How Ending Water Fluoridation Would Affect Children and State Medicaid Costs

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In this report, researchers at CareQuest Institute analyzed how ending water fluoridation would affect the well-being of children and Medicaid costs within five states: Florida, Kentucky, Louisiana, Oklahoma, and Missouri. Each of these states has legislation to ban or restrict water fluoridation, with a ban already passed in Florida.  

Researchers examined Medicaid costs because children from low-income households have a greater risk of cavities compared to children from upper-income households. For families living paycheck to paycheck and for state budgets, researchers found, costs to treat additional cavities can be unaffordable. 

Key Findings 

• A water fluoridation ban in just these five states would cause more than 132,000 additional children to need cavities filled or teeth pulled, and cost state Medicaid programs nearly $40 million within three years. 
• Children with tooth pain are three times more likely to miss school and four times more likely to receive lower grades. 
• In 2023, an estimated 6 million parents/guardians reported missing approximately 38.5 million work productivity hours in the prior year due to their children’s oral pain or unplanned dental visits. 

After more than 7,000 studies, the overwhelming weight of scientific evidence shows that fluoride in water at levels recommended in the US is safe and effective at preventing cavities. Researchers said:

Clearly, ending fluoridation would strike a blow to children’s health, well-being, and opportunity.”

You may also be interested in: 

• 2026 Community Water Fluoridation Policy Map, a map tracking the status of state legislation to ban, restrict, or protect water fluoridation. 
• Community Water Fluoridation, a collection of statistics and science-based resources on the topic. 
• Community Water Fluoridation: Proven, Safe, and Essential for Oral Health, a fact sheet highlighting the overwhelming benefits of community water fluoridation to prevent tooth decay and reduce health care costs.