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Dental Public Health Activities: Descriptive Summaries

Oklahoma Water Fluoridation Program

Practice Number: 39001
Submitted By: Dental Health Services, Oklahoma State Department of Health
Submission Date: February 2002
Last Reviewed: January 2015
Last Updated: January 2015
Best Practice Approach Example Oklahoma Water Fluoridation Program

The Oklahoma State Department of Health (OSDH), Dental Health Service, administers a community water fluoridation (CWF) program supporting fluoridation as safe and cost-effective while providing equitable benefits to all those who drink the water.  The practice of CWF has existed in Oklahoma since the early 1950’s and is seen as an important public health program.  The State Dental Director, Fluoride Consultant and Epidemiologist share the demands and duties of the Program.  Together, the OSDH and the Oklahoma Department of Environmental Quality (DEQ) assist communities with water fluoridation.  The DEQ, as the regulatory agency, ensures the delivery of safe drinking water to the consumer under state and federal rules.  Of the current active community water system in Oklahoma, 38  systems adjust the fluoride level, 252  purchase water from other public water systems that adjust (referred to as consecutive water systems), and 59  systems are naturally fluoridated.  The OSDH, along with stakeholders from the Governor’s Task Force on Children and Oral Health, the Oklahoma Oral Health Coalition, and the Oklahoma Dental Association work collectively to promote and sustain oral health initiatives statewide. 

The CWF program includes promoting and monitoring CWF activities; recording and compiling data from water treatment plants and other stakeholders; communicating with water treatment plants to verify fluoridation status; serving as a liaison with federal and state partners; increasing awareness regarding the effectiveness of water fluoridation among academic institutions, medical and dental organizations; maintaining a publicly accessible fluoridation data base through CDC; providing relevant information to stakeholders and policy makers; and providing information, statistical analysis and trends on water fluoridation regarding health effects, cost effectiveness, and safety. 

In 2012, OSDH prepared a state Community Water Fluoridation Plan.  The goal of the plan is to improve the oral health status of all Oklahomans.  American’s Health Rankings (2013) identifies Oklahoma as 44th in the nation in the percent of adults who have visited the dentist or a dental clinic within the past year for any reason.  In addition, 60 percent of Oklahoma’s third grade children have caries experience according to a 2013 survey.  Widespread CWF results in the remarkable decline in the prevalence and severity of dental decay, saving money for both families and the health care system and improving overall health.

Lessons Learned:

The Oklahoma Water Fluoridation Program has been successful through a multi-pronged approach including public education; working with partners, stakeholders, and policy makers; preparing a state CWF plan; and collecting and monitoring fluoride data.  A fluoride consultant and epidemiologist remain critical for a successful oral health program. 

The principal challenges have been overcoming the widespread belief that water fluoridation is less necessary in modern life; identifying the reasons a public water system discontinues the practice of fluoridation, whether philosophical, mechanical or financial; and continuing efforts to collect and monitor fluoride data, with local cost data being most difficult to obtain.  Many city officials fail to recognize the value of CWF 

Oklahoma remains proactive in identifying resources that support CWF as we continue to optimize efforts to promote CWF.

Contact Person(s) for Inquiries:

Jana S. Winfree, DDS,  Director, Dental Health Service, Oklahoma State Department of Health, 1000 NE 10th, Oklahoma City, OK 73117 Phone: 405-771-5502, Email:

Mary S. DeLeon, Fluoride Consultant, Dental Health Service, Oklahoma State Department of Health, 1000 NE 10th, Oklahoma City, OK 73117 Phone: 405-771-5502, Email: