Communal water fluoridation continues to be the cornerstone of an ideal caries prevention program. Its efficacy in reducing caries prevalence by about 50 to 60 percent was demonstrated throughout the seventies from Perth to Toronto. During the past decade, opponents of fluoridation have relentlessly attacked the safety of the procedure, but careful scientific analyses have not sustained their criticisms. The health and other scientific communities continue to endorse and recommend the practice of water fluoridation for improving dental health. During the seventies an additional 17 million Americans have benefitted from drinking fluoridated water, but this progress is too slow, particularly when compared with that of the fifties and sixties. Fluoridation campaigns in Seattle, Greater Boston, and California's Marin County and East Bay Municipal Utility district provide examples of successful tactics. An analysis of unsuccessful campaigns in Eugene, Los Angeles, and the State of Utah reveals mistakes which should not be repeated in future elections. For the eighties new approaches will be needed, particularly to reach the many smaller remaining communities. It is essential that the ADA and the USPHS maintain a stable office with sufficient staff and expertise on fluoridation. Training programs are needed to help prepare local community leaders and to assist them in obtaining fluoridation for their communities. Additional studies have documented the efficacy of school fluoridation programs for areas lacking a public water supply. Many school fluoridation programs were introduced during the seventies; nevertheless, they serve a very small number of children.
