Community Water Fluoridation: Nature’s Way to Fight Tooth Decay

By: Sara Carmichael Water Fluoridation Coordinator Iowa Department of Public Health

Tooth decay is the most common, chronic disease among children and the elderly. One in 5 people has untreated decay, also known as cavities,[1] which severely impacts social development, self-esteem, and overall quality of life.

But cavities are preventable! Besides practicing good oral hygiene like brushing twice a day for two minutes, flossing, and eating a healthy diet, an easy way to prevent cavities is by drinking optimally fluoridated water. The adjustment of fluoride levels in drinking water is called Community Water Fluoridation (CWF). Best of all, everyone benefits from water fluoridation, regardless of income, education, or place of residence. Fluoride is naturally present in all water sources, including surface water, groundwater, and pic 1oceans. Water fluoridation is the adjustment, up or down, of the natural fluoride to a recommended level of 0.7 mg/L to prevent tooth decay. The fluoride additives are produced from phosphorite rock, a type of limestone. The mechanism of production can be seen in the following diagram. All fluoride additives are thoroughly tested, regulated, and determined safe by the Environmental Protection Agency and independent organizations, including NSF International and Underwriters Laboratories.

Adding fluoride to water is managed by the local water operator to make sure the optimal amount is used. There are three additives for water fluoridation. The decision on which additive to use is based on cost, space, availability, and equipment. The three additives are

  • Fluorosilicic acid: a water-based solution used by most water systems in the United States.
  • Sodium fluorosilicate: a dry salt additive, dissolved into a solution before being added to the water.
  • Sodium fluoride: a dry salt additive, typically used in smaller water systems, and dissolved into a solution before being added to the water.

Currently, about 70% of Iowans have access to optimally fluoridated water. If you are on a community water system and want to know the level of fluoride, visit the CDC’s website, My Water’s Fluoride, at

Community water fluoridation is so effective at preventing decay that the Centers for pic 2Disease Control and Prevention named it one of 10 public health achievements of the 20th Century. Study after scientific study has shown that CWF reduces the amount of cavities seen in baby teeth by at least 35% and reduces decay in permanent teeth by at least 25%.[2] Over 100 national and international organizations support CWF, including the American Cancer Society, American Academy of Family Practice, and World Health Organization.

For more information, please contact Sara Carmichael, Water Fluoridation Coordinator at the Iowa Department of Public Health, at 515-204-3450 or




Project AWARE 2017

 Photo of Cedar River Coalition partners. Photo from @IWAReduceFloods, the Twitter account for the Iowa Watershed Approach.

Getting Down and Dirty for Cleaner Iowa Rivers

Last week we participated in cleaning up an Iowa river alongside the Iowa Department of Natural Resources and other water partners across the state for Project AWARE. This event is a week-long outdoor expedition to clean up a selected Iowa river. The purpose of this event is to increase awareness of and engagement with Iowa’s public waters. It gives Iowans the opportunity to make a difference in water no matter who they are and what they do in the state. Participants have the opportunity to do the cleanup for one day or stay and camp the whole week.

This year, the event was held on the Cedar River in Mitchell and Floyd Counties from July 10-14. Hundreds of water partners and community members across the state joined for this year’s cleanup. We attended the fourth day of the event. Our starting point was about 19 miles up river from Charles City, Iowa. Once we arrived in Charles City, we had the opportunity to go inner tubing down the Charles City Whitewater course to the campsite to receive a t-shirt and join in on evening fun at the site.

While we only attended one day of the trip, we found many canoe-loads of trash that does not belong in a river, such as barrels, tires, and even a couch!

See photos below for the highlights!

Introducing a new intern by reflecting on #iowah2o

Marianne Murchison joined the Iowa Water Center as an intern from University of Missouri Columbia Masters of Public Health Policy and Promotion program in June 2016.  Her background is in Political Science, Nonprofit Management and Public Health Policy.  Since 2013, she has been supporting conservation efforts of the USDA NRCS in Iowa, Missouri and Oklahoma.  She hopes to merge her education and experience to positively impact how the public views water quality and conservation as a public health issue.

“Drinking water supply is multidisciplinary.” – P. Barry Butler. These were the opening remarks for University of Iowa Public Policy Drinking Water Symposium titled Iowa’s Drinking Water: Could Flint Happen Here? held on June 17th 2016 in Des Moines.  Throughout the day, speakers elaborated on their areas of expertise concerning Iowa’s drinking water concerns.  Topics covered included: supply and demand (mainly making sure we price the commodity accurately), Lessons that Iowa can learn from the Flint, Michigan water crisis, exploration of the technology and innovation that are poised to revolutionize the drinking water industry, Iowa’s agricultural and natural threats to its drinking water supply and the best way to use policy to protect Iowa’s Drinking Water.  Each topic further elaborated on how complex an issue access to safe water resources is in the state and beyond.

The overarching message was that Iowa’s drinking water concerns are environmental and public health problems.  Framing safe drinking water as a public health necessity brings everyone together around this issue.  While there were various opinions of how to protect and improve Iowa’s water resources were discussed, what was not up for debate was that if nothing is done, Flint-like problems could hit vulnerable water resources and aging infrastructure in Iowa and beyond.  Everyone is part of the problem we all must be part of the solution.  Iowans and water quality experts need to own their responsibility to solve and prevent water quality issues and, in Gandhi’s words, “be the change we want to see in the world” . . . of water.

Comment below and tell us what part you play in a sustainable future for Iowa’s drinking water.