Water fluoridation is considered one of the most successful public health interventions of the 20th century and salt fluoridation has proven to be a cost-effective method for reducing caries in the Latin America and Caribbean Regions. The introduction of systemic and topical fluorides have drastically reduced the rate of dental decay worldwide.

This section offers information on fluoridation facts, national programs, varying modalities of fluoride use, as well as information about the practice of adding fluoride compounds to water, salt, etc. with the intended purpose of reducing tooth decay in the general population.


Introduction and Fact Sheets

Statements from Six Leading Health Authorities Regarding Community Water Fluoridation (31.4 kB) (Statements from ADA, CDC, AMA, U.S. Surgeon General, National Institute of Dental & Craniofacial Research (NIDCR), and WHO.)

Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States (CDC Morbidity and Mortality Weekly Report, 2001. Guide for dental and other health-care providers, public health officials, policy makers, and the public in the use of fluoride to achieve maximum protection against dental caries while using resources efficiently and reducing the likelihood of enamel fluorosis.)


Scientific and Technical Publications

Salt Flouridation

Promoting Oral Health: The Use of Salt Fluoridation to Prevent Dental Caries (1.21 MB)  (PAHO, 2006.  Introduction to book including salt fluoridation fact sheet, preface, press release and information about ordering a copy.)

pdf Promoción de la Salud Bucodental: El Uso de la Fluoruración de la Sal para Prevenir la caries dental (8.14 MB)  (PAHO, 2005.  Historia y ejemplo de éxito de experimentos, progreso en la Región, recomendaciones para educar comunidades sobre la fluoruración de la sal, métodos de producción y marketing de la sal y planificación estratégica para implementación de la fluoruración de la sal.)

pdf Promoting Oral Health: The Use of Salt Fluoridation to Prevent Dental Caries (7.35 MB)  (PAHO, 2005.  History and success stories of early experiments, progress in the Region, recommendations for educating communities about salt fluoridation programs, salt production methods and processing, marketing and strategic planning for salt fluoridation implementation.)

pdf Multi-Year Plan for Salt Fluoridation Programs in the Region of the Americas (Belize, Bolivia, Dominican Republic, Honduras, Nicaragua, Panama, Paraguay, Venezuela) (4.89 MB)  (PAHO, 2000. Final Report to the W.K. Kellogg Foundation Project #43225.  Program description, methodology for baseline studies, training in fluoridation techniques and quality assurance, surveillance systems and monitoring of salt fluoridation programs, general policy recommendations and legal framework.)

Water Flouridation

Populations Receiving Optimally Fluoridated Public Drinking Water - United States, 1992-2006 (CDC Morbidity and Mortality Weekly Report, 2008. Updated report on increasing fluoridation in the United States and progress toward Healthy People 2010 objective in the US.) 

pdf Fluoride in Drinking-water (1.03 MB)  (WHO, 2006.  Report on sources of fluoride, health effects, guidelines and standards, analytic methods, country data and indices of severity of dental fluorosis.) 

 Fluoride in Drinking Water: A Scientific Review of EPA's Standards (The National Academies, March 2006. A review of studies conducted in the last 10 years that warns against over-fluoridation.)

Nature's Way to Prevent Tooth Decay: Water Fluoridation (ADA, CDC, US Department of Health and Human Services, 2004.  Argues that water fluoridation benefits everyone in the community equally, is safe and cost-effective.)

pdf Defluoridation Systems for Latin America and the Caribbean (Mexico) (5.8 MB)  (PAHO & Secretaía de Salud de México 2004.  Task-Force Meeting Final Meeting. PAHO's Multi-Year Plan for Fluoridation Programs in the Region, survey of water supply, salt fluoridation and fluorosis.  International Standard Regulatory Criteria for Fluoride in drinking water and technical approach for management of acceptable fluoride exposure in ground water.)

Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. (CDC Morbidity and Mortality Weekly Report, 1999. The ten public health achievements highlighted in this MMWR series reflect the successful response of public health to the major causes of morbidity and mortality of the 20th century.)

Engineering and Administrative Recommendations for Water Fluorosis (CDC Morbidity and Mortality Weekly Report, 1995. Updated guidelines and/or recommendations for managers of fluoridated public water systems in the US.)

Milk Flouridation

Development of a Milk Fluoridation Scheme for Prevention of Dental Caries (484.5 kB) (WHO, 2001.  Feasibility study for implementation of milk fluoridation in communities for which neither water nor salt fluoridation can be implemented.)

Toothpaste Flouridation

Uso de Pastas Dentales y Consumo de Suplementos en Niños de 3-5 Años (Venezuela, Nicaragua, Honduras (1.84 MB) (OPS, 1998.  Objetivos, materiales, métodos, resultados, discusión y recomendaciones con anexos: estudio de pastas y suplementos fluorurados y formulario de encuesta.)

Training Materials

pdf Recomendaciones Administrativas y Técnicas para la Fluoruración del Agua (3.32 MB)  (OPS & US Dept. of Health and Human Services, 1997. Recomendaciones para comunidad y escuelas fluoruradas: administración, supervisión, requisitos técnicos y procedimientos de seguridad.)

Fluoruración del Agua: Un Manual para Ingenieros y Técnicos (8.74 MB)  (OPS, US Dept. of Health and Human Services, & CDC, 1997.  El propósito de este manual es ayudar al personal de servicio de agua en el correcto funcionamiento de los sistemas de fluoruración para diseñar o planificar una instalación de fluoruración de agua de manera que los clientes puedan disfrutar de todos los beneficios de fluoruración.)

Monitoring of Renal Fluoride Excretion in Community Preventative Programs on Oral Health (3.19 MB) (WHO, 1999. Study design, guidelines for tabulating and processing urine fluoride data and conclusions.)


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