States with the most fluoridated water

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United States Lowers Fluoride Levels in Drinking Water

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.

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

Patrick McNally / Flickr

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

brando.n / Flickr

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

Carissa Rogers / Flickr

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

Ryan McKee / Flickr

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

chadh / Flickr

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

Shreveport-Bossier: Louisiana's Other Side / Flickr

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

Gregory "Slobirdr" Smith / Flickr

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

lee / Flickr

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

Wolfgang Staudt / Flickr

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

Paxson Woelber / Flickr

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

Nicholas_T / Flickr

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

Dougtone / Flickr

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

OliBac / Flickr

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

pmsyyz / Flickr

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

Kansas Poetry (Patrick) / Flickr

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

TomCollins / Flickr

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

ahisgett / Flickr

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

jackgrayphotography / Flickr

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

Larry Smith2010 / Flickr

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

BostonPhotoSphere / Flickr

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

RLEVANS / Flickr

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

The Urban Scot / Flickr

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

Jasen Miller / Flickr

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

Nouhailler / Flickr

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

W.G. Dayton / Flickr

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

snowpeak / Flickr

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

luca.sartoni / Flickr

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

faungg's photos / Flickr

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

jar [] / Flickr

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

eschipul / Flickr

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

Tony in WA / Flickr

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

Nouhailler / Flickr

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

Randy Heinitz / Flickr

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

Richard Hurd / Flickr

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

string_bass_dave / Flickr

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

JKDs / Flickr

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

Dougtone / Flickr

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

Nicolas Raymond / Flickr

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

Katie Haugland

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

Always Shooting / Flickr

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

Jim Bauer / Flickr

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

pfarrell95 / Flickr

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

Geoff Livingston / Flickr

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

rvaphotodude / Flickr

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

TranceMist / Flickr

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

Electroburger / Flickr

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

Charlie Stinchcomb / Flickr

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

romanboed / Flickr

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

chefranden / Flickr

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

Jefferson County, KY

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

Nicolas Raymond / Flickr

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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