Updated on February 24, 2025
4 min read

South Dakota Water Fluoride: Updated Statistics

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South Dakota’s community water fluoridation program has drawn attention for its role in reducing tooth decay and improving oral health. While various estimates place the state’s coverage between 73.0% and 93.7%, recent data comparisons show several noteworthy trends worth examining.

This article provides a statistical breakdown of South Dakota’s water fluoride levels, coverage rates, and related oral health outcomes. By focusing on clear data points and regional comparisons, the aim is to help readers understand the scope and impact of these measures on communities across the state.

Key Statistics Snapshot

Below are a few key statistics to set the stage for more detailed data:

  • As of 2018, 73.0% of South Dakota’s community water system population had adjusted fluoride in their drinking water.
  • Approximately 631,000 residents receive fluoridated water in the state.
  • Including naturally occurring fluoride, access estimates rise to nearly 93.7%.
  • Fluoridated areas in South Dakota report 27% fewer tooth decay cases compared to non-fluoridated communities.

These figures highlight the widespread reach of fluoridated systems and underscore the significance of tracking coverage for public health. Next, we delve into more detailed numbers on coverage growth, comparisons with neighboring states, and concentration levels across various systems.

Coverage Growth in South Dakota

Understanding how water fluoridation coverage has changed over time offers insights into oral health trends statewide.

  • Between 2005 and 2018, the percentage of people on community water systems with fluoridation grew, eventually stabilizing by 2010 onward.
  • In 2018, 73.0% of all community water system users had adjusted fluoride in their water.
  • Another 12.1% of community water systems in the state rely primarily on naturally occurring fluoride.
  • Statewide, 90% of water systems depend on groundwater sources, while 10% use surface water.

Although the exact year-by-year breakdown for every period is not publicly reported, these points help illustrate a steady adoption of fluoridation across diverse water systems. Below is a table summarizing groundwater reliance and naturally occurring fluoride coverage in South Dakota.

Water Supply TypePercentage of SD SystemsNotes
Groundwater90%Primary source for most rural communities
Surface Water10%No recorded fluoride exceedances reported
Naturally Occurring Fluoride12.1% of CWSSome areas rely on naturally elevated levels

Comparison with Neighboring States

Juxtaposing South Dakota’s fluoridation figures with surrounding regions underscores the variability in adoption across the Upper Midwest.

  • North Dakota achieves 95.2% fluoridation coverage, one of the highest in the nation.
  • Iowa stands at approximately 90.9% coverage.
  • Nebraska reports around 88.1% coverage across its community water systems.
  • Minnesota’s coverage approaches 98.3%, representing near-universal fluoridation statewide.
  • Wyoming (at 49.6%) and Montana (at 62.3%) have notably lower coverage rates than South Dakota.

These numbers reflect policy differences and local attitudes toward fluoridation, often affecting long-term oral health outcomes and healthcare costs. The table below highlights regional coverage levels side by side.

StateFluoridation Coverage (%)
Minnesota98.3
North Dakota95.2
Iowa90.9
Nebraska88.1
South Dakota73.0
Montana62.3
Wyoming49.6

Demographic Disparities and Health Outcomes

Examining breakdowns across different population groups reveals how socioeconomic factors and regional variations contribute to gaps in fluoridation coverage and oral health indicators.

  • In rural, lower-income counties, fluoridation rates are 18% lower compared to wealthier areas.
  • Approximately 631,000 South Dakota residents have access to community water systems with adjusted fluoride.
  • Tooth decay rates run 27% lower in fluoridated areas versus non-fluoridated areas across the state.
  • In nearby Minnesota, lower decay rates (around 12% in children) contrast with South Dakota’s rate of 18% in similar pediatric groups.

Such differences underscore the influence of both local water systems and socioeconomic status on oral health. Additional data shows that in states with higher coverage, healthcare costs may decline, as reflected in certain per capita spending trends.

Fluoride Concentration Levels

Beyond coverage statistics, examining fluoride concentrations provides insights into compliance and potential health considerations.

  • Historically, 4.5% of U.S. community water systems exceeded the WHO’s 1.5 mg/L guideline between 2006 and 2011.
  • No recorded exceedances in surface waters have been reported in South Dakota to date.
  • The state’s reliance on groundwater (nearly 90% of systems) increases the need for consistent testing due to natural fluoride variations.
  • National health surveys often cite 0.7 mg/L as a beneficial fluoride level for cavity prevention.

Groundwater dynamics, local geology, and treatment protocols shape these concentrations, highlighting the importance of ongoing monitoring. Below is a simplified overview of common fluoride standards for reference.

GuidelineRecommended Level
Centers for Disease Control0.7 mg/L
World Health Organization1.5 mg/L (exceedance threshold)
Surface Water in SDNo known exceedance above 1.5 mg/L
Groundwater in SDVariable, requires active monitoring

Key Statistics Summary

  • 73.0% of South Dakotans on community systems receive adjusted fluoride.
  • North Dakota’s fluoridation coverage stands at 95.2%, while Minnesota’s reaches 98.3%.
  • Rural counties in South Dakota report up to 18% lower coverage than wealthier areas.
  • Tooth decay rates are 27% lower in fluoridated areas across the state.
  • Groundwater sources constitute 90% of South Dakota’s water systems, with natural fluoride levels requiring consistent testing.

Taken together, these figures illustrate the diverse influences shaping fluoridation in South Dakota. Overall coverage remains substantial, but uneven distribution and demographic factors highlight ongoing disparities. Keeping track of both fluoride concentrations and their correlation with oral health trends provides valuable insights for communities and stakeholders alike.

Last updated on February 24, 2025
7 Sources Cited
Last updated on February 24, 2025
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. South Dakota Water Fluoridation Metrics. America's Health Rankings, 2021.
  2. 2024 Integrated Report. South Dakota Department of Agriculture and Natural Resources, 2024.
  3. Community Water Fluoridation Reports. CDC My Water’s Fluoride, 2023.
  4. Fluoride Exceedance in US Public Water Systems. NIH, 2011.
  5. 2018 Water Fluoridation Statistics. Centers for Disease Control and Prevention, 2019.
  6. Fluoridated Drinking Water in South Dakota. South Dakota Dental Association, 2022.
  7. Fluoride Analysis and Safe Levels. SDPB, 2025.
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