Fluoride

Status: National drinking water standard exists

Fluoride occurs naturally in surface and groundwater and is also added to drinking water by many water systems. Read More.

Fluoride has been promoted as a chemical that reduces dental cavities. Yet it is now well-established that fluoride primarily exerts its protective effects through topical mechanisms, such as sodium fluoride in toothpaste and mouthwash. In contrast, long-term ingestion of fluoride in water increases dental fluorosis, which includes mottling, pitting and weakening of the teeth. EPA's maximum legal limit is set at 4 parts per million (ppm) to prevent skeletal fluorosis, a condition where bones become brittle and more susceptible to fractures, although these effects may occur at lower doses.

Even fluoride levels of 0.7 ppm, the amount of fluoride in drinking water recommended by the U.S. Public Health Service, can result in too much fluoride for bottle-fed babies. EWG recommends that caregivers mix baby formula with fluoride-free water. The National Toxicology Program is investigating the potential for low doses of fluoride to alter thyroid function and childhood brain development.

2017-2019:

FOUND

FOUND ABOVE LEGAL LIMIT

states detected

29,329

utilities detected

252 million

people served

states over legal limit

utilities over legal limit

26,699

people served over legal limit

Health concerns for fluoride

Harm to teeth

Harm to bones

Bone cancer

State and national drinking water standards and health guidelines

EPA Maximum Contaminant
Level (MCL) 4 ppm

ppm = parts per million

States reporting fluoride in drinking water

	UTILITIES WITH CONTAMINATION
State	Utilities	People Served
California		1,739	36,996,738
Texas		4,121	27,509,957
Florida		1,120	19,211,509
Illinois		1,540	10,533,842
Ohio		910	9,475,019
Georgia		1,222	9,258,253
North Carolina		1,203	8,606,374
New York		817	7,776,320
Pennsylvania		454	7,412,778
Virginia		747	6,813,100
Michigan		848	6,283,775
Colorado		767	6,150,306
Arizona		431	6,138,826
Maryland		281	5,068,015
New Jersey		248	4,981,379
Louisiana		928	4,942,944
Missouri		801	4,857,697
Indiana		646	4,592,120
Massachusetts		209	4,537,807
Alabama		254	4,472,892
Minnesota		752	4,418,263
Kentucky		352	4,322,487
Wisconsin		937	3,968,587
South Carolina		351	3,698,752
Utah		370	3,028,091
Nevada		121	2,751,570
Washington		510	2,688,552
Mississippi		795	2,685,881
Kansas		646	2,668,065
Oklahoma		380	2,630,394
Connecticut		308	2,580,762
Arkansas		395	2,502,578
Tennessee		74	2,353,960
Oregon		243	2,099,207
New Mexico		479	1,956,806
West Virginia		341	1,469,606
Nebraska		443	1,461,217
Hawaii		51	1,406,042
Iowa		231	1,197,876
Rhode Island		60	934,634
Delaware		128	896,572
Idaho		435	854,867
District Of Columbia		3	648,882
Maine		210	597,579
Montana		446	591,041
North Dakota		210	516,748
New Hampshire		406	511,301
Wyoming		158	348,946
Vermont		81	334,861
Alaska		46	329,349
South Dakota		81	294,311

LESS

Filtering technologies that reduce fluoride

Utilities with the highest amounts of fluoride, 2017-2019

ALL UTILITIES

LARGE UTILITIES

Utility	Location	Tests	Average level	People served
Green Ridge Mutual Domestic Water Consumers Association Inc.	Tijeras, NM	23 of 23	9.50 ppm	154
American Realty Mortgage Company	Maricopa, AZ	20 of 20	8.41 ppm	56
City of Wellman	Wellman, TX	24 of 24	6.67 ppm	225
Fort Jackson Mobile Estates	Lubbock, TX	12 of 12	6.41 ppm	72
Garden Valley Ranchettes Homeowners	Garden Valley, ID	27 of 27	6.04 ppm	78
Young-nak Presbyterian Church	Los Angeles, CA	2 of 2	5.97 ppm	2,015
City of Opdyke West	Levelland, TX	24 of 24	5.85 ppm	273
Terrells Mobile Home Park	Lovington, TX	24 of 24	5.71 ppm	60
San Simon Domestic Water Improvement District	San Simon, AZ	24 of 24	5.63 ppm	312
Southwest Garden Water	Lubbock, TX	24 of 24	5.57 ppm	375
Wolfforth Place	Wolfforth, TX	24 of 24	5.51 ppm	400
Birdsong Waterworks	Suffolk, VA	26 of 26	5.50 ppm	71
Seven Estates	Wolfforth, TX	10 of 10	5.50 ppm	261
Borden County Water System	Gail, TX	24 of 24	5.22 ppm	300
Springfield Downs	Smithfield, VA	26 of 26	5.04 ppm	120
City of Ropesville	Ropesville, TX	24 of 24	5.03 ppm	428
Grassland Water Supply Corporation	Tahoka, TX	24 of 24	5.03 ppm	55
Glen Acres Water Co-op	Lordsburg, NM	19 of 19	4.85 ppm	180
Milford, Village of	Lansing, MI	7 of 7	4.84 ppm	6,366
City of Seagraves	Seagraves, TX	37 of 37	4.80 ppm	2,417
Rescue Waterworks	Rescue, VA	26 of 26	4.72 ppm	203
114th Street Mobile Home Park	Lubbock, TX	24 of 24	4.66 ppm	125
Valley Estates	Shallowater, TX	11 of 11	4.64 ppm	70
City of Wolfforth	Wolfforth, TX	47 of 47	4.62 ppm	3,600
L.a. Residential Community Foundation	Saugus, CA	1 of 1	4.60 ppm	154
Pecan Grove Mobile Home Park	San Antonio, TX	24 of 24	4.60 ppm	81
Lordsburg Water Supply System*	Lordsburg, NM	24 of 24	4.43 ppm	3,028
Willing Workers Club	Carrollton, VA	14 of 14	4.39 ppm	31
Red Rader Rv Park	Benbrook, TX	23 of 23	4.36 ppm	46
Laurel Ridge S/d	Lakemont, GA	4 of 4	4.30 ppm	31
North Trails Mutual Water Company	Agua Dulce, CA	16 of 16	4.29 ppm	200
City of New Home	New Home, TX	24 of 24	4.28 ppm	345
Cox Addition Water System	Lubbock, TX	24 of 24	4.26 ppm	114
Town North Estates	Lubbock, TX	24 of 24	4.19 ppm	216
Town of Courtland	Courtland, VA	41 of 41	4.18 ppm	1,284
Champion Farms Subdivision	Troy, MO	50 of 50	4.14 ppm	30
Plott Acres	Lubbock, TX	48 of 48	4.13 ppm	204
Whitharral Water Supply Corporation	Whitharral, TX	24 of 24	4.04 ppm	200
Sonterra Municipal Utility District	Austin, TX	13 of 13	4.04 ppm	6,846
City of Plains	Plains, TX	24 of 24	4.03 ppm	1,481
Linger Lodge Trailer Trailer Park	Bradenton, FL	4 of 4	3.97 ppm	250
Shuler Point	Dallas, TX	13 of 13	3.96 ppm	33
Upper Holman Mutual Domestic Water Consumers Association	Holman, NM	22 of 22	3.96 ppm	325
Sunray Water Company Inc.	Chesapeake, VA	2 of 2	3.96 ppm	60
Umbarger Community Water Supply	Umbarger, TX	23 of 23	3.94 ppm	180
Plantation Mobile Home Park	Chesapeake, VA	15 of 15	3.93 ppm	150
Deer Run	Smithfield, VA	31 of 31	3.92 ppm	104
Country View Mobile Home Park	Shallowater, TX	8 of 8	3.92 ppm	55
Beachview Acres Water Association	Murchison, TX	2 of 2	3.91 ppm	56
Days Point	Isle Of Wight, VA	2 of 2	3.91 ppm	225

* This water utility supplies finished drinking water to at least one other water utility. The purchasing utility is not required to test for or report Fluoride, but it likely has the contaminant in its water supply.

Utility	Location	Tests	Average level	People served
US Army Fort Irwin	Fort Irwin, CA	350 of 350	3.67 ppm	16,000
Daleville Water & Sewer Board	Daleville, AL	5 of 5	3.57 ppm	10,014
City of Andrews	Andrews, TX	38 of 38	3.47 ppm	11,088
Bucksport Water Company	Conway, SC	27 of 27	3.21 ppm	15,297
City of Hereford	Hereford, TX	13 of 13	2.85 ppm	15,370
Gates County Water System	Gatesville, NC	2 of 2	2.80 ppm	11,621
Espanola Water System*	Espanola, NM	32 of 32	2.78 ppm	12,012
Lincoln County PWSD 1*	Winfield, MO	88 of 88	2.72 ppm	11,000
Allouez Waterworks	Green Bay, WI	2 of 2	2.50 ppm	13,932
Jonah Water SUD	Hutto, TX	11 of 11	2.47 ppm	26,865
City of Kyle	Kyle, TX	7 of 7	2.45 ppm	29,118
Canyon Municipal Water System	Canyon, TX	7 of 7	2.40 ppm	14,500
City of West Richland	West Richland, WA	9 of 9	2.37 ppm	15,320
Indianola Water Supply*	Indianola, IA	3 of 3	2.30 ppm	14,782
Jbsa - Randolph	Jbsa Lackland, TX	16 of 16	2.29 ppm	10,949
Portales Water System*	Portales, NM	4 of 4	2.15 ppm	14,067
Epcor Water New Mexico Inc Clovis	Clovis, NM	27 of 27	2.08 ppm	42,976
Lewiston Orchards Irrigation District	Lewiston, ID	4 of 4	2.04 ppm	20,000
City of Midland	Midland, TX	17 of 23	2.02 ppm	132,950
Troy*	Troy, MO	9 of 9	2.02 ppm	10,500
City of Euless	Euless, TX	5 of 5	1.98 ppm	56,160
City of Moses Lake	Moses Lake, WA	67 of 67	1.93 ppm	22,930
Goforth SUD	Niederwald, TX	5 of 5	1.93 ppm	27,639
Kaukauna Utilities	Kaukauna, WI	5 of 5	1.90 ppm	13,430
City of Safford	Safford, AZ	49 of 49	1.84 ppm	18,900
Ashwaubenon Waterworks*	Green Bay, WI	3 of 3	1.80 ppm	17,730
Lake Cities Municipal Utility Authority	Lake Dallas, TX	3 of 3	1.79 ppm	16,533
Fort Bend County MUD 23*	Houston, TX	5 of 5	1.77 ppm	12,297
City of Fountain	Fountain, CO	7 of 7	1.77 ppm	29,000
Guymon	Guymon, OK	7 of 7	1.74 ppm	11,442
DCWA Knightsville	Summerville, SC	11 of 11	1.73 ppm	23,513
City of Norco*	Norco, CA	435 of 440	1.69 ppm	27,160
City of Buckeye Sonora - Sundance	Buckeye, AZ	4 of 4	1.69 ppm	15,783
Little Chute Waterworks	Little Chute, WI	6 of 6	1.67 ppm	11,040
Atascosa Rural WSC	Atascosa, TX	5 of 5	1.65 ppm	11,007
Easton Utilities	Easton, MD	20 of 23	1.63 ppm	16,118
Stonegate MD	Parker, CO	2 of 2	1.61 ppm	15,071
Altoona Water Supply	Altoona, IA	1 of 1	1.60 ppm	14,541
City of Pecos*	Pecos, TX	2 of 2	1.60 ppm	12,480
Bertie County Regional Water	Windsor, NC	28 of 28	1.59 ppm	12,893
Arizona Water Company - White Tanks	Phoenix, AZ	4 of 4	1.55 ppm	10,186
U.S. Air Force Luke Air Force Base	Luke Afb, AZ	3 of 3	1.53 ppm	10,708
City of Grandview	Grandview, WA	18 of 18	1.52 ppm	11,010
City of Bedford	Bedford, TX	4 of 4	1.48 ppm	49,526
Global Water - Santa Cruz Water Company	Maricopa, AZ	90 of 91	1.48 ppm	17,005
Marco Rural Water Company*	Marion, SC	23 of 23	1.46 ppm	15,082
Darboy Sanitary District 1	Appleton, WI	4 of 4	1.45 ppm	12,000
Eastern Pines Water Corp	Greenville, NC	17 of 17	1.43 ppm	22,230
Harris Montgomery Counties MUD 386	Houston, TX	6 of 6	1.40 ppm	10,659
City of California City	California City, CA	12 of 12	1.38 ppm	14,212