I practiced dentistry in the midwest in a community with ideally supplemented fluoride for nearly a decade, and have spent the past dozen years in southern Utah which is not supplemented and only rises to about a third of the recommended ideal. Like other dentists who have spent time in both fluoridated and non- communities, there is a clearly noticeable difference in how quickly decay progresses and how aggressively treatment needs to proceed.
The only cavities in my family of six have been in the one child who was born in Utah.