Fluoride has been added to public water supplies for decades to prevent tooth decay. But now, a swirl of new research, legal challenges and political shifts are pushing fluoridation back into the headlines — and under the microscope.
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. announced this week that he plans to direct the CDC to stop recommending fluoridated drinking water. The move comes amid intensifying scrutiny of fluoride’s potential risks to brain development in children, especially in utero. It follows a landmark but contested federal court ruling declaring current fluoride levels an “unreasonable risk” to public health.
Public health officials warn that rolling back fluoridation could undo decades of progress in dental health — especially in underserved communities — as the Biden administration’s legal appeal and the incoming Trump administration’s policy decisions hang in the balance.
The EPA is currently reviewing its options, which range from issuing warning labels about fluoride risks to tightening regulations or potentially banning fluoridation altogether. Some communities are already questioning whether to keep fluoride in their water.
With all eyes on this issue, here are key tips for journalists covering fluoride and its potential health effects.
Don’t oversimplify the science. Water fluoridation is both a public health intervention and a hot-button issue. Avoid cherry-picking findings or framing the issue as “good” or “bad.” One study published in JAMA Pediatrics found that higher fluoride levels in pregnant women were linked to slightly lower IQ scores in boys — but not girls. It was a large, well-designed study, but it doesn’t prove causation. The study was not a clear-cut case. More research — especially U.S.-based studies — is needed.
The science behind water fluoridation is complex and evolving. Instead of leaning on dramatic headlines, help audiences understand what researchers do and don’t know. Use phrases like “associated with” rather than “caused by.” And be transparent about study limitations. Contextualize new findings alongside decades of data showing the benefits of fluoride for oral health.
Explain why the issue matters now. There’s a tendency for journalists to treat water fluoridation as an old story. But new research, legal proceedings, and shifting public opinion are giving the topic fresh urgency. The San Francisco lawsuit against the EPA could result in restricting or banning fluoride in U.S. water supplies. That would have sweeping implications for how cities manage drinking water and public health. Meanwhile, some local governments — like parts of Oregon — have already halted fluoridation, and others are considering similar steps, while other places like Calgary are reintroducing fluoride to its water supply. These changes make it crucial for reporters to track local debates and decisions that could fly under the radar.
Center public health equity in the narrative. Fluoridation has long been touted as a low-cost way to improve dental health for the greatest number of people, particularly in communities that lack access to dental care. If more cities pull fluoride from their water, what will that mean for rural and low-income communities?
Any potential risks of fluoride need to be weighed against the very real harm of untreated tooth decay. Dental issues disproportionately affect children in poverty, communities of color, and those without regular access to dentists. When covering this issue, make sure to interview public health experts who work with these populations and can speak to the tradeoffs.
Use plain language when explaining risk. When writing about fluoride’s possible health risks, be clear about what “risk” means. The JAMA Pediatrics study found an IQ difference of two to three points, on average, among boys with higher prenatal fluoride exposure. That’s statistically significant — but it’s not a dramatic drop. However, researchers say even small average effects can have big impacts at the population level. Avoid sensationalizing or minimizing findings. Instead, use examples to help audiences make sense of the numbers: What does a 2-point IQ difference mean in real-world terms? Why are some researchers concerned even if the difference seems small?
Avoid false balance — but acknowledge uncertainty. In contentious health debates like this one, reporters sometimes feel pressure to “balance” a story by giving equal time to opposing viewpoints. But not all opinions are backed by the same weight of scientific evidence. The consensus among major health organizations — including the CDC, ADA, and WHO — has long been that water fluoridation is safe and effective. That said, newer studies are introducing real and credible concerns, particularly about prenatal exposure.
Your job isn’t to frame this as a two-sided fight between “pro-” and “anti-” fluoride camps — it’s to help your audience understand where legitimate scientific uncertainty exists, and where there’s overwhelming agreement. Avoid “he said, she said” reporting. Instead, focus on evidence: What do we know? What are scientists still trying to figure out? And what’s being done in response?
Dig into the data — local and national. Fluoride levels in water systems vary widely, and so do oral health outcomes. National statistics tell part of the story, but local data can reveal more meaningful patterns. If you’re reporting in a city or region that’s considering a change in its fluoridation policy, request local dental health data from public health departments, school systems or Medicaid programs. Look for rates of childhood tooth decay before and after any changes in fluoridation.
Also, check the U.S. Environmental Protection Agency’s (EPA) database for fluoride concentrations in your area’s drinking water. Compare those to the U.S. Public Health Service’s recommended level of 0.7 milligrams per liter. If levels are above that, communities may be taking steps to reduce them — or not. That’s a story.
Make connections to broader environmental health concerns. The fluoride conversation isn’t happening in isolation. Public concern over contaminants in drinking water has grown dramatically in recent years, especially around PFAS (“forever chemicals”), lead and microplastics. Fluoride — once widely accepted as a public health win — is now part of that larger dialogue about chemical exposure, especially during pregnancy and early development.
Consider tying your fluoride reporting into broader themes of environmental justice, maternal health and children’s brain development. These connections can bring new audiences to the story and help readers see the bigger picture.
Keep an eye on messaging from federal agencies. One reason the fluoride conversation is heating up is mixed messaging from U.S. health agencies. While the CDC and ADA continue to support water fluoridation, the National Toxicology Program (NTP) published a systematic review in 2024 that flagged potential neurodevelopmental risks of fluoride exposure in utero.
The release of that report was met with disagreements over its strength and public impact. Groups like the American Dental Association doubled down on their support for water fluoridation.
In September 2024, U.S. District Judge Edward Chen ruled that the current maximum fluoride concentration of 0.7 milligrams per liter, considered “optimal” in the United States, poses an “unreasonable risk” to public health, especially to children’s IQs. This decision requires the Environmental Protection Agency (EPA) to take regulatory action under the Toxic Substances Control Act, although the specifics of the response are left to the agency’s discretion.
In January 2025, attorneys for the Biden administration filed an appeal against this ruling just days before a deadline, signaling continued legal contention. The incoming Trump administration, which has expressed openness to banning fluoridation, will decide whether to continue pursuing this appeal or adopt alternative policies.
The mixed messaging by health agencies is part of the evidence presented in the legal battles over our water supplies and could force federal agencies to revisit their guidance and reshape the national conversation.
Give your audience tools, not just information. When people hear conflicting messages about something as basic as tap water, confusion and anxiety can follow. As you report, aim to empower your audience with useful, actionable information. For example:
- Can pregnant people filter fluoride from their tap water, and if so, how?
- Are there safe alternatives to water fluoridation for preventing tooth decay?
- How can families know how much fluoride they’re exposed to through water, toothpaste, or diet?
Consider adding a brief explainer box or sidebar that walks readers through practical options without fear-mongering. Health literacy is key here — especially for vulnerable readers who may not have the time or resources to dig through scientific studies themselves.
In short: this story is about more than fluoride. Water fluoridation touches on public trust in science, equity in health care, and how we protect vulnerable populations — especially children — from disease and environmental risk. As a journalist, you have the chance to tell a richer, more nuanced story that moves beyond the fluoride “debate” and explores what it reveals about our systems, science and our communities. By combining solid science reporting with empathy and local perspective, you can help your audience make sense of a confusing issue — and make informed choices.
Original article online at: https://healthjournalism.org/blog/2025/04/reporting-on-water-fluoridation-during-an-infodemic/