2020 Fluoridation Statistics
NOTE: Updated 7/7/2023. Control factor applied to state provided populations for PA. US population on fluoridated drinking water systems and percentage of US population on CWS receiving fluoridated water values were updated accordingly.
These statistics were prepared using water system data reported by states to the CDC Water Fluoridation Reporting System as of December 31, 2020, by the US Census Bureau state population estimates for April 2020, and by population estimates served by public water supply as of 2015, as published by the US Geological Survey June 19, 2018.
2020 National Water Fluoridation Statistics
| Total US population, personsa | 331,501,080 |
|---|---|
| US population on community water systems (CWS), personsb,c | 287,798,584 |
| Total US population on fluoridated drinking water systems, personsb,c | 209,145,650 |
| Percentage of US population receiving fluoridated waterc,d | 62.9% |
| Percentage of US population on CWS receiving fluoridated waterc,e | 72.7% |
| Total number of CWS in United Statesb | 51,373 |
| Number of CWS providing fluoridated waterb | 17,558 |
| Number of CWS adjusting fluorideb | 5,728 |
| Number of CWS consecutive to systems with optimal fluoride levelsb | 5,696 |
| Number of CWS with naturally occurring fluoride at or above optimal levelsb | 5,636 |
| Population served by CWS with naturally occurring fluoride at or above optimal levelsb,c | 11,578,079 |
2020 State Fluoridation Percentage Calculations and States Ranked by Fluoridation Percentage
| State | Persons Receiving Fluoridated Waterc | Persons Served by CWSc | % Population Served by CWS Receiving Fluoridated Water | Rankf |
|---|---|---|---|---|
| US | 209,145,650 | 287,798,584 | 72.7 | |
| Alabama | 3,469,133 | 4,467,001 | 77.7 | 24 |
| Alaska | 229,789 | 545,179 | 42.1 | 45 |
| Arizona | 4,011,354 | 6,948,635 | 57.7 | 39 |
| Arkansas | 2,458,935 | 2,866,138 | 85.8 | 20 |
| California | 21,879,582 | 38,051,212 | 57.5 | 40 |
| Colorado | 4,123,671 | 5,480,628 | 75.2 | 28 |
| Connecticut | 2,473,983 | 2,736,539 | 90.4 | 14 |
| Delaware | 609,473 | 801,422 | 76 | 27 |
| District of Columbia | 690,093 | 690,093 | 100 | 1 |
| Florida | 14,886,493 | 18,952,021 | 78.5 | 23 |
| Georgia | 8,671,136 | 9,135,654 | 94.9 | 7 |
| Hawaii | 119,044 | 1,394,816 | 8.5 | 51 |
| Idaho | 441,664 | 1,405,388 | 31.4 | 47 |
| Illinois | 11,457,094 | 11,640,823 | 98.4 | 4 |
| Indiana | 4,683,083 | 5,066,252 | 92.4 | 11 |
| Iowa | 2,409,673 | 2,684,404 | 89.8 | 15 |
| Kansas | 1,820,664 | 2,785,355 | 65.4 | 34 |
| Kentucky | 4,050,483 | 4,055,441 | 99.9 | 2 |
| Louisiana | 1,582,811 | 4,161,676 | 38 | 46 |
| Maine | 544,916 | 685,410 | 79.5 | 22 |
| Maryland | 4,410,410 | 4,709,311 | 93.7 | 9 |
| Massachusetts | 3,691,328 | 6,385,621 | 57.8 | 38 |
| Michigan | 6,638,231 | 7,432,372 | 89.3 | 16 |
| Minnesota | 4,432,008 | 4,483,603 | 98.8 | 3 |
| Mississippi | 1,542,928 | 2,527,257 | 61.1 | 36 |
| Missouri | 3,843,523 | 5,323,578 | 72.2 | 30 |
| Montana | 240,294 | 765,861 | 31.4 | 48 |
| Nebraska | 1,317,170 | 1,784,114 | 73.8 | 29 |
| Nevada | 2,220,915 | 2,906,645 | 76.4 | 26 |
| New Hampshire | 398,698 | 863,017 | 46.2 | 44 |
| New Jersey | 1,333,544 | 8,279,024 | 16.1 | 50 |
| New Mexico | 1,398,194 | 1,820,853 | 76.8 | 25 |
| New York | 12,596,165 | 17,610,152 | 71.5 | 31 |
| North Carolina | 6,985,222 | 7,950,174 | 87.9 | 18 |
| North Dakota | 705,703 | 731,260 | 96.5 | 5 |
| Ohio | 9,177,890 | 9,901,174 | 92.7 | 10 |
| Oklahoma | 2,447,980 | 3,600,546 | 68 | 33 |
| Oregon | 944,045 | 3,576,686 | 26.4 | 49 |
| Pennsylvaniag | 5,680,881 | 9,468,135 | 60 | 37 |
| Rhode Island | 809,308 | 979,110 | 82.7 | 21 |
| South Carolina | 3,567,836 | 3,891,342 | 91.7 | 12 |
| South Dakota | 710,136 | 757,461 | 93.8 | 8 |
| Tennessee | 5,592,155 | 6,296,831 | 88.8 | 17 |
| Texas | 19,743,163 | 27,818,869 | 71 | 32 |
| Utah | 1,637,472 | 3,214,451 | 50.9 | 43 |
| Vermont | 221,018 | 392,292 | 56.3 | 41 |
| Virginia | 6,713,205 | 7,027,639 | 95.5 | 6 |
| Washington | 4,304,476 | 6,616,621 | 65.1 | 35 |
| West Virginia | 1,277,174 | 1,409,744 | 90.9 | 13 |
| Wisconsin | 3,695,850 | 4,260,757 | 86.7 | 19 |
| Wyoming | 255,654 | 459,997 | 55.6 | 42 |
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 2021. Source: US Census Bureau, Population Division. Accessed at https://www2.census.gov/programs-surveys/popest/tables/2020-2021/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 US 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). http://water.epa.gov/infrastructure/drinkingwater/pws/factoids.cfm.
c Estimates of state populations served by CWSs and reported in WFRS are controlled by using a product of the US Census state population estimate and the US 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. US 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: US Geological Survey Circular 1441, 65 p., 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 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).
g Complete data were not available from WFRS. State provided additional information.