Dr. Santosh¹, Yaroslav Herin^2,, Dr. Imran Idrees³, Dr. Sree Rekha Movva⁴, Sofia Olena Herin⁵, Dr. Amanpreet Kaur⁶, Dr. Ridhi Bhola⁷, Dr. Sandeep Singh⁷

Community water fluoridation (CWF) has been recognized as one of the most effective population-based strategies for preventing dental caries and improving oral health equity. However, its continued relevance in developed countries has become a subject of debate due to declining caries rates, widespread use of fluoride-containing products, evolving preventive approaches, and concerns regarding safety and individual autonomy. This comprehensive review evaluates the current evidence on the mechanisms, effectiveness, safety, and global policy perspectives of CWF. Current data support the safety of optimally fluoridated water, with dental fluorosis being the only consistently documented adverse effect, predominantly mild and cosmetic. International experiences demonstrate varied approaches, with some countries continuing CWF as a key public health intervention while others rely on alternative strategies such as fluoride toothpaste, salt fluoridation, school-based programs, fluoride varnish, and silver diamine fluoride. Future caries prevention is likely to involve integration of population-based measures with precision public health, artificial intelligence, assisted risk prediction, and personalized preventive dentistry. Overall, CWF remains a relevant, evidence-based, and equitable public health strategy, particularly when incorporated within a comprehensive approach to oral disease prevention.

Water fluoridation, Fluorosis, Dental Caries, Salt fluoridation, Milk fluoridation