What to know
Biennially, CDC summarizes WFRS data into National Water Fluoridation Statistics. The 2018 statistics include the estimated proportion of the U.S. population receiving fluoridated water, and the estimated proportion of people on community water systems that receive fluoridated water, both nationally and in each state. These data were updated in July 2023.
2018 national statistics
| Total U.S. population, personsa | 327,167,434 |
|---|---|
| U.S. population on community water systems (CWS), personsb,c | 284,075,868 |
| Total U.S. population on fluoridated drinking water systems, personsb,c | 207,426,535 |
| Percentage of U.S. population receiving fluoridated waterc,d | 63.4% |
| Percentage of U.S. population on CWS receiving fluoridated waterc,e | 73.0% |
| Total number of CWS in United Statesb | 52,211 |
| Number of CWS providing fluoridated waterb | 17,917 |
| Number of CWS adjusting fluorideb | 5,753 |
| Number of CWS consecutive to systems with optimal fluoride levelsb | 6,340 |
| Number of CWS with naturally occurring fluoride at or above optimal levelsb | 5,727 |
| Population served by CWS with naturally occurring fluoride at or above optimal levelsb,c | 12,059,342 |
2018 state fluoridation percentage calculations and ranking
| State | Persons Receiving Fluoridated Waterc | Persons Served by CWSc | % Population Served by CWS Receiving Fluoridated Water | Rankf |
|---|---|---|---|---|
| U.S. | 207,426,536 | 284,075,868 | 73.0% | |
| Alabama | 3,388,374 | 4,345,270 | 78.0% | 24 |
| Alaska | 272,280 | 548,898 | 49.6% | 44 |
| Arizona | 4,028,381 | 6,942,498 | 58.0% | 38 |
| Arkansas | 2,448,389 | 2,867,653 | 85.4% | 21 |
| California | 22,613,284 | 38,106,418 | 59.3% | 37 |
| Colorado | 4,040,612 | 5,396,543 | 74.9% | 29 |
| Connecticut | 2,431,568 | 2,715,564 | 89.5% | 15 |
| Delaware | 670,879 | 781,453 | 85.9% | 20 |
| District of Columbia | 702,455 | 702,455 | 100.0% | 1 |
| Florida | 14,566,063 | 18,714,257 | 77.8% | 25 |
| Georgia | 8,531,824 | 8,959,918 | 95.2% | 7 |
| Hawaii | 120,106 | 1,364,632 | 8.8% | 51 |
| Idaho | 422,483 | 1,334,224 | 31.7% | 47 |
| Illinois | 11,386,618 | 11,600,611 | 98.2% | 4 |
| Indiana | 4,615,264 | 4,996,245 | 92.4% | 11 |
| Iowa | 2,396,677 | 2,657,024 | 90.2% | 14 |
| Kansas | 1,799,573 | 2,762,230 | 65.1% | 34 |
| Kentucky | 4,016,850 | 4,023,426 | 99.8% | 2 |
| Louisiana | 1,627,351 | 4,169,527 | 39.0% | 46 |
| Maine | 533,959 | 673,397 | 79.3% | 23 |
| Maryland | 4,317,542 | 4,610,160 | 93.7% | 9 |
| Massachusetts | 3,593,419 | 6,276,435 | 57.3% | 39 |
| Michigan | 6,605,118 | 7,379,404 | 89.5% | 16 |
| Minnesota | 4,356,770 | 4,408,195 | 98.8% | 3 |
| Mississippi | 1,549,996 | 2,552,607 | 60.7% | 36 |
| Missouri | 4,007,462 | 5,299,333 | 75.6% | 27 |
| Montana | 229,620 | 749,018 | 30.7% | 48 |
| Nebraska | 1,293,907 | 1,754,837 | 73.7% | 30 |
| Nevada | 2,124,516 | 2,832,273 | 75.0% | 28 |
| New Hampshire | 396,895 | 849,619 | 46.7% | 45 |
| New Jersey | 1,291,123 | 7,947,833 | 16.2% | 50 |
| New Mexico | 1,381,128 | 1,801,817 | 76.7% | 26 |
| New York | 12,200,464 | 17,074,791 | 71.5% | 32 |
| North Carolina | 6,915,858 | 7,894,251 | 87.6% | 18 |
| North Dakota | 688,710 | 713,531 | 96.5% | 5 |
| Ohio | 9,083,082 | 9,816,237 | 92.5% | 10 |
| Oklahoma | 2,417,819 | 3,583,323 | 67.5% | 33 |
| Oregon | 930,527 | 3,533,823 | 26.3% | 49 |
| Pennsylvania | 5,203,809 | 9,335,064 | 55.7% | 42 |
| Rhode Island | 785,748 | 944,353 | 83.2% | 22 |
| South Carolina | 3,543,429 | 3,855,997 | 91.9% | 12 |
| South Dakota | 706,191 | 753,308 | 93.7% | 8 |
| Tennessee | 5,470,615 | 6,160,242 | 88.8% | 17 |
| Texas | 19,861,964 | 27,327,755 | 72.7% | 31 |
| Utah | 1,614,982 | 3,096,343 | 52.2% | 43 |
| Vermont | 214,896 | 382,403 | 56.2% | 41 |
| Virginia | 6,675,987 | 6,934,535 | 96.3 | 6 |
| Washington | 4,128,148 | 6,459,585 | 63.9% | 35 |
| West Virginia | 1,290,637 | 1,422,373 | 90.7% | 13 |
| Wisconsin | 3,670,473 | 4,203,809 | 87.3% | 19 |
| Wyoming | 262,712 | 460,371 | 57.1% | 40 |
Footnotes
a Census Population Count 2018. Annual Estimates of the Population for the United States, Regions, States, and Puerto Rico: April 1, 2010, to July 1, 2018. Source: U.S. Census Bureau, Population Division. Release Date: December 2018. Accessed April 9, 2024. https://www2.census.gov/programs-surveys/popest/tables/2010-2018/state/totals/
b Reported in CDC Water Fluoridation Reporting System (WFRS). For purposes of this report, a water system is considered a community water system if so, designated by the state drinking water administrator in accordance with the regulatory requirements of the U.S. Environmental Protection Agency. A community water system (CWS) supplies water to the same population year-round. It serves at least 25 people at their primary residences or at least 15 residences that are primary residences (for example, municipalities, mobile home park, sub-divisions). https://www.epa.gov/dwreginfo/information-about-public-water-systems
c State populations served by CWS reported in WFRS are controlled using a product of the U.S. Census state population estimate and the U.S. Geological Survey's estimate of the percentages of state populations on public water systems. Populations served by each CWS are controlled proportionately within each state. For details on the population controlling method used, see Calculating Fluoridation Statistics. U.S. Geological Survey: Dieter CA, Maupin MA, Caldwell RR, et al. Estimated use of water in the United States in 2015: U.S. Geological Survey Circular 1441; 2018. https://doi.org/10.3133/cir1441 [Supersedes USGS Open-File Report 2017–1131.]
d Fluoridated population divided by total population.
e Fluoridated population divided by population served by community water systems.
f Rank is based on highest to lowest percentage of population served by CWS receiving fluoridated water. Includes all states and Washington, DC (51 total rankings).