many toothpastes have it, no need to use multivitamins

Most places that do add it to the water supply match the levels of places where flouride occurs naturally

https://static.spokanecity.org/documents/citycouncil/interest-items/2020/09/city-council-information-on-fluoride-2020-09-08.pdf

• Water fluoridation reaches over 13 million Europeans through programs in England, Ireland, Poland, Serbia and Spain

• Children in deprived areas benefit most from water fluoridation according to 2018 English health agency report

• Over 70 million Europeans receive fluoridated salt through programs in Austria, France, Germany, Switzerland and other countries. Salt fluoridation is recommended when water fluoridation is not feasible

• European Academy of Pediatric Dentistry endorses water fluoridation as "core component of oral health policy"

• Fluoridated milk programs have operated in Bulgaria, England, Hungary, Russia and Scotland

• Several European countries provide free or subsidized fluoride treatments through national healthcare:

  • Sweden: free dental care through age 23
  • Denmark: free dental care until age 18
  • Finland: public dental clinic access for all legal residents

• Scandinavian schools offer fluoride varnish, tablets and rinse programs

• Some regions in Europe have naturally fluoridated water, such as parts of Italy. Italian health officials support water fluoridation but don't implement additional programs due to naturally optimal fluoride levels in some areas

https://www.cdc.gov/fluoridation/about/statement-on-the-evidence-supporting-the-safety-and-effectiveness-of-community-water-fluoridation.html

• Evidence shows that water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride, ultimately reducing tooth decay by about 25% in children and adults.

• evidence shows that schoolchildren living in communities where water is fluoridated have, on average, 2.25 fewer decayed teeth compared to similar children not living in fluoridated communities.

• A study to compare costs associated with community water fluoridation with treatment savings achieved through reduced tooth decay, which included 172 public water systems, each serving populations of 1,000 individuals or more, found that 1 year of exposure to fluoridated water yielded an average savings of $60 per person when the lifetime costs of maintaining a restoration were included.

• Analyses of Medicaid claims data in 3 other states (Louisiana, New York, and Texas), have also found that children living in fluoridated communities have lower caries related treatment costs than do similar children living in non-fluoridated communities; the difference in annual per child treatment costs ranged from $28 to $67.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9544072/

• community water fluoridation continues to decrease cavities by 25% at the population level.

• Even with fluoridated products such as toothpaste and mouth rinses, this public health practice can reduce an additional 25% of tooth decay in children and adults

• In 1945, Grand Rapids, Michigan became the first U.S. city to fluoridate its public water supply. Five years later, Grand Rapids schoolchildren were found to have significantly fewer cavities than children from the control community of Muskegon, and additional water districts, including Muskegon began fluoridating and seeing similar results

• Studies have shown that populations from lower socioeconomic groups within fluoridated communities have less tooth decay when compared to peers in nonfluoridated communities

• The cost of a lifetime of water fluoridation for one person is less than the cost of one filling

More info: https://www.ada.org/resources/community-initiatives/fluoride-in-water