In response to recent citizen petitions regarding fluoridation in drinking water supply, the City of Raleigh Public Utilities Department is providing the following facts related to fluoridation in its water and what the City is doing.

Although addition of Fluoride is not necessary for drinking water treatment, the City of Raleigh has fortified the potable water supply with Fluoride since Fluoridation was approved by public referendum on December 11, 1956 to promote dental health. Fluoride is fed into the potable water supply in the form of Hydrofluorosilicic Acid (H2SiF6).  The products used by the City of Raleigh have been certified to meet American Water Works Association (AWWA) Standard B-703 and National Sanitation Foundation (NSF) standard 60.  Fluoride is mixed with the potable water at the E.M. Johnson Water Treatment Plant and at the Dempsey E. Benton Water Treatment Plant.  The amount of Fluoride delivered to the water system is measured at each plant by weight and flow.  Fluoride reports are filed on a weekly basis with the North Carolina Public Water Supply Section.  Currently the City of Raleigh feeds H2SiF6 to reach a target concentration of 0.7 parts per million of Fluoride in the drinking water as recommended by the Environmental Protection Agency.

During the fiscal year 2012, the City of Raleigh spent a total of $206,392.00 to purchase H2SiF6. Similar expenditures are expected for fiscal year 2013.

The US Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services (HHS), NC Division of Public Health and other health organizations recommend fluoridation of drinking water at the appropriate level to help prevent tooth decay.

In 2010, the Department of Health and Human Services convened a panel of scientists to review information related to fluoride intake.  This review resulted in a January, 2011 recommendation by the HHS to change the fluoride dosage guideline from the range of 0.7 - 1.2 parts per million (ppm) to 0.7 ppm.  The City of Raleigh's current practice is to fluoridate our drinking water at 0.7 ppm.  The panel's final report and recommendation will be published in the HHS Public Health Reports, July-August 2015, Volume 130.

Recommendations by health organizations

Organizations and agencies that support an endorse fluoridation of drinking water include, in addition to the CDC and HHS:

  • National Cancer Institute (NCI)
  • American Academy of Family Physicians (AAFP)
  • National Institute of Dental and Craniofacial Research (NIDCR)
  • American Dental Association (ADA)
  • American Medical Association (AMA)
  • American Association of Public Health Dentistry (AAPHD)
  • U.S. Public Health Services (USPHS)
  • World Health Organization (WHO)

The CDC says that "fluoridation is one of the top ten greatest public health achievements of the past century," "that it is the single most effective public health measure to prevent tooth decay and improve oral hygiene over a lifetime for children and adults, regardless of socioeconomic levels," and that "studies to date have produced no credible evidence of an association between fluoridated drinking water and an increased risk for cancer." 

A 2001 report by the CDC, which involved several professionals from the School of Public Health and the School of Dentistry at the University of North Carolina, included the following: "To ensure additional gains in oral health, water fluoridation should be extended to additional communities, and fluoride toothpaste should be used widely."

The CDC further stated the following in 2006 concerning a review by the National Research Council (NRC) concerning the fluoridation of drinking water: "The findings of the NRC reports have been consistent with CDC's assessment that water is safe at the levels used for water fluoridation (0.7-1.2 mg/L). Water fluoridation should be continued in communities currently fluoridating and extended to those without fluoridation."

The CDC also stated that the reviewed scientific evidence "does not support any association between fluoridation of water and any adverse health effect or systemic disorder."

The NCI has reviewed reports and studies from the past 40 years and states that "optimal fluoridation of drinking water does not pose a detectable cancer risk to humans."

Dr. Jean Spratt, Chief- NC Dental Health Section, indicated that the Dental Health Section continues to encourage utilities to add fluoride to drinking water and has provided funding to small utilities to support installation of fluoridation equipment.

If you have additional questions, please contact our Assistant Director of Public Utilities at 919-996-4582.

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