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Dental surgery under general anesthesia (DGA) is an ineffective, costly treatment for caries. Interventions to reduce the need for DGA are challenging because children's parents may not seek care until surgery is required. Community water fluoridation (CWF) effectively prevents early childhood caries, but its effectiveness in reducing severe early childhood caries is unknown. To determine whether access to CWF is associated with the prevalence of DGA. This is a cross-sectional analysis of Medicaid claims data from 2011 to 2012. Deidentif