A Texas city was a pioneer in adding fluoride to drinking water. Could RFK Jr. remove it?

Fluoride is a sometimes naturally occurring mineral that promotes tooth enamel health. The U.S. Department of Health and Human Services recommends a level of 0.7 milligrams per liter of fluoride in drinking water to prevent tooth decay.

The mineral was first added to drinking water in the U.S. in 1945, at the recommendation of several scientists who concluded fluoridated water resulted in fewer cavities and less severe tooth decay, according to the U.S. Centers for Disease Control and Prevention.

Grand Rapids, Michigan became the first U.S. city to implement water fluoridation in 1945. Less than a year later, the city of Marshall in East Texas became the first city in the state, and one of just three in the U.S., to implement community water fluoridation.

Now, 72% of Texans drink adjusted or naturally occurring fluoride in their water, according to the Texas Department of State Health Services.

Why does RFK Jr. want to remove fluoride from drinking water?

In his post, Kennedy claims fluoride is associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders and thyroid diseases.

A recent study by the National Toxicology Program did find exposure to more than 1.5 milligrams of fluoride per liter was associated with lower IQ in children. However, the study did not find sufficient evidence that children’s IQs are affected by the low level of fluoride currently recommended for community drinking water.

The CDC warns that exposure to high levels of fluoride can result in denser bones, but these bones may be more fragile and brittle, therefore there may be an increased risk of breaking the bone.

Studies have not found a clear or strong link between high levels of fluoride and an increased risk of cancer in humans, according to the CDC.

To avoid exposure to high levels of fluoride, the CDC recommends that parents prevent children from swallowing dental products like fluoridated toothpaste, gels or mouthwashes. Individuals living in areas with naturally occurring high levels of fluoride should seek alternate drinking water options, such as bottled water.

Can the federal government remove fluoride from water?

No, the federal government cannot decide to remove or place fluoride in water systems as it is up to local governments.

Officials at the federal level could attempt to influence local governments to stop community water fluoridation, but cannot mandate whether communities implement water fluoridation.

Texas does not mandate water fluoridation and leaves the decision up to local governments.

Harris County is home to hundreds of water systems, according to the CDC, some of which are listed as fluoridated. The CDC states that a fluoridated water system is a system that delivers optimally fluoridated water to consumers, regardless of whether the system adds fluoride.

The Harris County Municipal Utility District 248, for example, is listed as fluoridated on the CDC website, but the district’s website states that the entity does not add fluoride to its water.

As of Tuesday afternoon, Houston Public Works had not responded to a request to confirm if the city adds fluoride to the water. But its 2023 water quality report shows Houston’s main system, which serves 2.4 million customers, contained an average of 0.3 milligrams of fluoride per liter of drinking water.

Since fluoridation can also occur naturally, water systems may contain fluoride even if it is not added by any government entities.

Correction (Nov. 19, 11:30 a.m.): A previous version of the article incorrectly stated that Houston, Texas, residents voted to stop adding fluoride to the water system in 2018. The vote occurred in Houston, Missouri.