The format of this page is

  • A summary of the key points relevant up to 2020
  • An online and printable version of the 2012/3 publication “one in a million”
  • A summary of the main points raised by more recent papers and reports
  • Access to a list of the key papers and reports published since 2012/3
  • Access to an archive of other reports etc.

Key Points (Updated 2020)

  • Oral health and general health are strongly linked. Poor oral health can impact adversely on general health and well-being.
  • Epidemiological studies and independent review of the relevant medical and scientific literature have consistently failed to find evidence that fluoride in water at or around one part per million has any deleterious effect on general health.
  • People have drunk naturally fluoridated water at or around the one part per million concentration for generations. There is no evidence that they have suffered harm to their general health from doing so. There is evidence, however, that naturally fluoridated water benefits dental health.
  • Today, an estimated 50 million people around the world are drinking naturally fluoridated water. More than  400 million people in 25 countries are supplied with fluoridated water.

One in a Million

Our One in a Million online database includes a comprehensive section on water fluoridation and general health.


Fluoridation and general health (3rd edition, 2012)


Fluoridation and general health.- Printable

Summary of Data Published Post 2012/2013

  • Additional systematic reviews have been carried out in Ireland, New Zealand and Australia (Sutton et al, 2015; Royal Society of New Zealand, 2014; Jack et al, 2016; NHMRC, 2017a) covering a wide range of conditions. The three reviews could find no reliable evidence of any association between any of these conditions and community water fluoridation. The Australian review went further noting that there was clear evidence that cancer, Down syndrome, cognitive function, IQ, and hip fracture were not associated with community water fluoridation. In 2022 a new review was conducted by colleagues in Ireland.
  • Kim et al (2020) extend their2011 study to reaffirm that “community water fluoridation is not associated with an increased risk for osteosarcoma”.
  • The Journal of the American Dental Association (JADA) has published a study that examined the potential link between topical fluoride or dietary fluoride supplements and osteosarcoma (bone cancer). The authors reached this conclusion: “Neither topical nor dietary fluoride supplements are associated with an increased risk of developing osteosarcoma.” The JADA article’s authors included Catherine Hayes, Chet Douglass and Frances Kim, all of whom collaborated on a 2011 article, which examined whether there was an association between the bone fluoride levels and osteosarcoma risk. The 2011 article found no significant association between the two. Many of you can recall that 10 years ago, bone cancer was one of the leading issues that fluoridation opponents raised (at least within the United States) when they attacked state or local CWF policies.
  • A recent study has raised once again the issue of hypothyroidism (Peckham et al, 2015; 2017). However, this study has been widely criticised (Newton et al 2015; 2017; Foley, 2015; Grimes, 2015; Warren and Saraiva, 2015;) for a misleading interpretation of the existing literature, for an unusual analysis of the data and for failing to recognise the limitations of the study in drawing conclusions and recommendations. Analysing data from the national Canadian Health Measures Survey, Barbeirio et al (2017) found no association between fluoride exposure and thyroid functioning.
  • Public Health England’s monitoring report (2018) presents new data on Down’s syndrome, hip fracture, kidney stones, osteosarcoma and bladder cancer.    The report concludes that the findings are consistent with the view that water fluoridation is an effective and safe public health measure. The 2022 Health Monitoring Report backs up earlier reports into the safety and efficacy of water fluoridation.
  •  Researchers in Canada have presented new data claiming an association between fluoride exposure in pregnant women and cognitive function of their offspring. As a consequence, the US National Toxicology Program (NTP) undertook a systematic review of the literature. The NTP’s draft review (2019) was subjected to peer review by the prestigious National Academy of Sciences, Engineering and Medicine (2020). The National Academy’s Expert Committee was critical of the design and methods of many of the studies reviewed by the NTP, was critical of NTP’s own analysis, and of NTP’s failure to provide adequate support for its conclusions. The National Academy’s Expert Committee recommended that NTP conduct further work. The NTP has subsequently produced a second monograph, but a committee of The NASEM says that it ‘still falls short of providing clear and convincing documentation of the evidence to support its conclusions.’ The NASEM committee has recommended that the NTP further improves its monograph. It issued a review rejecting the NTP conclusion regarding fluorides safety. NASEM specifically states that NTP’s analysis cannot be used to draw any conclusions in regards to fluoride at the concentration used for community water fluoridation. Australian researchers meanwhile have stated thet “Exposure to fluoridated water during the first 5 y of life was not associated with altered measures of child emotional and behavioral development and executive functioning.”Do, Spenser and Ha
  • A review by researchers in Germany (Guth et al 2020) concluded that “based on the totality of currently available scientific evidence the present review does not support the presumption that fluoride should be assessed as a human developmental neurotoxicant at the current exposure levels in Europe” and that “the evidence does not provide sufficient arguments to raise concerns” about water fluoridation or “justify the conclusion that fluoride is a human developmental neurotoxicant.”.
  •   Meanwhile, commenting on the new Canadian studies, the NHS website (2019) noted that “considerable past research has been conducted into the safety of fluoride including those conducted by the UK government and other international organisations. Overall, these studies all found that fluoride was not associated with significant health risks”.