Get guidance on choosing water fluoridation in your community with new California Fluoridation Manual

July 26, 2022
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Quick Summary:
The California Fluoridation Manual, published by the UCSF California Oral Health Technical Assistance Center, is available online and includes step-by-step guidance on advocating for fluoridation from the early research and strategizing stages to the desired result. Specifically, the manual explains the process of obtaining fluoridation for communities in California, the governing processes involved in choosing fluoridation and how to make the case for community water fluoridation.

Local health jurisdictions and oral health advocates in California now have guidance for promoting water fluoridation in their communities based on generally accepted, peer-reviewed scientific evidence and experience. 

The California Fluoridation Manual, published by the UCSF California Oral Health Technical Assistance Center, is available online and includes step-by-step guidance on advocating for fluoridation from the early research and strategizing stages to the desired result.

“Community support for fluoridation is essential, and education about the benefits of fluoridation is the foundation of developing that support,” says Marjorie Stocks, MPH, co-author of the manual.

Specifically, the manual explains:

  • The process of obtaining fluoridation for communities in California
  • The governing processes involved in choosing fluoridation
  • How to make the case for community water fluoridation

Included are a sample project plan, timeline, talking points and sample letters plus checklists to assist fluoridation strategy, education, advocacy, policy making and management.  

‘Robust scientific evidence to support fluoridation’

The safety and oral health benefits of fluoridation are well-established, and nearly all medical, dental and public health organizations recommend it. Among them are CDA, the American Academy of Pediatrics and the World Health Organization.

“There is robust scientific evidence to support fluoridation,” says Howard Pollick, BDS, MPH, co-author of the California Fluoridation Manual. “We share some of this evidence and review California’s own history of fluoridation and the statutes and regulations on fluoridation. Community water fluoridation has been shown to save money for families and the health care system by reducing tooth decay.”

Step-by-step guidance on strategy, education, policy making and capital funding

The manual is organized into six main chapters with clear actionable steps in each: strategy, education and advocacy, policy making, preventing or reversing a rollback, capital funding and communicating with operators. 

The chapter on strategizing, for example, covers assessment of a region’s water supply, development of a coalition and communication strategy and preparation for first meetings, while the education and advocacy chapter discusses ways to engage volunteers, educate the community and obtain letters of support for decision-makers.

Chapter 6 explains how to prevent or reverse a rollback, which refers to the cessation of fluoridation in a community often initiated by individuals opposed to fluoridation. 

Four years in the making and reviewed by experts

The California Fluoridation Manual was developed over four years with the help of many experts in both public health and dental faculty.

“Providing universal access to optimal fluoride concentrations in drinking water is the best way a community can protect the oral health of all residents,” said State Dental Director Jayanth Kumar, DDS, MPH, co-author of the Community Fluoridation Manual. “The manual is a significant tool that local jurisdictions and health advocates can use to build on California’s successes improving oral health through fluoridation. Those seeking to minimize the burden of tooth decay for all, regardless of socioeconomic status, age or other considerations, will find this a very useful guide.”

The manual can be read online through the UCSF website or on the