Hawaii Water Fluoride: Updated Statistics
by Mara Sugue, NewMouth (excerpt)
Hawaii has long stood out in national comparisons of water fluoridation, with some of the lowest fluoridation rates in the United States. This article compiles key data points and trends from the past two decades to provide a clear statistical overview of how limited fluoridation continues to impact oral health statewide.
While most U.S. states maintain higher coverage rates, Hawaii’s unique geographical and political landscape has contributed to consistently low levels of community water fluoridation. Below, we examine core statistics regarding coverage, tooth decay prevalence, costs, and regional comparisons, presenting the data in a concise format for ease of reference.
Key Statistics Snapshot
Here are a few immediate figures that illuminate Hawaii’s fluoridation status and oral health challenges:
8.5% of Hawaii residents served by community water systems receive fluoridated water.
70.6% of third graders in Hawaii experience tooth decay—the highest rate in the nation.
47% of Hawaii adults have lost at least one tooth due to decay.
Hawaii’s Medicaid dental costs for children exceed $12 million annually.
These numbers provide only a glimpse. Further sections break down additional data on fluoride coverage, oral health impacts, and comparative state statistics, offering a broad foundation for understanding this issue.
Historical and Current Coverage Levels
Data on fluoridation coverage in Hawaii highlight a longstanding pattern of minimal adoption across community water systems.
As of 2025, 8.5% of the population served by community water systems receives fluoridated water.
This coverage percentage has remained stagnant since at least 2020, showing no measurable increase.
In contrast, the average U.S. fluoridation rate is approximately 72.3%.
Military installations (federal systems) make up nearly all fluoridated sources in Hawaii, serving 11.7% of residents.
Coverage data underscores how Hawaii’s overall fluoridation rates lag well behind other states....
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