The following information is provided by Graphiq and HealthGrove.
Since its inception in the 1940s, community water fluoridation has been lauded by public health agencies as one of the top public health achievements of the 20th century. Water fluoridation, the controlled addition of fluoride to public water supplies, is done to reduce tooth decay in children and adults. According to the Centers for Disease Control and Prevention, children living in communities with fluoridated water have about 2.25 fewer decayed teeth than those without it.
Despite adoption in many communities, water fluoridation is a contentious issue for some. One fear is that fluoride build-up in the bones can occur. However, this is only a threat after long-term exposure to fluoridation levels higher than 4.0 mg/L.
This is well beyond the fluoride level of 0.7mg/L recommended by the United States Public Health Service.
Other opponents argue that water fluoridation is a form of compulsory mass medication and that it denies consumers choice. While these arguments are valid, scientific studies underscore numerous benefits, leading policy makers to believe the pros outweigh the cons.
Because not all Americans have access to dental care, many view water fluoridation as a free preventative health measure, like enriched flour or fortified milk. Especially in low-income communities where there may not be many dentists or where people can’t afford to visit one, water fluoridation reduces the risk of serious oral health problems.
Over time, the mounting evidence in favor of fluoridation has contributed to a more widespread adoption, as seen below.
While much of the country fluoridates its water supply (nearly 75 percent of people on community water systems receive fluoridated water, according to the Centers for Disease Control and Prevention), some states fluoridate more of their water than others. Using data from the CDC, the experts at HealthGrove discovered which states fluoridate the most.
For this list, HealthGrove ranked the states, including the District of Columbia, by percent of people on community water systems that have fluoridated water. Additionally, density of dentists per 100,000 people (as of 2013) and the percent of people who visit a dentist or dental clinic within the past year (as of 2014) are included for context.
Note: In the case of ties, the higher ranking goes to the state with the largest number of people served by community water systems.
#51. Hawaii
Percent of Community Water Supply That is Fluoridated: 10.8%
Number of People Receiving Fluoridated Water: 139,598
Total Population Served by Community Water Supply: 1,290,549
Dentists per 100K People: 81.6
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 71.6%
#50. New Jersey
Percent of Community Water Supply That is Fluoridated: 14.6%
Number of People Receiving Fluoridated Water: 1,206,270
Total Population Served by Community Water Supply: 8,288,715
Dentists per 100K People: 80.7
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 70.2%
#49. Oregon
Percent of Community Water Supply That is Fluoridated: 22.6%
Number of People Receiving Fluoridated Water: 833,557
Total Population Served by Community Water Supply: 3,688,540
Dentists per 100K People: 73.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 65.7%
#48. Montana
Percent of Community Water Supply That is Fluoridated: 32%
Number of People Receiving Fluoridated Water: 252,299
Total Population Served by Community Water Supply: 788,805
Dentists per 100K People: 66.5
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 62.6%
#47. Idaho
Percent of Community Water Supply That is Fluoridated: 36.1%
Number of People Receiving Fluoridated Water: 395,863
Total Population Served by Community Water Supply: 1,097,332
Dentists per 100K People: 63.9
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 64.3%
#46. Louisiana
Percent of Community Water Supply That is Fluoridated: 43.4%
Number of People Receiving Fluoridated Water: 1,996,568
Total Population Served by Community Water Supply: 4,601,893
Dentists per 100K People: 50.6
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 58.3%
#45. Wyoming
Percent of Community Water Supply That is Fluoridated: 43.6%
Number of People Receiving Fluoridated Water: 195,891
Total Population Served by Community Water Supply: 449,223
Dentists per 100K People: 58.2
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 65%
#44. New Hampshire
Percent of Community Water Supply That is Fluoridated: 46%
Number of People Receiving Fluoridated Water: 383,333
Total Population Served by Community Water Supply: 832,631
Dentists per 100K People: 67.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 69.4%
#43. Utah
Percent of Community Water Supply That is Fluoridated: 51.7%
Number of People Receiving Fluoridated Water: 1,384,638
Total Population Served by Community Water Supply: 2,676,448
Dentists per 100K People: 66.6
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 68.9%
#42. Alaska
Percent of Community Water Supply That is Fluoridated: 52.9%
Number of People Receiving Fluoridated Water: 361,240
Total Population Served by Community Water Supply: 682,528
Dentists per 100K People: 86.2
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 64.4%
#41. Pennsylvania
Percent of Community Water Supply That is Fluoridated: 54.6%
Number of People Receiving Fluoridated Water: 5,885,390
Total Population Served by Community Water Supply: 10,780,146
Dentists per 100K People: 62.5
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 66.8%
#40. Vermont
Percent of Community Water Supply That is Fluoridated: 56.1%
Number of People Receiving Fluoridated Water: 252,920
Total Population Served by Community Water Supply: 450,483
Dentists per 100K People: 63.8
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 72.2%
#39. Arizona
Percent of Community Water Supply That is Fluoridated: 57.8%
Number of People Receiving Fluoridated Water: 3,199,068
Total Population Served by Community Water Supply: 5,536,324
Dentists per 100K People: 57.3
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 59%
#38. Mississippi
Percent of Community Water Supply That is Fluoridated: 58.2%
Number of People Receiving Fluoridated Water: 1,738,478
Total Population Served by Community Water Supply: 2,984,926
Dentists per 100K People: 43
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 56.8%
#37. Kansas
Percent of Community Water Supply That is Fluoridated: 63.6%
Number of People Receiving Fluoridated Water: 1,719,503
Total Population Served by Community Water Supply: 2,702,452
Dentists per 100K People: 52.8
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 67.3%
#36. Washington
Percent of Community Water Supply That is Fluoridated: 63.6%
Number of People Receiving Fluoridated Water: 3,515,797
Total Population Served by Community Water Supply: 5,525,840
Dentists per 100K People: 75.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 67%
#35. California
Percent of Community Water Supply That is Fluoridated: 63.7%
Number of People Receiving Fluoridated Water: 24,215,234
Total Population Served by Community Water Supply: 38,041,430
Dentists per 100K People: 77.5
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 65.1%
#34. Arkansas
Percent of Community Water Supply That is Fluoridated: 66.9%
Number of People Receiving Fluoridated Water: 1,785,679
Total Population Served by Community Water Supply: 2,669,485
Dentists per 100K People: 42.8
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 57.1%
#33. Oklahoma
Percent of Community Water Supply That is Fluoridated: 70.1%
Number of People Receiving Fluoridated Water: 2,486,718
Total Population Served by Community Water Supply: 3,548,057
Dentists per 100K People: 55.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 56.8%
#32. Massachusetts
Percent of Community Water Supply That is Fluoridated: 70.4%
Number of People Receiving Fluoridated Water: 4,681,038
Total Population Served by Community Water Supply: 6,646,144
Dentists per 100K People: 91.2
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 74.7%
#31. Nebraska
Percent of Community Water Supply That is Fluoridated: 71.2%
Number of People Receiving Fluoridated Water: 1,015,094
Total Population Served by Community Water Supply: 1,425,664
Dentists per 100K People: 69
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 66.4%
#30. New York
Percent of Community Water Supply That is Fluoridated: 71.8%
Number of People Receiving Fluoridated Water: 12,989,488
Total Population Served by Community Water Supply: 18,094,452
Dentists per 100K People: 76.6
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 67.3%
#29. Colorado
Percent of Community Water Supply That is Fluoridated: 72.4%
Number of People Receiving Fluoridated Water: 3,757,694
Total Population Served by Community Water Supply: 5,187,582
Dentists per 100K People: 73
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 67%
#28. Nevada
Percent of Community Water Supply That is Fluoridated: 73.5%
Number of People Receiving Fluoridated Water: 1,870,698
Total Population Served by Community Water Supply: 2,544,079
Dentists per 100K People: 55.9
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 59.9%
#27. Missouri
Percent of Community Water Supply That is Fluoridated: 76.4%
Number of People Receiving Fluoridated Water: 3,994,342
Total Population Served by Community Water Supply: 5,226,360
Dentists per 100K People: 52.1
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 58.6%
#26. New Mexico
Percent of Community Water Supply That is Fluoridated: 77%
Number of People Receiving Fluoridated Water: 1,210,877
Total Population Served by Community Water Supply: 1,571,600
Dentists per 100K People: 57.5
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 61.3%
#25. Florida
Percent of Community Water Supply That is Fluoridated: 78%
Number of People Receiving Fluoridated Water: 13,371,262
Total Population Served by Community Water Supply: 17,149,724
Dentists per 100K People: 53.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 61.9%
#24. Alabama
Percent of Community Water Supply That is Fluoridated: 78.4%
Number of People Receiving Fluoridated Water: 3,781,607
Total Population Served by Community Water Supply: 4,822,023
Dentists per 100K People: 44.3
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 60%
#23. Maine
Percent of Community Water Supply That is Fluoridated: 79.4%
Number of People Receiving Fluoridated Water: 527,163
Total Population Served by Community Water Supply: 664,063
Dentists per 100K People: 56.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 63.6%
#22. Texas
Percent of Community Water Supply That is Fluoridated: 79.6%
Number of People Receiving Fluoridated Water: 20,002,506
Total Population Served by Community Water Supply: 25,113,656
Dentists per 100K People: 51.5
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 58.2%
#21. Rhode Island
Percent of Community Water Supply That is Fluoridated: 83.9%
Number of People Receiving Fluoridated Water: 837,549
Total Population Served by Community Water Supply: 997,824
Dentists per 100K People: 61.2
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 72.1%
#20. Delaware
Percent of Community Water Supply That is Fluoridated: 86.3%
Number of People Receiving Fluoridated Water: 705,824
Total Population Served by Community Water Supply: 818,110
Dentists per 100K People: 45.2
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 66.5%
#19. North Carolina
Percent of Community Water Supply That is Fluoridated: 87.5%
Number of People Receiving Fluoridated Water: 6,164,847
Total Population Served by Community Water Supply: 7,042,655
Dentists per 100K People: 50.8
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 64.2%
#18. Wisconsin
Percent of Community Water Supply That is Fluoridated: 89.4%
Number of People Receiving Fluoridated Water: 3,597,525
Total Population Served by Community Water Supply: 4,025,756
Dentists per 100K People: 61.3
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 70.1%
#17. Tennessee
Percent of Community Water Supply That is Fluoridated: 89.7%
Number of People Receiving Fluoridated Water: 5,229,461
Total Population Served by Community Water Supply: 5,826,866
Dentists per 100K People: 50.1
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 58.3%
#16. Michigan
Percent of Community Water Supply That is Fluoridated: 90.2%
Number of People Receiving Fluoridated Water: 7,218,670
Total Population Served by Community Water Supply: 7,999,859
Dentists per 100K People: 67.3
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 68.6%
#15. Connecticut
Percent of Community Water Supply That is Fluoridated: 90.3%
Number of People Receiving Fluoridated Water: 2,350,532
Total Population Served by Community Water Supply: 2,603,377
Dentists per 100K People: 77.8
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 74.9%
#14. West Virginia
Percent of Community Water Supply That is Fluoridated: 91.1%
Number of People Receiving Fluoridated Water: 1,365,697
Total Population Served by Community Water Supply: 1,499,749
Dentists per 100K People: 48.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 54.2%
#13. Iowa
Percent of Community Water Supply That is Fluoridated: 92%
Number of People Receiving Fluoridated Water: 2,555,593
Total Population Served by Community Water Supply: 2,778,894
Dentists per 100K People: 59.9
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 69.4%
#12. Ohio
Percent of Community Water Supply That is Fluoridated: 92.2%
Number of People Receiving Fluoridated Water: 9,716,289
Total Population Served by Community Water Supply: 10,537,957
Dentists per 100K People: 57.3
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 65.3%
#11. South Dakota
Percent of Community Water Supply That is Fluoridated: 93.6%
Number of People Receiving Fluoridated Water: 646,671
Total Population Served by Community Water Supply: 690,759
Dentists per 100K People: 55.2
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 70.5%
#10. South Carolina
Percent of Community Water Supply That is Fluoridated: 93.8%
Number of People Receiving Fluoridated Water: 3,602,956
Total Population Served by Community Water Supply: 3,839,526
Dentists per 100K People: 49.9
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 58.3%
#9. Indiana
Percent of Community Water Supply That is Fluoridated: 94.8%
Number of People Receiving Fluoridated Water: 4,342,273
Total Population Served by Community Water Supply: 4,582,496
Dentists per 100K People: 50.7
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 61.5%
#8. Virginia
Percent of Community Water Supply That is Fluoridated: 96%
Number of People Receiving Fluoridated Water: 6,159,737
Total Population Served by Community Water Supply: 6,416,760
Dentists per 100K People: 62.1
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 69.3%
#7. Georgia
Percent of Community Water Supply That is Fluoridated: 96.3%
Number of People Receiving Fluoridated Water: 9,551,793
Total Population Served by Community Water Supply: 9,919,945
Dentists per 100K People: 47.6
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 60.6%
#6. North Dakota
Percent of Community Water Supply That is Fluoridated: 96.7%
Number of People Receiving Fluoridated Water: 612,560
Total Population Served by Community Water Supply: 633,645
Dentists per 100K People: 58.5
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 65.5%
#5. Maryland
Percent of Community Water Supply That is Fluoridated: 97.2%
Number of People Receiving Fluoridated Water: 5,060,379
Total Population Served by Community Water Supply: 5,204,155
Dentists per 100K People: 71.8
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 70.2%
#4. Illinois
Percent of Community Water Supply That is Fluoridated: 98.5%
Number of People Receiving Fluoridated Water: 12,682,543
Total Population Served by Community Water Supply: 12,875,255
Dentists per 100K People: 68.8
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 63.9%
#3. Minnesota
Percent of Community Water Supply That is Fluoridated: 98.8%
Number of People Receiving Fluoridated Water: 4,134,663
Total Population Served by Community Water Supply: 4,184,753
Dentists per 100K People: 65.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 72.6%
#2. Kentucky
Percent of Community Water Supply That is Fluoridated: 99.9%
Number of People Receiving Fluoridated Water: 4,375,026
Total Population Served by Community Water Supply: 4,380,415
Dentists per 100K People: 59.4
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 61%
#1. District of Columbia
Percent of Community Water Supply That is Fluoridated: 100%
Number of People Receiving Fluoridated Water: 595,000
Total Population Served by Community Water Supply: 595,000
Dentists per 100K People: 116.5
Percent of Population That Visited a Dentist or Dental Clinic in Past Year: 70.8%
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