The aim of this study was to evaluate the operational control of water fluoridation at the city water supply plant in Niterói, Rio de Janeiro, Brazil, from January to December 2000. The water treatment supervisor filled out a questionnaire on the control of water fluoridation. In addition, water samples were collected every two weeks for fluoride analysis before and after treatment. Samples were analyzed by an independent laboratory using an ion-specific electrode. According to the water treatment supervisor, the entire process for controlling fluoride concentration in the water was rigorous and complied with Brazilian guidelines, but according to testing, 96% of samples were inadequate in terms of risks/benefits of fluoride use from water. The information obtained from the plant supervisor and the test data were thus mutually inconsistent. Based on these data, an independent water fluoride concentration control program is needed to ensure the benefits of dental caries prevention for the population.