By age 11 years, an American child living in poverty has twice the level of dental caries (tooth decay) as one living at 3 times the poverty threshold. To achieve the Healthy People 2020 overarching goal of health equity, interventions must preferentially prevent disease at the lower end of the income distribution. Research conducted in Canada suggests that water fluoridation might reduce inequality, but that possibility has not been investigated in the United States. We used 2 nationally representative data sets to investigate whether water fluoridation attenuated income-related inequality in dental caries among US children and adolescents.

*Online at https://jamanetwork.com/journals/jamapediatrics/article-abstract/2722663

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