Fluoride is a naturally occurring element in groundwater that supports bone and dental health at low concentrations but can cause health problems at elevated concentrations in drinking water. This study investigates spatial and temporal trends for fluoride concentrations in untreated groundwater from over 20,000 public supply wells in California. The presence of a significant temporal trend in fluoride concentrations in a well was assessed using the Mann-Kendall test and a spatial-weighting approach was used to identify the areal extent of the groundwater resources with significant trends. Less than 2% of the groundwater resources used for public supply in the state have concentrations above the California maximum contaminant level of 2?mg/L. Approximately 14% of the groundwater resource used for public supply show a significant recent trend (2000–2019), with decreasing trends occurring in 10% of the resource. Potential drivers for trends were evaluated in two of the areas in southern California with the greatest prevalence of trends but distinct climate and hydrogeological characteristics. Aquifers in the Mojave and Whitewater River watersheds, located in the desert region, and the Los Angeles Basin, located on the coast, have been replenished with imported and treated water over the last half century to maintain sustainable groundwater levels. The recharge of imported water with different chemistries has altered the geochemical conditions in the aquifers, driving changes in fluoride concentrations.