South Carolina Water Fluoride: Updated Statistics

South Carolina has long maintained high levels of water fluoridation coverage, surpassing many other states in the region. With changes in federal recommendations over the past decade, residents and operators alike have sought clarity on how much fluoride is actually in their drinking water.

This article presents a detailed, data-driven view of South Carolina’s fluoridation levels, focusing on coverage percentages, recommended dosing compliance, and health-related statistics. By highlighting the core figures from recent state and regional findings, we aim to offer a concise, fact-focused resource for individuals, communities, and professionals.

Key Statistics at a Glance

• Between 92% and 93.3% of the state’s public water system population is served by fluoridated water.
• Only about 30% of systems fully meet the 0.7 mg/L recommended fluoride level.
• Approximately 25% fewer childhood cavities are reported where fluoridation is at or near optimal levels.
• Nearly 10 communities in the state have considered discontinuing water fluoridation in the past decade.

These figures reveal a substantial commitment to water fluoridation across South Carolina while illustrating ongoing challenges in achieving recommended dosage levels. Below, the data is explored in greater depth.

Adoption and Coverage Levels

Understanding how many people receive fluoridated water offers insight into the reach of statewide efforts.

• 92%–93.3% of South Carolina’s public water system population benefits from water fluoridation.
• In 2002, coverage stood at 91.4%, exceeding the then-national average of 66%.
• By 2024, out of 41 water systems that adjust fluoride, 36.6% reported levels at or below 0.7 mg/L, indicating under-dosing in some cases.
• 69 systems in the state rely on naturally occurring fluoride levels of at least 0.7 mg/L, serving nearly 97,000 residents.

Despite early success, reported figures show that many operators still misinterpret the 0.7 mg/L mark, leading to instances of both under-dosing and variable compliance.

Comparison with Neighboring States

South Carolina’s coverage levels can be better understood by looking at neighboring states.

• Georgia reports 99.7% water fluoridation coverage, supported by state-level legal requirements.
• North Carolina’s overall coverage is at 88%, though local opt-outs have risen in recent years.
• In Tennessee, 95.9% of residents on public systems receive fluoridated water.
• South Carolina’s compliance with the 0.7 mg/L target (63.4% of adjusting systems) remains below Georgia’s 96% figure.

While Georgia leads in coverage, its stricter state-mandated fluoridation policy contrasts with more county-driven approaches elsewhere, including North and South Carolina.

Health-Related Statistics

Data on cavities, fluorosis, and other health indicators often guide community opinions and program funding.

• An estimated 25% reduction in childhood cavities occurs in areas with effective water fluoridation.
• Studies have noted 20–40% lower childhood decay rates in fluoridated Georgia and South Carolina regions compared to non-fluoridated counties in North Carolina.
• High-fluoride regions (above 1.5 mg/L) in other countries have been linked to a 1.63–2.5 IQ point deficit, but typical U.S. levels fall well below that threshold.
• Dentists estimate that low-income populations see 3× higher rates of untreated decay without fluoridation.

Fluoridation remains significant for reducing overall caries, and many public health efforts focus on ensuring that concentrations align with recommended guidelines.

Operational and Cost Data

Several factors influence the cost and operational upkeep of fluoridation systems in South Carolina.

• Annual program costs average $0.25 per capita in larger municipalities like Charleston.
• Implementation expenses can rise to $1.25 per capita in smaller rural systems.
• Roughly 15% of rural systems report aging equipment as a primary barrier to maintaining proper fluoride levels.
• A state-run grant program provides $50,000 each year for fluoridation equipment upgrades, assisting around 10,000 residents annually.

Funding sources, operator training, and continued awareness campaigns all factor into the operational viability and consistency of achieving recommended levels.

Key Statistics Summary

• Approximately 92–93.3% of South Carolina residents on public water systems receive fluoridated water.
• Only 30% of fluoridating systems achieve the recommended 0.7 mg/L.
• Children in fluoridated areas experience a 25% reduction in cavity prevalence.
• Georgia’s coverage rate of 99.7% is higher than South Carolina’s 92%.
• Annual fluoride program costs range from $0.25 to $1.25 per capita.

South Carolina’s water fluoridation program demonstrates extensive reach, reflecting both historical successes and modern challenges. Coverage remains among the highest in the country, yet operational hurdles continue to affect consistent dosing. By closely examining these figures, stakeholders can gain a clearer sense of where the state stands in delivering cost-effective oral health support.