Community water fluoridation (CWF) was introduced in Ireland in 1964 as a public health measure to improve oral health. Water fluoridation is the adjustment of the natural concentration of fluoride in drinking water for the prevention of dental caries (tooth decay). Fluoridation policy is provided for in the Health (Fluoridation of Water Supplies) Act, 1960 and in the Fluoridation of Water Supplies Regulations 2007.
There is strong evidence supportive of effective preventive approaches to reduce dental disease, including the value of water fluoridation. Under the Fluoridation of Water Supplies Regulations 2007 (S.I No 42 of 2007), Ireland is legally required to maintain its fluoridation levels at 0.6-0.8ppm. This is well below the threshold permitted under EU legislation, which requires this level must be less than 1.5ppm (European Union (Drinking Water) Regulations 2023 (S.I. No. 99/2023)). Many parts of the world including Canada, Australia, New Zealand, Malaysia, Singapore, and parts of the UK and Spain have long-standing and comprehensive community water fluoridation programs. New water fluoridation programs continue to commence internationally most recently in further regions in Australia and most recently in Vietnam building on successes elsewhere.
Statutory responsibility for the monitoring of fluoride levels in public drinking water rests with Uisce Éireann as the water supplier. Under the European Union (Drinking Water) Regulations 2023, fluoride is classified as a chemical parameter and is subject to risk-based compliance monitoring, with sample frequency determined by the size and risk profile of the supply.
The HSE undertakes a monthly monitoring programme to assess compliance by Uisce Éireann with the provision of the Fluoridation of Water Supplies Regulations 2007 (S.I No 42 of 2007).
The Health Research Board (HRB) on behalf of this Department has conducted three comprehensive umbrella evidence reviews on the impact of water fluoridation at its current level on the health of the population. The most recent review ‘Effect of artificial community water fluoridation on dental health’ was completed in May 2025 and the most up to date evidence continues to support that CWF confers a substantial oral health benefit. The two previous reviews examined the impact on General health (‘Health Effects of Water Fluoridation’ (2015) and ‘Impact of community water fluoridation on systemic health excluding oral health’ (2022)). The conclusion was that there was no current evidence that there are negative health impacts at the optimal level of fluoridation as legislated for in Ireland. These evidence reviews were published by the HRB and are available on its website: www.hrb.ie.
The primary goal of the National Oral Health Policy (NOHP), Smile agus Sláinte, is to provide the supports, including delivery of dental services, to enable every individual to achieve their personal best oral health and to reduce inequalities within the population. Evidence from water fluoridation and its impact on oral health supports both goals.
The Department keeps the policy of water fluoridation, a core public health initiative, under constant review. To this end the Minister put in place a task force, the Fluoridation Surveillance Working Group (FSWG), in July 2023 to evaluate best practices in surveillance to ensure that Ireland’s continued monitoring of fluoridation and its impacts remain aligned with international best practices.
