Water fluoridation
Health and dental organizations worldwide have endorsed its safety and effectiveness. Its use began in 1945, following studies of children in a region where higher levels of fluoride occur naturally in the water. Further research showed that moderate fluoridation prevents tooth decay.
Fluorine
Population studies from the mid-20th century onwards show topical fluoride reduces dental caries. This was first attributed to the conversion of tooth enamel hydroxyapatite into the more durable fluorapatite, but studies on pre-fluoridated teeth refuted this hypothesis, and current theories involve fluoride aiding enamel growth in small caries. After studies of children in areas where fluoride was naturally present in drinking water, controlled public water supply fluoridation to fight tooth decay began in the 1940s and is now applied to water supplying 6 percent of the global population, including two-thirds of Americans. Reviews of the scholarly literature in 2000 and 2007 associated water fluoridation with a significant reduction of tooth decay in children. Despite such endorsements and evidence of no adverse effects other than mostly benign dental fluorosis, opposition still exists on ethical and safety grounds. The benefits of fluoridation have lessened, possibly due to other fluoride sources, but are still measurable in low-income groups. Sodium monofluorophosphate and sometimes sodium or tin(II) fluoride are often found in fluoride toothpastes, first introduced in the U.S. in 1955 and now ubiquitous in developed countries, alongside fluoridated mouthwashes, gels, foams, and varnishes.