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Water fluoridation has been identified by CDC as one of 10 great public health achievements of the 20th century. The decline in the prevalence and severity of dental caries (tooth decay) in the United States during the past 60 years has been attributed largely to the increased use of fluoride. Community water fluoridation is an equitable and cost-effective method for delivering fluoride to the community. A Healthy People 2010 objective is to increase to 75% the proportion of the U.S. population served by community water systems who receive optimally fluoridated water. To update and revise previous reports on fluoridation in the United States and describe progress toward the Healthy People 2010 objective, CDC analyzed fluoridation data for the period 1992-2006 from the 50 states and District of Columbia (DC). The results indicated that the percentage of the U.S. population served by community water systems who received optimally fluoridated water increased from 62.1% in 1992, to 65.0% in 2000, and 69.2% in 2006, and those percentages varied substantially by state. Public health officials and policymakers in states with lower percentages of residents receiving optimal water fluoridation should consider increasing their efforts to promote fluoridation of community water systems to prevent dental caries.