Community Water Fluoridation (CWF) and Oral Health Policy

Status: Current

Location: National
Client: Foundations and Bank Trusts
Services Provided: Assessment and Planning, Policy & Health Systems Improvement, Communications and Social Marketing
Technical Expertise: Oral Health
Website: fluoridationtoolkit.org


Despite its proven safety and effectiveness, community water fluoridation (CWF) implementation remains a challenge and is often thwarted, while de-fluoridation efforts are also ramping up throughout the country. A small, vocal, well-organized minority that relies on junk science and appeals to fear-based messaging means that fluoridation can no longer win on its scientific merits alone.

With support from the DentaQuest foundation, HRiA is implementing a new approach to CWF via coalition building, grassroots organizing, and social marketing to leverage community values. These approaches have been applied with great success in the larger public health field but have had limited application to oral health practice and policy.

With applying the new approach, HRiA has developed, implemented, and managed campaigns in two very different New England communities with the assistance of local coalitions and local organizers: a large, ethnically diverse urban city in Massachusetts and a small, rural and homogeneous community in Vermont. The campaigns involved multiple components including community champion engagement, value-based message development, community education, decision-maker outreach, and media advocacy.

In conjunction with this important work, HRiA has developed an online Community Toolkit for use by anyone interested in implementing — or preventing the termination of — community water fluoridation in their community. The toolkit provides a “how-to” on advocating for CWF, including assessing your community’s readiness, developing messages, identifying key community champions, and how to talk with policymakers and elected officials.

When the project comes to a close, HRiA will release a report of findings and best practices as well as pre- and post- qualitative and quantitative data.