Pennsylvania Water Fluoride: Updated Statistics

In Pennsylvania, water fluoridation has long played a role in public health strategies aiming to reduce dental caries rates. Despite this, the state maintains lower coverage levels than many neighboring states, leading to significant variations in fluoride access.

Understanding the latest numbers on water fluoridation coverage, health impacts, and regional disparities can help illustrate the evolving nature of fluoride use. Below is a data-rich overview of how water fluoridation looks across Pennsylvania in 2025, comparing the state's figures with nearby regions, examining trends from 2005 onward, and highlighting key public health indicators connected with fluoridation efforts.

Noteworthy Statistics at a Glance

Below are four prominent data points central to understanding water fluoridation in Pennsylvania today:

• 50% of Pennsylvanians receive fluoridated water, placing the state 42nd nationwide.
• Maryland stands at 94.7% coverage, whereas New Jersey reports only 16.1%.
• State-level data suggests a 5.4% increase in fluoridated populations between 2015 and 2025.
• 59.7% of third-grade children in a statewide survey were found to have caries, with fluoridation linked to a 16% lower risk.

These data points provide a quick snapshot of how widely fluoridation is implemented and how it connects with oral health measures. The next sections delve deeper into coverage trends, regional differences, health findings, and small water systems technology.

Coverage Trends Over Time

Examining water fluoridation coverage over a 20-year span offers insights into the state’s shifting landscape.

• In 2005, 52% of Pennsylvania’s population was served by fluoridated water.
• By 2021, coverage lingered at around 50%, with no significant jump in most regions.
• At least 16 counties in Pennsylvania remain entirely unfluoridated.
• The statewide maximum contaminant level set at 2.0 mg/L is stricter than the federal standard of 4.0 mg/L.
• Pennsylvania requires a permit for both starting and ceasing fluoridation, slowing rapid changes in coverage rates.

Although progress has not been dramatic, some areas have seen modest increases in fluoridation access. The following table demonstrates shifts in statewide percentages for select years.

These figures reflect a gradual yet non-uniform trajectory, influenced by local activism, permit regulations, and infrastructural changes in certain Pennsylvania communities.

Regional Comparisons

Comparing Pennsylvania to bordering states offers perspective on how it ranks in water fluoridation coverage.

• 42nd is Pennsylvania’s national rank in percentage of the population receiving fluoridated water through public systems.
• Maryland maintains 94.7% coverage, placing it 3rd nationwide.
• New Jersey has a notably low coverage of 16.1%, ranking it 49th in the nation.
• Ohio stands at 75.2%, positioning it around 15th nationally.
• West Virginia has approximately 72.3% coverage, landing near 22nd place.

These comparative data points underscore significant differences in policy approaches and longstanding practices. Below is a snapshot of how Pennsylvania’s numbers line up with its neighbors.

These figures reveal a wide spectrum of fluoridation efforts and outcomes, influenced by factors such as centralized regulation, local mandates, and public acceptance.

Dental Health Impacts

Assessing oral health data helps connect these coverage numbers to real-world implications.

• A recent survey found 59.7% of third-grade students in Pennsylvania had caries.
• Children in fully fluoridated areas showed a 16% lower caries risk than those without fluoridation.
• Students receiving free or reduced lunch had a 33% higher overall caries risk, indicating socioeconomic disparities.
• Philadelphia and Pittsburgh, fluoridated since the 1950s, have the state’s highest reported dental fluorosis rates.
• Guidelines from 2015 set 0.7 mg/L as the optimal level to balance protective benefits against fluorosis risk.

With nearly 60% of children showing signs of caries, these statistics underscore the benefits—and ongoing concerns—of water fluoridation in preventing tooth decay.

Although fluoridation has demonstrated a measurable impact on dental health, certain communities continue to see disparities related to socioeconomic status and other factors.

Small Water Systems Technology

Adopting low-cost technology can help extend fluoridation to communities with fewer resources.

• A CDC-funded dissolvable fluoride tablet initiative could benefit 32,000 small utilities across the country.
• An estimated 19 million Americans could gain access to fluoridated water through this method.
• In Pennsylvania, implementing tablet systems might boost coverage in rural counties like Juniata and Forest.
• Cost considerations in some Western Pennsylvania towns have led to debates on whether to keep or remove fluoride due to annual expenses as low as $4,000.
• Between 2003 and 2015, cessation of fluoridation was documented in Yardley, York, and Shaler, often citing operational costs and local opposition.

Introducing tablet-based fluoridation in small or rural water systems may gradually reduce these coverage gaps, although its adoption depends on regulatory approval and local acceptance. The table below highlights potential coverage expansions in underserved areas.

Small-scale, dissolvable tablet solutions appear promising, but the overall impact will depend on broader acceptance and the cost-benefit analysis of local water authorities.

Key Statistics Summary

• Pennsylvania’s fluoridation coverage stands at 50% of its population.
• Fluoridation can reduce dental caries risk among children by 16%.
• Maryland leads neighboring states with 94.7% coverage; New Jersey lags at 16.1%.
• 16 counties in Pennsylvania remain entirely unfluoridated.
• A recent statewide survey reported 59.7% caries prevalence among third-grade students.

These statistics illustrate persistent disparities among different regions of Pennsylvania and its neighboring states, despite clear indications that water fluoridation provides measurable benefits to oral health. While some communities benefit from nearly complete fluoridation coverage, others continue to debate or resist its implementation due to financial or social concerns.