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Water Fluoridation in Israel: Ethical and Legal Aspects


Fluoridation of community drinking water for prevention of dental caries commenced in the United States in 1945 and has become one of the major achievements of public health according to the US Center for Disease Control. It has been adopted widely, mainly on voluntary basis by local authorities responsible for community water supplies. Fluoridation is the most effective method to prevent dental caries at the community level and promotes equality because all benefit regardless of their awareness or the importance they give to dental health. However, fluoridation is still regarded as an unnecessary and allegedly harmful intervention by a few dedicated opponents who express their views through aggressive postings on the internet and all other channels of communication.

After many years of failed attempts to implement “voluntary” fluoridation by local authorities, Israel implemented mandatory fluoridation legislation in 2002. Public controversy and persistent opposition led to challenges to the legislation passed by the Israeli Knesset (parliament) and brought the matter to the Supreme Court. The Court confirmed the Ministry of Health’s responsibility for the health of the public and that the evidence presented indicated fluoridation was a safe and reasonable measure to help achieve that mandate. Fluoridation has since been implemented across the country based on this legislative mandate. In 2012, a private bill to stop fluoridation was defeated in the Knesset. This case represents an ideological struggle between opponents to a public health measure and its resolution in a higher court decision in favor of safe and effective public health benefits and in legislation.


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Correspondence to Shlomo P. Zusman DMD, MSc(DPH), MPA.

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Zusman, S.P. Water Fluoridation in Israel: Ethical and Legal Aspects. Public Health Rev 34, 6 (2012).

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Key Words

  • Community water fluoridation
  • ethics in public health
  • legislative mandate in public health
  • Israel