Fluoride occurs naturally in all water supplies, having been dissolved out of the rocks and soils over which the water has travelled.

The fluoride level in water varies significantly.  In some places it could be as low as 0.01 parts of fluoride per million parts of water (ppm).  Elsewhere it could be around 0.1 ppm, 0.5 ppm, 1 ppm, 2 ppm or higher.

Levels of 50 to 60 ppm, and even higher, have been recorded in some countries of Africa and Asia.  The level in sea water is generally between around 0.8 ppm and 1.4 ppm

Research in the first half of the 20th century identified that people consuming around  1 ppm of fluoride in their water for all or most of their lives had less tooth decay than those whose water contained much lower fluoride levels.

Community water fluoridation schemes to adjust the naturally occurring level of fluoride in water to the optimum level for oral health

Artificial water fluoridation – often referred to as ‘community water fluoridation’ –  is the process of adjusting the naturally occurring fluoride in water supplies where it is deficient and raising it to the optimal level for oral health.

Worldwide, a total of 57 million people are estimated to be consuming water with a naturally occurring fluoride content of around this level.  In the UK, the figure is estimated to be around 330,000 people, including those living in Hartlepool, Uttoxeter and parts of the East of England.

To replicate the dental benefits observed in places where the naturally occurring fluoride level is 1 ppm, community water fluoridation schemes are operating today in around 25 countries.  Together, they are serving an estimated total of about 380 million people.  In the UK, nearly 6 million people are benefiting from such schemes.

When fluoride occurs in water, whether naturally or because it has been added in a water fluoridation process, it is present in the form of simple fluoride ions.  The laws of chemistry dictate that fluoride ions in water are identical whether they occur naturally in the water or are added.

In other words, in a glass of water there is no difference between the fluoride present naturally and the fluoride added as part of a community water fluoridation scheme.  In laboratory analysis, the fluoride ions would be indistinguishable from one another, regardless of their origins.