Florida and Utah have already removed fluoridation from public water systems. What if the rest of the country follows?

The long-term effects of banning fluoride from public drinking water across the country could cost families billions of dollars and result in millions of rotten teeth, a new analysis predicts.

The study, published Friday in JAMA Health Forum, shows that if all 50 states stopped community water fluoridation programs, kids in the U.S. could expect to develop 25.4 million more cavities within the next five years.

That’s the equivalent of a decayed tooth in 1 out of every 3 children.

The number of cavities would more than double in 10 years, to 53.8 million.