Added for dental health but excessive levels cause bone problems. Below are US cities ranked by their measured Fluoride levels compared to EPA limits. Higher percentages indicate greater concern.
Vulnerable Populations: Infants and young children most susceptible to dental fluorosis. People with kidney problems may accumulate fluoride.
Ranked by percentage of the EPA limit, using one real EPA measurement per water system (2012–2019 (SYR4)). Click any city for its full report.
Historical data. Figure shown is the average of the system's 2012–2019 finished-water compliance samples (EPA Six-Year Review 4), non-detects counted as zero. Treat as history, not today's tap water.
| Rank | City | State | Level | Period | EPA Limit | % of Limit | Status | Population |
|---|---|---|---|---|---|---|---|---|
| #1 | Lewiston | Idaho | 2.042 ppmAverage of 4 samples | 2012–2019 | 4.000 ppm | 51.0% | Elevated | 20,000 |
| #2 | Easton | Maryland | 1.904 ppmAverage of 30 samples | 2012–2019 | 4.000 ppm | 47.6% | Within Limit | 17,357 |
| #3 | Fountain | Colorado | 1.764 ppmAverage of 11 samples | 2012–2019 | 4.000 ppm | 44.1% | Within Limit | 25,130 |
| #4 | Buckeye | Arizona | 1.439 ppmAverage of 19 samples | 2012–2019 | 4.000 ppm | 36.0% | Within Limit | 30,377 |
| #5 | Maricopa | Arizona | 1.427 ppmAverage of 128 samples | 2012–2019 | 4.000 ppm | 35.7% | Within Limit | 84,000 |
| #6 | Alexandria | Louisiana | 1.323 ppmAverage of 24 samples | 2012–2019 | 4.000 ppm | 33.1% | Within Limit | 66,798 |
| #7 | Kingman | Arizona | 1.185 ppmAverage of 26 samples | 2012–2019 | 4.000 ppm | 29.6% | Within Limit | 45,000 |
| #8 | Dodge City | Kansas | 1.143 ppmAverage of 43 samples | 2012–2019 | 4.000 ppm | 28.6% | Within Limit | 27,104 |
| #9 | Joliet | Illinois | 1.119 ppmAverage of 32 samples | 2012–2019 | 4.000 ppm | 28.0% | Within Limit | 160,000 |
| #10 | Michigan City | Indiana | 1.121 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 28.0% | Within Limit | 33,996 |
| #11 | Marion | Iowa | 1.100 ppmAverage of 93 samples | 2012–2019 | 4.000 ppm | 27.5% | Within Limit | 41,623 |
| #12 | Seaford | Delaware | 1.057 ppmAverage of 309 samples | 2012–2019 | 4.000 ppm | 26.4% | Within Limit | 6,699 |
| #13 | Surprise | Arizona | 1.017 ppmAverage of 128 samples | 2012–2019 | 4.000 ppm | 25.4% | Within Limit | 40,007 |
| #14 | Cleveland | Ohio | 0.986 ppmAverage of 380 samples | 2012–2019 | 4.000 ppm | 24.7% | Within Limit | 1,308,955 |
| #15 | Toledo | Ohio | 0.982 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 24.5% | Within Limit | 360,000 |
| #16 | Carpentersville | Illinois | 0.976 ppmAverage of 3 samples | 2012–2019 | 4.000 ppm | 24.4% | Within Limit | 37,983 |
| #17 | Akron | Ohio | 0.966 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 24.2% | Within Limit | 280,000 |
| #18 | Parker | Colorado | 0.966 ppmAverage of 51 samples | 2012–2019 | 4.000 ppm | 24.2% | Within Limit | 75,949 |
| #19 | Elkhart | Indiana | 0.950 ppmAverage of 12 samples | 2012–2019 | 4.000 ppm | 23.8% | Within Limit | 46,455 |
| #20 | Moline | Illinois | 0.953 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 23.8% | Within Limit | 44,500 |
| #21 | DeKalb | Illinois | 0.953 ppmAverage of 15 samples | 2012–2019 | 4.000 ppm | 23.8% | Within Limit | 40,290 |
| #22 | St. Charles | Illinois | 0.953 ppmAverage of 25 samples | 2012–2019 | 4.000 ppm | 23.8% | Within Limit | 33,103 |
| #23 | Galesburg | Illinois | 0.951 ppmAverage of 3 samples | 2012–2019 | 4.000 ppm | 23.8% | Within Limit | 31,620 |
| #24 | Palm Desert | California | 0.947 ppmAverage of 6 samples | 2012–2019 | 4.000 ppm | 23.7% | Within Limit | 270,000 |
| #25 | Romeoville | Illinois | 0.941 ppmAverage of 15 samples | 2012–2019 | 4.000 ppm | 23.5% | Within Limit | 50,458 |
| #26 | Pine Bluff | Arkansas | 0.938 ppmAverage of 300 samples | 2012–2019 | 4.000 ppm | 23.5% | Within Limit | 43,438 |
| #27 | Gardner | Kansas | 0.940 ppmAverage of 40 samples | 2012–2019 | 4.000 ppm | 23.5% | Within Limit | 23,942 |
| #28 | Oswego | Illinois | 0.938 ppmAverage of 22 samples | 2012–2019 | 4.000 ppm | 23.4% | Within Limit | 38,169 |
| #29 | Hanover Park | Illinois | 0.936 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 23.4% | Within Limit | 37,470 |
| #30 | Hammond | Indiana | 0.926 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 23.2% | Within Limit | 78,384 |
| #31 | Noblesville | Indiana | 0.927 ppmAverage of 9 samples | 2012–2019 | 4.000 ppm | 23.2% | Within Limit | 45,575 |
| #32 | Columbus | Ohio | 0.910 ppmAverage of 18 samples | 2012–2019 | 4.000 ppm | 22.8% | Within Limit | 1,305,946 |
| #33 | Lubbock | Texas | 0.914 ppmAverage of 17 samples | 2012–2019 | 4.000 ppm | 22.8% | Within Limit | 275,041 |
| #34 | Georgetown | Delaware | 0.914 ppmAverage of 256 samples | 2012–2019 | 4.000 ppm | 22.8% | Within Limit | 7,259 |
| #35 | New Bedford | Massachusetts | 0.908 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 22.7% | Within Limit | 101,079 |
| #36 | Manchester | Connecticut | 0.905 ppmAverage of 26 samples | 2012–2019 | 4.000 ppm | 22.6% | Within Limit | 51,198 |
| #37 | Smyrna | Delaware | 0.903 ppmAverage of 303 samples | 2012–2019 | 4.000 ppm | 22.6% | Within Limit | 11,813 |
| #38 | Elgin | Illinois | 0.899 ppmAverage of 10 samples | 2012–2019 | 4.000 ppm | 22.5% | Within Limit | 114,797 |
| #39 | North Chicago | Illinois | 0.900 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 22.5% | Within Limit | 16,813 |
| #40 | Burlington | Massachusetts | 0.898 ppmAverage of 13 samples | 2012–2019 | 4.000 ppm | 22.4% | Within Limit | 25,864 |
| #41 | Winchester | Kentucky | 0.891 ppmAverage of 16 samples | 2012–2019 | 4.000 ppm | 22.3% | Within Limit | 29,823 |
| #42 | Rockford | Illinois | 0.889 ppmAverage of 59 samples | 2012–2019 | 4.000 ppm | 22.2% | Within Limit | 147,051 |
| #43 | Peoria | Illinois | 0.890 ppmAverage of 21 samples | 2012–2019 | 4.000 ppm | 22.2% | Within Limit | 137,575 |
| #44 | Dover | Delaware | 0.885 ppmAverage of 813 samples | 2012–2019 | 4.000 ppm | 22.1% | Within Limit | 39,491 |
| #45 | Rock Island | Illinois | 0.881 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 22.0% | Within Limit | 39,018 |
| #46 | Murray | Kentucky | 0.881 ppmAverage of 10 samples | 2012–2019 | 4.000 ppm | 22.0% | Within Limit | 26,302 |
| #47 | Granite City | Illinois | 0.875 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 21.9% | Within Limit | 33,572 |
| #48 | Haverhill | Massachusetts | 0.870 ppmAverage of 7 samples | 2012–2019 | 4.000 ppm | 21.8% | Within Limit | 61,277 |
| #49 | Wakefield | Massachusetts | 0.873 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 21.8% | Within Limit | 27,090 |
| #50 | Cincinnati | Ohio | 0.863 ppmAverage of 16 samples | 2012–2019 | 4.000 ppm | 21.6% | Within Limit | 750,200 |
| #51 | Fremont | California | 0.862 ppmAverage of 133 samples | 2012–2019 | 4.000 ppm | 21.6% | Within Limit | 344,000 |
| #52 | Hartford | Connecticut | 0.862 ppmAverage of 24 samples | 2012–2019 | 4.000 ppm | 21.5% | Within Limit | 390,887 |
| #53 | Fall River | Massachusetts | 0.859 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 21.5% | Within Limit | 94,000 |
| #54 | Bloomington | Illinois | 0.856 ppmAverage of 9 samples | 2012–2019 | 4.000 ppm | 21.4% | Within Limit | 77,610 |
| #55 | Crystal Lake | Illinois | 0.857 ppmAverage of 15 samples | 2012–2019 | 4.000 ppm | 21.4% | Within Limit | 40,661 |
| #56 | Nicholasville | Kentucky | 0.857 ppmAverage of 27 samples | 2012–2019 | 4.000 ppm | 21.4% | Within Limit | 35,266 |
| #57 | New Haven | Connecticut | 0.848 ppmAverage of 82 samples | 2012–2019 | 4.000 ppm | 21.2% | Within Limit | 418,900 |
| #58 | Henderson | Kentucky | 0.850 ppmAverage of 15 samples | 2012–2019 | 4.000 ppm | 21.2% | Within Limit | 31,705 |
| #59 | Groton | Connecticut | 0.848 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 21.2% | Within Limit | 30,200 |
| #60 | Lexington | Kentucky | 0.842 ppmAverage of 49 samples | 2012–2019 | 4.000 ppm | 21.1% | Within Limit | 669,042 |
| #61 | Shreveport | Louisiana | 0.843 ppmAverage of 9 samples | 2012–2019 | 4.000 ppm | 21.1% | Within Limit | 192,378 |
| #62 | Champaign | Illinois | 0.843 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 21.1% | Within Limit | 150,000 |
| #63 | Russellville | Arkansas | 0.845 ppmAverage of 103 samples | 2012–2019 | 4.000 ppm | 21.1% | Within Limit | 29,260 |
| #64 | Aurora | Illinois | 0.840 ppmAverage of 10 samples | 2012–2019 | 4.000 ppm | 21.0% | Within Limit | 183,000 |
| #65 | New Britain | Connecticut | 0.841 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 21.0% | Within Limit | 73,534 |
| #66 | Marlborough | Massachusetts | 0.834 ppmAverage of 5 samples | 2012–2019 | 4.000 ppm | 20.9% | Within Limit | 41,799 |
| #67 | Jacksonville | Arkansas | 0.838 ppmAverage of 105 samples | 2012–2019 | 4.000 ppm | 20.9% | Within Limit | 32,875 |
| #68 | Temple Terrace | Florida | 0.835 ppmAverage of 47 samples | 2012–2019 | 4.000 ppm | 20.9% | Within Limit | 31,250 |
| #69 | Algonquin | Illinois | 0.837 ppmAverage of 9 samples | 2012–2019 | 4.000 ppm | 20.9% | Within Limit | 30,700 |
| #70 | Rexburg | Idaho | 0.827 ppmAverage of 9 samples | 2012–2019 | 4.000 ppm | 20.7% | Within Limit | 40,695 |
| #71 | Shelbyville | Kentucky | 0.826 ppmAverage of 34 samples | 2012–2019 | 4.000 ppm | 20.7% | Within Limit | 23,760 |
| #72 | Pueblo | Colorado | 0.819 ppmAverage of 32 samples | 2012–2019 | 4.000 ppm | 20.5% | Within Limit | 114,070 |
| #73 | Waterbury | Connecticut | 0.819 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 20.5% | Within Limit | 107,271 |
| #74 | Decatur | Illinois | 0.821 ppmAverage of 10 samples | 2012–2019 | 4.000 ppm | 20.5% | Within Limit | 76,122 |
| #75 | Danville | Kentucky | 0.819 ppmAverage of 16 samples | 2012–2019 | 4.000 ppm | 20.5% | Within Limit | 32,600 |
| #76 | Fort Thomas | Kentucky | 0.816 ppmAverage of 64 samples | 2012–2019 | 4.000 ppm | 20.4% | Within Limit | 259,949 |
| #77 | Cambridge | Massachusetts | 0.816 ppmAverage of 6 samples | 2012–2019 | 4.000 ppm | 20.4% | Within Limit | 118,214 |
| #78 | Normal | Illinois | 0.814 ppmAverage of 4 samples | 2012–2019 | 4.000 ppm | 20.4% | Within Limit | 52,736 |
| #79 | Louisville | Kentucky | 0.814 ppmAverage of 44 samples | 2012–2019 | 4.000 ppm | 20.3% | Within Limit | 806,997 |
| #80 | Waukegan | Illinois | 0.812 ppmAverage of 8 samples | 2012–2019 | 4.000 ppm | 20.3% | Within Limit | 87,149 |
| #81 | Castle Rock | Colorado | 0.802 ppmAverage of 31 samples | 2012–2019 | 4.000 ppm | 20.1% | Within Limit | 110,298 |
| #82 | Columbus | Indiana | 0.805 ppmAverage of 4 samples | 2012–2019 | 4.000 ppm | 20.1% | Within Limit | 51,122 |
| #83 | Milford | Delaware | 0.803 ppmAverage of 385 samples | 2012–2019 | 4.000 ppm | 20.1% | Within Limit | 9,800 |
| #84 | Twin Falls | Idaho | 0.801 ppmAverage of 7 samples | 2012–2019 | 4.000 ppm | 20.0% | Within Limit | 56,121 |
| #85 | Hialeah | Florida | 0.793 ppmAverage of 14 samples | 2012–2019 | 4.000 ppm | 19.8% | Within Limit | 238,000 |
| #86 | Jonesboro | Arkansas | 0.791 ppmAverage of 361 samples | 2012–2019 | 4.000 ppm | 19.8% | Within Limit | 81,888 |
| #87 | Georgetown | Kentucky | 0.794 ppmAverage of 16 samples | 2012–2019 | 4.000 ppm | 19.8% | Within Limit | 44,608 |
| #88 | Moscow | Idaho | 0.793 ppmAverage of 5 samples | 2012–2019 | 4.000 ppm | 19.8% | Within Limit | 26,000 |
| #89 | Bristol | Connecticut | 0.788 ppmAverage of 16 samples | 2012–2019 | 4.000 ppm | 19.7% | Within Limit | 52,079 |
| #90 | Santa Maria | California | 0.782 ppmAverage of 73 samples | 2012–2019 | 4.000 ppm | 19.6% | Within Limit | 109,477 |
| #91 | Lawrence | Massachusetts | 0.786 ppmAverage of 7 samples | 2012–2019 | 4.000 ppm | 19.6% | Within Limit | 89,143 |
| #92 | Paragould | Arkansas | 0.783 ppmAverage of 99 samples | 2012–2019 | 4.000 ppm | 19.6% | Within Limit | 31,188 |
| #93 | Sahuarita | Arizona | 0.783 ppmAverage of 3 samples | 2012–2019 | 4.000 ppm | 19.6% | Within Limit | 18,178 |
| #94 | Fairfield | California | 0.779 ppmAverage of 65 samples | 2012–2019 | 4.000 ppm | 19.5% | Within Limit | 120,377 |
| #95 | Bardstown | Kentucky | 0.780 ppmAverage of 14 samples | 2012–2019 | 4.000 ppm | 19.5% | Within Limit | 31,185 |
| #96 | Florence | Arizona | 0.780 ppmAverage of 3 samples | 2012–2019 | 4.000 ppm | 19.5% | Within Limit | 15,900 |
| #97 | Houma | Louisiana | 0.781 ppmAverage of 7 samples | 2012–2019 | 4.000 ppm | 19.5% | Within Limit | 11,658 |
| #98 | Key West | Florida | 0.775 ppmAverage of 123 samples | 2012–2019 | 4.000 ppm | 19.4% | Within Limit | 86,000 |
| #99 | Commerce City | Colorado | 0.776 ppmAverage of 264 samples | 2012–2019 | 4.000 ppm | 19.4% | Within Limit | 75,559 |
| #100 | Benton | Arkansas | 0.776 ppmAverage of 200 samples | 2012–2019 | 4.000 ppm | 19.4% | Within Limit | 30,681 |
Most effective home option for fluoride removal.
Specialized media for fluoride. Point-of-use systems.
Natural option for fluoride reduction.
Water fluoridation at 0.7 mg/L is added to prevent tooth decay. The EPA limit of 4 mg/L protects against bone disease from natural or industrial contamination.
No. Standard activated carbon does not remove fluoride. You need reverse osmosis or activated alumina.
CDC recommends fluoridation at 0.7 mg/L as safe and beneficial. Concerns arise only at levels approaching EPA limit of 4 mg/L.