© 2025 American Dental Association l 111
Fluoridation Facts
When it comes to the cost of treating dental disease, everyone pays, not just those who need treatment,
but the entire community through higher health insurance premiums and higher taxes. Cutting dental
care costs by reducing tooth decay is something a community can do to improve oral health and save
money for everyone. With the escalating cost of health care, fluoridation remains a community public
health measure that saves money and therefore benefits all members of the community.
When it comes to the cost of treating dental disease, everyone pays, not just those
who need treatment, but the entire community through higher health insurance
premiums and higher taxes. Cutting dental care costs by reducing tooth decay is
something a community can do to improve oral health and save money for everyone.
The economic importance of fluoridation is underscored by the fact that the cost of treating dental disease
frequently is paid not only by the affected individual, but also by the general public through services
provided by health departments, community health clinics, health insurance premiums, the military, and
other publicly supported medical programs.475 For example, results from a New York state study published in
2010476 that compared the number of Medicaid claims in 2006 for cavity-related procedures in fluoridated
counties and non-fluoridated counties showed a 33.4% higher level of claims for fillings, root canals,
and extractions in non-fluoridated counties as compared to such claims in fluoridated counties.476
Fluoridation contributes much more to overall health than simply reducing tooth decay. It prevents
needless infection, pain, suffering, and loss of teeth and saves vast sums of money in dental treatment
cost—particularly in cases where dental care is received through surgical intervention (fillings, root
canals, prosthodontics, and/or extractions) in a hospital or through hospital emergency services.
In a study477 conducted in Louisiana, Medicaid-eligible children ages 1–5 years residing in communities
without fluoridated water were three times more likely than Medicaid-eligible children residing in
communities with fluoridated water to receive dental treatment in a hospital, and the cost of dental
treatment per eligible child was approximately twice as high. In addition to community water fluoridation
status, the study took into account per capita income, population, and number of dentists per county.477
National Preventive Dentistry Demonstration Program
School-based dental disease prevention activities, such as fluoride mouthrinse or tablet programs,
professionally applied topical fluorides, dental health education, and placement of dental sealants, are
beneficial but are not as cost-effective in preventing tooth decay as community water fluoridation.478
In 1985, the National Preventive Dentistry Demonstration Program analyzed various types and
combinations of school-based preventive dental services to determine the cost and effectiveness of
these types of prevention programs.478 Ten sites from across the nation were selected. Five of the
sites had fluoridated water and five did not. More than 20,000 second and fifth graders participated
in the study during a period of four years. Students were examined and assigned by site to one or a
combination of the following groups:
• Biweekly in-class brushing and flossing plus a home supply of fluoride toothpaste and dental
health lessons (10 per year)
• In-class daily fluoride tablets (in non-fluoridated areas)
• In-school weekly fluoride mouthrinsing
Fluoridation Facts
When it comes to the cost of treating dental disease, everyone pays, not just those who need treatment,
but the entire community through higher health insurance premiums and higher taxes. Cutting dental
care costs by reducing tooth decay is something a community can do to improve oral health and save
money for everyone. With the escalating cost of health care, fluoridation remains a community public
health measure that saves money and therefore benefits all members of the community.
When it comes to the cost of treating dental disease, everyone pays, not just those
who need treatment, but the entire community through higher health insurance
premiums and higher taxes. Cutting dental care costs by reducing tooth decay is
something a community can do to improve oral health and save money for everyone.
The economic importance of fluoridation is underscored by the fact that the cost of treating dental disease
frequently is paid not only by the affected individual, but also by the general public through services
provided by health departments, community health clinics, health insurance premiums, the military, and
other publicly supported medical programs.475 For example, results from a New York state study published in
2010476 that compared the number of Medicaid claims in 2006 for cavity-related procedures in fluoridated
counties and non-fluoridated counties showed a 33.4% higher level of claims for fillings, root canals,
and extractions in non-fluoridated counties as compared to such claims in fluoridated counties.476
Fluoridation contributes much more to overall health than simply reducing tooth decay. It prevents
needless infection, pain, suffering, and loss of teeth and saves vast sums of money in dental treatment
cost—particularly in cases where dental care is received through surgical intervention (fillings, root
canals, prosthodontics, and/or extractions) in a hospital or through hospital emergency services.
In a study477 conducted in Louisiana, Medicaid-eligible children ages 1–5 years residing in communities
without fluoridated water were three times more likely than Medicaid-eligible children residing in
communities with fluoridated water to receive dental treatment in a hospital, and the cost of dental
treatment per eligible child was approximately twice as high. In addition to community water fluoridation
status, the study took into account per capita income, population, and number of dentists per county.477
National Preventive Dentistry Demonstration Program
School-based dental disease prevention activities, such as fluoride mouthrinse or tablet programs,
professionally applied topical fluorides, dental health education, and placement of dental sealants, are
beneficial but are not as cost-effective in preventing tooth decay as community water fluoridation.478
In 1985, the National Preventive Dentistry Demonstration Program analyzed various types and
combinations of school-based preventive dental services to determine the cost and effectiveness of
these types of prevention programs.478 Ten sites from across the nation were selected. Five of the
sites had fluoridated water and five did not. More than 20,000 second and fifth graders participated
in the study during a period of four years. Students were examined and assigned by site to one or a
combination of the following groups:
• Biweekly in-class brushing and flossing plus a home supply of fluoride toothpaste and dental
health lessons (10 per year)
• In-class daily fluoride tablets (in non-fluoridated areas)
• In-school weekly fluoride mouthrinsing
