New York Water Fluoride: Updated Statistics

New York’s water fluoridation efforts have undergone notable shifts over the past two decades, reflecting diverse practices and demographic differences across the state. Although public water fluoridation has traditionally been a key preventive health measure, coverage has trended downward in some regions while stabilizing or expanding in others.

In examining these statistics, we see that coverage rates, infrastructure demands, and socioeconomic factors intersect to shape oral health outcomes. The data below provide a detailed look at how these elements evolve county by county and across different segments of the population.

Key Figures at a Glance

Here are four important data points that highlight the recent trends and disparities in New York’s water fluoridation coverage:

• 71.4% statewide fluoridation coverage in 2012, down from 75% in 2000
• 100% coverage in New York City, sustained since the 1960s
• 0% fluoridation rate on Long Island, despite dense population
• 19% rise in pediatric caries claims during Buffalo’s fluoridation gap (2015–2023)

These key statistics offer a glimpse into varying local policies and illustrate how differences in coverage contribute to disparities in oral health outcomes. Further data help clarify these trends across time and regions.

Statewide Coverage Trends

Understanding New York’s changing coverage rates over time underscores the wide-ranging impact on oral health services and preventive care usage.

• The number of community water systems fluoridating dropped from 139 in 2009 to 125 in 2012
• Overall coverage stabilized at around 71% by 2020, placing New York 31st among U.S. states
• Statewide coverage in 2005 was higher than in 2012, reflecting a gradual decline over the period
• Fluoridation rates have historically been strong in urban centers but uneven in rural and suburban areas

Although the decline has slowed in recent years, these figures emphasize the need to assess how coverage variations correlate with health outcomes and cost implications. Below is a simplified view of overall fluoridation changes by select time points.

Regional Disparities

Coverage rates vary considerably across New York, highlighting local policy decisions and infrastructure considerations that lead to different outcomes.

• 100% coverage in New York City ensures universal availability for over 8 million residents
• 89.8% coverage in Western New York counties, reflecting high rates in urban centers offset by gaps in rural water systems
• Only 39.5% coverage in the Capital Region, influenced by historic resistance in Albany and Schenectady
• 0% fluoridation in Nassau and Suffolk counties on Long Island, affecting a large suburban population

These localized differences relate directly to observed oral health outcomes and costs. The table below gives a snapshot of 2025 fluoridation rates by major region.

Oral Health Impacts

The connection between water fluoridation and caries prevention is well-documented, with data illustrating how differing coverage rates shape oral health burdens and healthcare costs.

• A 19% rise in pediatric caries procedures in Buffalo during its 2015–2023 fluoridation gap
• 33% more restorative procedures among Medicaid enrollees in low-fluoridation counties
• $23.65 higher per-capita treatment costs in non-fluoridated regions
• 27% lower caries incidence in fluoridated Newburgh compared to non-fluoridated Kingston, narrowing to a 16% gap in 2024

These findings underscore the significance of consistent fluoridation for long-term cost reduction and caries prevention across various population groups. The table below highlights select oral health indicators in key counties.

Comparisons and Infrastructure Factors

Comparative data across neighboring states and within New York reveal how policy history and aging water systems contribute to the variability in fluoridation coverage.

• Massachusetts (92.1%) and Connecticut (88.4%) far exceed New York’s ~71% coverage
• Statewide 5th-grade caries rate in New York stands at 34%, above 28% in Connecticut and 26% in Massachusetts
• Only 61% of New York children receive dental sealants, compared to 69% in New England
• Up to 43% of upstate water systems require major upgrades, costing an estimated $2.1 billion

Infrastructure improvements and the presence or absence of fluoridation technology continue to shape public health outcomes, with upgrades in major cities like New York City temporarily affecting coverage levels. The table below provides a brief comparison with nearby states.

Key Statistics Summary

• Coverage dropped from 75% (2000) to 71.4% (2012), stabilizing near 71% by 2020
• Long Island remains at 0% fluoridation despite a large suburban population
• Children in low-fluoridation counties face 33% more restorative procedures
• New York ranks 31st in the nation for community water fluoridation rates
• Massachusetts and Connecticut both exceed 88% coverage, contrasting with New York’s lower rate

These data underscore how infrastructure constraints, local policies, and regional variations contribute to divergent oral health outcomes statewide. Despite universal coverage in New York City, other regions continue to grapple with reduced access to fluoridated water and its associated benefits.