A new Annenberg Public Policy Center survey of 1,639 U.S. adults found that 74% trust the American Dental Association (ADA) as a reliable source of fluoride information, while only 34% expressed confidence in Health and Human Services Secretary Robert F. Kennedy Jr. The results come as community water fluoridation debates resurface on both sides of the border, raising questions Canadian dental professionals should be prepared to address.
As of June 2026, the intersection of public health policy and political rhetoric has created a new challenge for dental professionals: patients are arriving at appointments with questions — and sometimes strong opinions — about fluoride safety. The Annenberg survey, published June 19, provides the most comprehensive snapshot yet of where the public stands.
What the Survey Found
The Annenberg Public Policy Center at the University of Pennsylvania surveyed 1,639 adults between April 14 and 28, 2026, asking about trust in fluoride information sources, attitudes toward community water fluoridation, and beliefs about fluoride's health effects.
The headline finding: dental professionals remain the public's most trusted source of fluoride information. Seventy-four percent of respondents said they are confident the ADA provides trustworthy fluoride guidance, compared to just 34% who expressed confidence in Kennedy's fluoride-related statements. Among those skeptical of Kennedy, 42% said they are "not at all confident" in his fluoride information.
Public Opinion on Water Fluoridation
The survey revealed that 43% of adults favour community water fluoridation, while 26% oppose it and 30% remain neutral. When asked specifically about their own community's water supply, the numbers held steady: 43% would favour fluoridation, 23% would oppose it, and 34% expressed no preference.
A more telling split emerged between supporters of the "Make America Healthy Again" (MAHA) movement and the general public. Among MAHA supporters, 41% oppose adding fluoride to their community's water compared to 26% who favour it. Among non-MAHA respondents, the dynamic reversed sharply: 63% favour fluoridation and just 11% oppose it.
Perceptions of Fluoride's Health Effects
Across all respondents, 42% said fluoride has positive health effects, 17% said negative effects, and 35% were unsure. That 35% "unsure" group represents a significant population of patients who may be open to professional guidance — or susceptible to misinformation.
Why This Matters for Canadian Dental Professionals
While the Annenberg survey polled American adults, the fluoride conversation does not stop at the border. Canadian dental professionals face their own version of this debate, and U.S. political rhetoric has a documented spillover effect on Canadian public discourse.
Canada's Fluoridation Landscape
Community water fluoridation in Canada remains a municipal decision, and the patchwork result is significant. Toronto, Ottawa, and Hamilton fluoridate their water. Calgary famously voted to remove fluoride in 2011, then reversed course in 2021 after observing rising cavity rates — particularly in children. Windsor, Ontario, stopped fluoridation in 2013, and subsequent research documented increased dental decay among Windsor children compared to fluoridated communities.
The Canadian Dental Association (CDA) maintains an unequivocal position: community water fluoridation is a safe, effective, and equitable public health measure. Health Canada's guidelines recommend an optimal fluoride concentration of 0.7 mg/L in municipal water supplies.
Pro Tip: Keep CDA fluoride fact sheets in your patient education materials. When patients raise concerns, pointing to a Canadian authority — not just the ADA — reinforces relevance and trust. The CDA's position statement on fluoridation is available at cda-adc.ca.
How to Handle Patient Questions About Fluoride
The Annenberg data suggests that most patients still trust their dental professionals above political figures. That trust is an asset — but it requires active maintenance. Here is what dental professionals in Ontario and across Canada should consider:
- Acknowledge the concern before correcting the claim. Patients who raise fluoride questions are often responding to social media content they found persuasive. Dismissing the concern outright risks alienating the patient.
- Lead with Canadian data. Reference Health Canada's fluoride guidelines and the CDA's position rather than defaulting to U.S. agencies. Canadian patients respond better to Canadian authority.
- Cite the Calgary case study. Calgary's 10-year natural experiment — removing fluoride in 2011, restoring it in 2021 after measurable increases in childhood caries — is one of the most compelling real-world examples available.
- Use the "unsure" window. With 35% of survey respondents unsure about fluoride's effects, dental professionals have an opportunity to provide balanced, evidence-based information to patients who have not yet formed a strong opinion.
Pro Tip: Train your front desk and hygiene team on 2-3 key fluoride talking points. Patients often raise fluoride questions during hygiene appointments, not just with the dentist. A consistent message across your team builds credibility.
The Broader Trend: Science Communication in the Chair
The fluoride trust survey is part of a larger pattern. Dental professionals are increasingly expected to serve as frontline science communicators, addressing patient concerns about topics ranging from mercury amalgam to BPA in composites to radiation from dental X-rays. The Royal College of Dental Surgeons of Ontario (RCDSO) has emphasized that patient communication is a core competency, not an optional skill.
For practice owners in the Greater Toronto Area and across Ontario, this means investing in staff training, maintaining current patient education materials, and staying informed about the specific claims circulating in your patient population.
What Comes Next
The U.S. fluoride debate shows no signs of cooling. Kennedy's Department of Health and Human Services has signalled continued scrutiny of community fluoridation, and municipal fluoride votes are scheduled in several American cities through 2026 and 2027. Canadian municipalities, watching these developments, may face renewed pressure from organized anti-fluoride campaigns.
The Ontario Dental Association (ODA) and CDA have both reaffirmed their support for community water fluoridation in 2026 statements. Dental professionals who stay current on these positions — and who develop clear, empathetic patient communication strategies — will be best positioned to maintain patient trust during a politically charged period.
Frequently Asked Questions
Q: Is community water fluoridation safe according to Canadian health authorities?
Yes. Both the Canadian Dental Association (CDA) and Health Canada support community water fluoridation at the recommended concentration of 0.7 mg/L. Decades of research confirm that water fluoridation reduces dental caries by 25-40% across populations, with no credible evidence of harm at recommended levels.
Q: Do Ontario dental offices need to address fluoride misinformation with patients?
While there is no regulatory requirement, the Royal College of Dental Surgeons of Ontario (RCDSO) emphasizes patient communication as a core professional competency. Proactively addressing fluoride questions strengthens patient trust and supports informed consent for fluoride treatments.
Q: What happened when Calgary removed fluoride from its water supply?
Calgary removed fluoride in 2011 and restored it in 2021. During the decade without fluoridation, researchers documented measurable increases in childhood dental caries compared to fluoridated communities, providing one of the clearest real-world case studies of fluoridation's protective effect.
EBIKO Dental will continue monitoring fluoride policy developments in Canada and their implications for dental professionals across Ontario and the GTA.