The estimated total increase in dental costs from eliminating fluoride in community water systems is estimated at more than $45 billion across the U.S. over the next five years, according to data from the American Dental Association.
California and Texas are projected to have the highest increase in dental care costs out of any state, with both expected to increase by $4 billion.
The ADA estimated the cost using a recently published cost-effectiveness analysis, as well as 2022 data from the Medical Expenditure Panel Survey.
As of 2022, 62.6% of the U.S. receives fluoridated water through a community water system, according to the Water Fluoridation Reporting System managed by the CDC.
Here is the estimated five-year increase in dental care costs due to the removal of fluoride in community water systems for all 50 states:
Alabama: $757.8 million
Alaska: $50.5 million
Arizona: $899.6 million
Arkansas: $551.0 million
California: $4.8 billion
Colorado: $917.8 million
Connecticut: $548.4 million
Delaware: $126.3 million
District of Columbia: $148.2 million
Florida: $3.4 billion
Georgia: $1.9 billion
Hawaii: $26.0 million
Idaho: $99.7 million
Illinois: $2.5 billion
Indiana: $1.0 billion
Iowa: $524.4 million
Kansas: $398.6 million
Kentucky: $888.7 million
Louisiana: $340.5 million
Maine: $122.6 million
Maryland: $962.4 million
Massachusetts: $815.0 million
Michigan: $1.5 billion
Minnesota: $973.4 million
Mississippi: $260.2 million
Missouri: $897.0 million
Montana: $57.0 million
Nebraska: $290.2 million
Nevada: $483.8 million
New Hampshire: $88.0 million
New Jersey: $293.2 million
New Mexico: $305.6 million
New York: $2.7 billion
North Carolina: $1.6 billion
North Dakota: $154.4 million
Ohio: $2.0 billion
Oklahoma: $507.0 million
Oregon: $208.4 million
Pennsylvania: $1.2 billion
Rhode Island: $181.7 million
South Carolina: $809.7 million
South Dakota: $159.9 million
Tennessee: $1.2 billion
Texas: $4.4 billion
Utah: $313.1 million
Vermont: $49.5 million
Virginia: $1.5 billion
Washington: $945.4 million
West Virginia: $278.9 million
Wisconsin: $791.8 million
Wyoming: $55.9 million
