How about brush your teeth with fluoride and spit it out instead?
So kids have to take tablets if they want the impact. But this is far less effective.
Ask a dentist here. Locals have more tooth decay.
What about genetic predisposition to cavities?
Kind of depends how you track things I'd think. New Jersey, the state with the highest population density in the US, largely doesn't put fluoride in the water outside of a few municipalities.
There's no fluoride in the water in almost the entirety of Hudson, Essex, and Bergen counties, which are located near NYC and include the cities of Newark and Jersey City. Combined population of those three counties is over 2.5 million people.
By comparison Portland’s is 3%. Probably why dentists see high level of tooth decay here.