In 1951, the average cost of a new house in the U.S. was $9,000, gas was 19 cents a gallon and the “I Love Lucy” television show made its debut. That same year, dental health in Tennessee took an important step forward when Milan, in Gibson County, became the first city in the Volunteer State to fluoridate its water supply.

The addition of fluoride, a naturally occurring mineral proven to reduce cavities, soon improved lives in the small West Tennessee community. From 1951 to 1956, there was a 57 percent reduction in tooth decay for six-year-old children served by the Milan water system. That decrease was noted by parents, doctors and dentists, and fluoridation of community water became accepted across the state and nation as a safe, effective way to reduce cavities.

Dentist Dr. James Gillcrist stated:


Comparisons of dental health before and after fluoridation in Tennessee showed a 75 percent decline in decay of children’s permanent teeth from the early 1950s to the late 1980s. Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH, said cost-effective fluoridation to protect teeth is important for many reasons.

“Every dollar spent on community water fluoridation saves $38 in dental costs and helps to keep our children in school, learning, instead of sitting in a dentist’s chair with a toothache. We lose 51 million school hours each year in the U.S. due to dental-related childhood illnesses. Fluoride protects Tennessee’s most vulnerable children from dental pain and decay and gives them the healthy teeth needed for strong self-esteem and success in life.”

“I’m happy to collaborate with other state departments to promote and educate our communities about the benefits of fluoridated water,” Tennessee Department of Environment and Conservation Commissioner Bob Martineau said. “Community water fluoridation is an important process for the dental health of our citizens and our economy.”

“Properly fluoridated community water is important to the economic health of individuals and to our state,” said TennCare Director Darin Gordon. “When you reduce cavities and improve dental health, you lessen the financial burden on families and tax payer funded programs like TennCare.”

According to the Centers for Disease Control and Prevention, children not having access to fluoridated community water have a 20 to 40 percent higher chance of tooth decay, which can impact not just their dental and physical health, but also their social and economic health as they grow older. Nationally, 74.6 percent of those served by community water systems in 2012 received fluoridated water. In Tennessee the rate was at 88.05 percent in 2014, down from the 95.2 percent statewide highest rate achieved in 2004. Tennessee follows recommendations from the U.S. Department of Health and Human Services that the amount of fluoride in drinking water is 0.7 mg/l for prevention of dental caries.

“Today nearly one-third of adults more than 65 in Tennessee have none of their natural teeth,” said TDH Chief Medical Officer David Reagan, MD, PhD. “Most of these adults did not benefit from fluoridation as kids. That story is changing. We can look forward to a time when the majority of adults in Tennessee have their natural teeth for their whole lives. This vision of the future requires the benefits of fluoridated water for adults and children.”

“We can’t allow complacency about the improved dental health we enjoy today to impact tomorrow’s decisions regarding fluoridation,” said Veran Fairrow, DDS, director of TDH Oral Health Services. “Tennesseans have healthier teeth now than they did decades ago for primarily one reason: optimally-fluoridated community water. Unfortunately, some communities fail to provide this important service or are discontinuing it, which will ultimately generate increased dental and health-related expenses. Not offering properly fluoridated water is particularly harmful to the most vulnerable in a community: those who cannot afford regular dental care or who are not supported in good dental hygiene habits.”

Fairrow said misinformation about and opposition to scientific advances such as fluoridation are “expressed by a vocal handful but hurt the many.” She suggests those who do not want fluoridated community water can use filters to remove it or drink readily available, inexpensive distilled water.

The CDC cited fluoridated community water as one of the top 10 public health achievements of the last century. The April 2000 edition of the Journal of Dental Research stated the use of fluoride was primarily responsible for savings of approximately $40 billion in oral health care from 1960 to 2000.

The current cost for community water fluoridation is approximately 50 cents per person, per year, which is a fraction of the cost for repairing one cavity. For additional facts and information about fluoride, visit