Fluoridation in New York State: Costs and Savings

Studies continue to show that community water fluoridation prevents cavities and saves money, both for families and the health care system.

  • Cost of fluoridation depends on the size of the community and the amount of fluoride added to the water supply. In one study, the median cost per person per year ranged from $2.70 among 19 systems serving <5000 people to $0.40 among 35 systems serving ≥20,000 people.1
  • The results of the National Preventive Dentistry Demonstration Program study found that water fluoridation was the most cost effective means of reducing tooth decay in children. It prevented as much tooth decay as a dental sealant program. In contrast to the $23 per year cost of maintaining a child in a sealant program, the annual per capita cost (in 1981 dollars) of water fluoridation in five United States communities ranged from $0.06 in Denver, Colorado to $0.80 in rural West Virginia.2
  • Fluoride tablets and drops, rinses and toothpastes, are more expensive and less effective than the fluoridation of drinking water.3
  • Every dollar spent on fluoridation on average saves $38 in avoided dental bills. Over a lifetime the cost of fluoridation is typically less than the cost of one dental filling.4
  • The difference in treatment costs per Medicaid-eligible child residing in parishes in Louisiana with community water fluoridation (F) compared with those residing in parishes without fluoridation (NF) ranged from $14.68 for 1-year-olds to $58.91 for 3-year-olds; at all ages, costs were higher in NF than in F parishes. In 1995-1996, the mean difference in treatment costs per eligible preschooler was $36.28 (95% confidence interval=$9.69-$62.87).5
  • A study found that the annual savings associated with fluoridation in Colorado was $148.9 million (credible range, $115.1 million to $187.2 million) in 2003, or an average of $60.78 per person (credible range, $46.97 to $76.41).6
  • Recently, an increase in the cost of fluoride chemicals has been reported. It still costs much less to fluoridate, when compared to the costs for dental fillings for a single tooth over a lifetime because the cost of fillings has also increased. This is further compounded, by the need to restore and maintain fillings. On an average, fillings are expected to last about 12 years.


  1. Truman BI, Gooch BF, Sulemana I, et al., and the Task Force on Community Preventive Services. Reviews of evidence on interventions to reduce dental caries, oral and pharyngeal cancers, and sports-related craniofacial injury. American Journal of Preventive Medicine 2002;23(1S): 1–84.
  2. Klein SP, Bohannan HM, Bell RM, Disney JA, Foch CB, Graves RC. The cost and effectiveness of school-based preventive dental care. Am J Public Health 1985; 75(4):382-391.
  3. Kumar JV, Moss ME. Fluorides in dental public health programs. Dent Clin N Am 2008;52: 387-401.
  4. Griffin SO, Jones K, Tomar SL. An economic evaluation of community water fluoridation. J Public Health Dent 2001; 61(2):78-86.
  5. Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. Water Fluoridation and Costs of Medicaid Treatment for Dental Decay—Louisiana, 1995-1996. MMWR. September 02, 1999/48(34);753-757.
  6. O'Connell JM, Brunson D, Anselmo T, Sullivan PW. Costs and savings associated with community water fluoridation programs in Colorado. Prev Chronic Dis 2005; 2 Spec no:A06.

For more information, contact:

Division of Oral Health
Centers for Disease Control and Prevention
4770 Bufford Highway, NE, MSF-10
Atlanta, GA 30333
Phone: 770-488-6054
New York State Department of Health
Bureau of Dental Health
ESP, Tower Bldg, Room 542
Albany NY, 12237
Phone: 518-474-1961
Bureau of Water Supply Protection
New York State Department of Health
547 River Street
Troy, New York, 12180-2216
Phone: (518) 402 7652