in preventing dental caries. Thankfully, the Portland City Council voted unanimously to fluoridate Portland’s water.

  11. This is BS, Gary, you are just a repeater of what has been repeated before you but you yourself has never looked at the science. The scientific evidence is highly inconclusive as to beneficial effects of fluoride yet we know fluoridated water causes dental fluorosis, those spots on kids teeth, and is a harmful neurotoxin. Why put something in water that isn’t proven successful? It’s insane and actually began as a way for Alcoa to get rid of its toxic by-product. It was put in the water with no independent study done.

  12. gary, your reasoning is also backwards. Something doesn’t need to be proven harmful to NOT put it in the water. On the contrary, something needs to be proven beneficial to put it in the water. Fluoride has been shown to be a very harmful neurotoxin in rats. Of course, such a study would be difficult to prove in humans. I have also read many studies that show fluoride does no benefit to the teeth and if anything harms them through fluorosis. The way overwhelming factor for dental care is diet. For instance, people who drink acidic sugary drinks like sodas get way way more caries than those that don’t.

  13. How about stats done on portland? Do they suffer caries significantly more than other cities? Why not cite any stats on portland–it’s a perfect opportunity to really test this fluoride poison.

  14. Dr. Levy, I know that you know that the scientific evidence is anything but inconclusive about the beneficial effects of optimally fluoridated community water. Oregonians do have a higher caries rate compared to the national average and there are several reasons for this. Lack of access to fluoridated water is one important reason. You may want to review the report at
    In addition, I know that you know that there are many chemicals that are healthful in correct amounts and harmful to lethal in larger amounts.

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