Most western, industrialized countries have rejected water fluoridation, but have nevertheless experienced the same decline in childhood dental decay as fluoridated countries. (See data from World Health Organization presented graphically in the Figure below).
This simple graph demolishes the concept that Fluoridated water was singualry responsible for American reduced carries. In fact, it demonstrates that fluoridated water is not necessary for reduced carries.
Perhaps not surprisingly, therefore, tooth decay rates have declined at similar rates in all western countries in the latter half of the 20th century – irrespective of whether the country fluoridates its water or not. Today, tooth decay rates thoughout continental western Europe are as low as the tooth decay rates in the United States – despite a profound disparity in water fluoridation prevalence in the two regions.
Within countries that do fluoridate their water (such as the United States and Australia), recent large-scale surveys of dental health – utilizing modern scientific methods not employed in the early surveys from the 1930s-1950s – have found little difference in tooth decay, including in “baby bottle tooth decay”, between fluoridated and unfluoridated communities.