What to know
Biennially, CDC summarizes Water Fluoridation Reporting System data into National Water Fluoridation Statistics. The 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.
2022 National Water Fluoridation Statistics
These statistics were prepared using water system data reported by states to the CDC Water Fluoridation Reporting System as of December 31, 2022, by the U.S. Census Bureau state population estimates as of July 1, 2020, and by population estimates served by public water supply as of 2015, as published by the U.S. Geological Survey June 19, 2018.
Values were aggregated or calculated at county and state levels. National-level values are a summation (or appropriate calculation based on a summation) of state-level values.
| Total U.S. population, personsa | 333,261,756 |
|---|---|
| U.S. population on community water systems (CWS), personsb,c | 289,330,482 |
| U.S. population on fluoridated drinking water systems, personsb,c | 209,135,866 |
| Percentage of U.S. population receiving fluoridated waterc,d | 62.8% |
| Percentage of U.S. population on CWS receiving fluoridated waterc,e | 72.3% |
| Total number of CWS in United Statesb | 51,842 |
| Number of CWS providing fluoridated waterb | 17,394 |
| Number of CWS adjusting fluorideb | 5,561 |
| Number of CWS consecutive to adjusting systems or to systems with naturally occurring fluoride at or above optimal levelsb | 5,749 |
| Number of CWS with naturally occurring fluoride at or above optimal levelsb | 5,542 |
| Population served by CWS with naturally occurring fluoride at or above optimal levelsb,c | 11,850,115 |
2022 State Fluoridation Percentage Calculations and States Ranked by Fluoridation Percentage
| State | Persons Served by CWS Receiving Fluoridated Waterc | Persons Served by CWSc | % Population Served by CWS Receiving Fluoridated Waterd | Rankf |
|---|---|---|---|---|
| U.S. | 209,135,866 | 289,330,482 | 72.3 | |
| Alabama | 3,454,238 | 4,511,000 | 76.6 | 24 |
| Alaska | 230,703 | 546,029 | 42.3 | 45 |
| Arizona | 4,095,922 | 7,124,056 | 57.5 | 38 |
| Arkansas | 2,515,336 | 2,897,922 | 86.8 | 19 |
| California | 21,707,473 | 37,598,067 | 57.7 | 37 |
| Colorado | 4,173,964 | 5,533,326 | 75.4 | 27 |
| Connecticut | 2,490,818 | 2,756,260 | 90.4 | 15 |
| Delaware | 574,020 | 822,842 | 69.8 | 32 |
| District of Columbia | 671,803 | 671,803 | 100.0 | 1 |
| Florida | 15,261,629 | 19,545,001 | 78.1 | 23 |
| Georgia | 8,835,367 | 9,294,995 | 95.1 | 7 |
| Hawaii | 118,083 | 1,383,562 | 8.5 | 51 |
| Idaho | 457,121 | 1,474,799 | 31.0 | 48 |
| Illinois | 11,251,149 | 11,455,800 | 98.2 | 4 |
| Indiana | 4,668,351 | 5,101,636 | 91.5 | 12 |
| Iowa | 2,393,799 | 2,694,378 | 88.8 | 16 |
| Kansas | 1,822,457 | 2,786,560 | 65.4 | 33 |
| Kentucky | 4,051,820 | 4,062,962 | 99.7 | 2 |
| Louisiana | 1,555,209 | 4,107,130 | 37.9 | 46 |
| Maine | 554,377 | 697,013 | 79.5 | 22 |
| Maryland | 4,384,852 | 4,703,193 | 93.2 | 9 |
| Massachusetts | 3,697,733 | 6,349,023 | 58.2 | 36 |
| Michigan | 6,729,495 | 7,407,603 | 90.8 | 13 |
| Minnesota | 4,440,949 | 4,491,474 | 98.9 | 3 |
| Mississippi | 1,188,471 | 2,512,886 | 47.3 | 42 |
| Missouri | 4,088,368 | 5,343,885 | 76.5 | 26 |
| Montana | 259,366 | 791,719 | 32.8 | 47 |
| Nebraska | 1,328,229 | 1,789,997 | 74.2 | 28 |
| Nevada | 2,200,897 | 2,966,103 | 74.2 | 29 |
| New Hampshire | 397,977 | 873,905 | 45.5 | 43 |
| New Jersey | 1,334,775 | 8,262,926 | 16.2 | 50 |
| New Mexico | 1,391,829 | 1,817,223 | 76.6 | 25 |
| New York | 12,321,385 | 17,192,696 | 71.7 | 30 |
| North Carolina | 7,155,990 | 8,134,002 | 88.0 | 18 |
| North Dakota | 705,946 | 731,540 | 96.5 | 5 |
| Ohio | 9,157,130 | 9,872,178 | 92.8 | 10 |
| Oklahoma | 2,318,319 | 3,653,044 | 63.5 | 35 |
| Oregon | 945,389 | 3,575,500 | 26.4 | 49 |
| Pennsylvania | 5,231,249 | 9,455,294 | 55.3 | 40 |
| Rhode Island | 823,747 | 976,881 | 84.3 | 21 |
| South Carolina | 3,685,922 | 4,006,552 | 92.0 | 11 |
| South Dakota | 731,457 | 776,865 | 94.2 | 8 |
| Tennessee | 5,666,939 | 6,416,232 | 88.3 | 17 |
| Texas | 20,215,247 | 28,591,918 | 70.7 | 31 |
| Utah | 1,442,776 | 3,311,537 | 43.6 | 44 |
| Vermont | 224,047 | 395,082 | 56.7 | 39 |
| Virginia | 6,759,993 | 7,069,628 | 95.6 | 6 |
| Washington | 4,299,642 | 6,674,055 | 64.4 | 34 |
| West Virginia | 1,265,766 | 1,398,211 | 90.5 | 14 |
| Wisconsin | 3,603,383 | 4,260,914 | 84.6 | 20 |
| Wyoming | 254,959 | 463,275 | 55.0 | 41 |
Footnotes
a Census Population Count 2020. Annual Estimates of the Resident Population for the United States, Regions, States, District of Columbia, and Puerto Rico: April 1, 2020, to July 1, 2021 (NST-EST2021-POP); released December 2022. Source: U.S. Census Bureau, Population Division. Accessed at https://www2.census.gov/programs-surveys/popest/tables/2020-2022/state/totals/
b Reported in CDC Water Fluoridation Reporting System (WFRS). For this report, a water system is considered a community water system (CWS) if so designated by the state drinking water administrator, in accordance with the regulatory requirements of the U.S. Environmental Protection Agency. A CWS supplies water to the same population year-round and 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 Estimates of state populations served by CWSs and reported in WFRS are controlled by 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 that are on public water systems. Estimates for 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, C.A., Maupin M.A., Caldwell R.R., Harris, M.A., Ivahnenko, T.I., Lovelace, J.K., Barber, N.L., and Linsey, K.S., 2018, Estimated use of water in the United States in 2015: U.S. Geological Survey Circular 1441, 65 p., https://doi.org/10.3133/cir1441. [Supersedes USGS Open-File Report 2017–1131.]
d Population served by CWSs receiving fluoridated water divided by total population.
e Population served by CWSs receiving fluoridated water divided by population served by CWSs.
f Based on highest to lowest percentage of population served by CWS receiving fluoridated water. Includes all states and Washington, DC (51 total rankings).