Introduction

Most fresh surface water (e.g., lakes, rivers, streams, and springs) contain very low levels of fluoride. However, as with other toxic substances, such as arsenic and lead, some water supplies — particularly those that draw water from deep underground — are contaminated with high levels of naturally occurring fluoride.  In this section of the website, we provide a list of water systems in the United States that have been identified as having high levels of naturally occurring fluoride.

The information in this series comes primarily from the Centers for Disease Control and Prevention’s (CDC) 1993 report titled Fluoridation Census and their 2020 Fluoridation Status Reports by state. However, the CDC’s 2020 report did not list all states in either 1993 or 2020.

In 1993, the CDC did not list the natural levels of fluoride in drinking water for AK, AR, HI, KY, ME, NY, PA, RI, TN, VT, and WV, and provided very little information for some others.

In 2020, the CDC did not do a Fluoridation Status Report for these 18 states, AZ, HI, ID, MD, MT, NJ, NM, NY, NC, OH, OK, OR, PA, SD, UT, WA, WI, WY. We will be doing everything we can to get data for these states and will update this series as we receive the data. If you want to help in this effort or have information about elevated fluoride levels in communities that we have not identified, please email us.