While the predominant effect is topical after eruption, that effect is from low levels of fluoride that is secreted by the saliva continuously all day long,in addition to toothpaste and fluoride rinses. The word Predominant is not synonymous with the word ONLY.
Dr. Connett attempts to make the case that water fluoridation is unnecessary according to the information from his slide depicting research published by the CDC in 1999. He failed to reveal that low levels of fluoride were also important in preventing cavities after the teeth come through the gums.
He further totally chooses to ignore the fact that systemic fluoride, water fluoridation, is also critical to the permanent teeth of children under the age of 8 years old while these teeth are still developing under the gums.
Here are the current facts as presented by up-to-date, 2015 information from the CDC: