A study by the CareQuest Institute for Oral Health has found that if five states ban fluoride in drinking water, the costs to Medicaid could reach $40 million within three years. The study used Medicaid claims data and survey responses to predict outcomes if the five states, Florida, Kentucky, Louisiana, Missouri and Oklahoma, stopped adding fluoride to their drinking water systems. Within three years, 132,572 additional children would need a cavity filled or a tooth pulled. The Centers for Disease Control and Prevention maintains that community water fluoridation is one of the greatest public health achievements of the past century and has contributed to reducing tooth decay in America by 25%. However, like vaccines, fluoride has been under attack in recent years.