The need for trusted health information has never felt more urgent. Community water fluoridation is the single most cost-effective, equitable and safe public health measure to prevent tooth decay and improve oral health. And for more than two decades, the CDA Foundation has led the charge to expand sustained access to optimal community water fluoridation. This evidence-based initiative has helped millions of Californians, especially children, benefit from fluoridated water.
Then: Strategic growth and infrastructure development
“When opposition to fluoridated water began rising 25 years ago, CDA was at the forefront, as it has been on so many issues since,” shared Foundation board member Linda Seifert, who was CDA’s general counsel at the time. “Legal and grassroots challenges to existing water supplies were emerging, as well as efforts to prevent the implementation of fluoridated water systems. The Foundation was born out of a philanthropic commitment to protect and educate the public.”
Using a three-phase model—strategy, advocacy and policymaking—the CDA Foundation and its partners increased fluoridation coverage from 17% in 1992 to 63% by 2011.
In 1995, dedicated advocacy resulted in the passage of Assembly Bill 733, which mandated fluoridation in water systems serving over 10,000 connections when external funding was available, and the Foundation then mobilized a broad coalition to implement statewide expansion.
“When the legislature passed the bill, there was no funding to actually implement the program,” reflects Dr. Irene Hilton. “However, The California Endowment allowed the Foundation to be a key partner in distributing those funds to local communities.”
Serving as a fiscal intermediary of a $15 million grant from The California Endowment, the Foundation provided strategic leadership to launch major fluoridation infrastructure projects in Los Angeles, Sacramento, San Francisco and San Diego. The program achieved large-scale results through partnerships with CDA, First 5 California, The Health Trust and local leaders while setting legal precedents to defend state policy against local opposition.
Now: Advocacy and protection in a shifting landscape
While past efforts focused on expansion, today’s fluoridation work reflects a changing and sometimes volatile public health environment with growing misinformation and opposition to fluoride.
The CDA Foundation has pivoted toward defending existing fluoridation systems and dispelling myths about the safety of fluoride. Working alongside CDA’s legislative and policy advocates, the Foundation now works to protect water systems under threat, equips dental professionals with science-based communication tools and counters public misconceptions with sound science. Educational strategies continue to be a cornerstone of these efforts, reinforcing the well-established evidence on fluoride’s safety and effectiveness. Today, CDA’s local advocacy efforts support the investment of updating water treatment systems to continue fluoridation for years to come.
More than 23 million Californians now benefit from community water fluoridation, a testament to sustained investment in prevention-based oral health.
“The CDA Foundation has been a tireless champion in advancing and defending community water fluoridation for decades,” said Dr. Lindsey Robinson, senior editor of the Journal of the California Dental Association, which is focused on peer-reviewed oral health research. “The efforts in advocacy and education are ongoing, and the Foundation will be there at every step of the way.”
The CDA Foundation remains committed to preserving these gains and is engaging new communities through coalition-building and essential health education. Learn about oral health initiatives and how you can get involved at cdafoundation.org.