Research shows that community water fluoridation offers perhaps the greatest return-on-investment of any public health strategy. The reduction in just the costs of filling and extracting diseased teeth and time lost from work to get care—not counting reduction in dental pain and discomfort—more than makes up for the cost of fluoridation. In recent decades, the evidence showing savings has grown:

  • For most cities, every $1 invested in water fluoridation saves $38 in dental treatment costs.
  • A Texas study confirmed that the state saved $24 per child, per year in Medicaid expenditures for children because of the cavities that were prevented by drinking fluoridated water.
  • A 2010 study in New York State found that Medicaid enrollees in less fluoridated counties needed 33 percent more fillings, root canals, and extractions than those in counties where fluoridated water was much more prevalent. As a result, the treatment costs per Medicaid recipient were $23.65 higher for those living in less fluoridated counties.
  • Researchers estimated that in 2003 Colorado saved nearly $149 million in unnecessary treatment costs by fluoridating public water supplies—average savings of roughly $61 per person.
  • A 1999 study compared Louisiana parishes (counties) that were fluoridated with those that were not. The study found that low-income children in communities without fluoridated water were three times more likely than those in communities with fluoridated water to need dental treatment in a hospital operating room.
  • By reducing the incidence of decay, fluoridation makes it less likely that toothaches or other serious dental problems will drive people to hospital emergency rooms (ERs)—where treatment costs are high. A 2010 survey of hospitals in Washington State found that dental disorders were the leading reason why uninsured patients visited ERs.
  • Scientists who testified before Congress in 1995 estimated that national savings from water fluoridation totaled $3.84 billion each year.