Worldwide caries-related treatment needs are still high and are even increasing as a result of factors such as population growth and increased longevity, as well as changes in diet [1]. Many researchers claim that the most effective way to prevent caries at the community level is water fluoridation due to its ability to reach and affect large proportions of the population [2,3]. The efficacy of fluoridation is greatest for the deciduous dentition, to a lesser extent for the mixed dentition, and has least impact on the permanent dentition [4]. Mandatory water fluoridation is particularly important to people of low socioeconomic status among whom the caries burden is especially high [5]. Israel implemented mandatory fluoridation legislation in 2002, enabling 75% of the population to enjoy the benefits of fluoridated water, a move that later resulted in a dramatic decline in caries experience among children [2]. In 2010, legislation for reforming dental care for children was passed, adding dental care to the basket of free services provided under the National Health Insurance Law. Coverage of children and adolescents has gradually been broadened and now extends from birth to age 18 years [6].

The purpose of this study was to compare the caries-related treatment needs of young adults who were not exposed to water fluoridation or dental care reforms, with young adults within the same population who were exposed to water fluoridation either alone or in combination with dental care reforms.