There’s a legitimate debate to be had about adding fluoride to drinking water. The practice has long been lauded as a victory for dental health because the chemical can strengthen tooth enamel and prevent cavities. But too much of it presents real health risks.
In other words, the issue is complicated and calls for nuance and respect for science. Unfortunately, many politicians — cheered on by Health and Human Services Secretary Robert F. Kennedy Jr. — have opted for over-the-top rhetoric and ham-fisted bans.
Kennedy has described fluoride, a naturally occurring mineral, as “industrial waste” and a “dangerous neurotoxin.” He has vowed to remove it from drinking water in the United States, and in recent weeks he has celebrated as two states — Utah and Florida — voted to ban it. “It makes no sense to have fluoride in our water,” he said after Utah’s vote. “The evidence against fluoride is overwhelming.”
In Florida, Republican Gov. Ron DeSantis cast the issue as one of personal freedom, describing fluoridation as “forced medication.” His state’s surgeon general, Joseph A. Ladapo, called it “public health malpractice.” Lawmakers in several other states are considering measures to curb use of the mineral.
At best, this anti-fluoride campaign is an overreaction. At worst, it is an attempt to distort research to promote ideology over public health.
It’s not unreasonable to question fluoridation practices; in the past half-century, dental hygiene has greatly improved, and most toothpaste products now contain fluoride, so it is less essential that it be in drinking water. As it was adopted in the second half of the 20th century, fluoridation reduced dental cavities among children by 40 to 70 percent, the Centers for Disease Control and Prevention reports. But these days it might offer only “slightly less” tooth decay among children, according to a 2024 meta-analysis of 21 studies. And it might make “little or no difference.”
Not all communities are the same, however. Many populations, especially in rural areas, lack easy access to dental care. And while products such as fluoridated toothpastes and mouthwashes exist to prevent tooth decay, not all low-income families will buy them. (The Trump administration is actively seeking to remove from the market prescription fluoride tablets that can help fight cavities, claiming that the products are bad for children’s gut health.) For these communities, fluoridation remains essential for good oral health.
Moreover, it is easy enough to address fluoridation’s potential harms without banning it. High exposure to the substance can cause tooth discoloration and bone deformities. Some research also shows that very high fluoride consumption might even disrupt children’s brain development. During the Biden administration, the National Toxicology Program reviewed more than 70 studies and concluded with “moderate confidence” that higher levels of fluoride consumption are associated with lower IQ in children.
But this doesn’t suggest fluoride should be eliminated. Instead, state and local officials should reduce it in places where levels are high, or help families in those communities access filtration. A 2023 study estimated that as many as 3 million Americans live in areas with tap water fluoride levels exceeding 1.5 milligrams per liter, more than twice what the federal government recommends.
Federal officials could press the issue by reducing the amount of fluoride allowed in drinking water. The Environmental Protection Agency currently sets the maximum limit at 4 milligrams per liter; this should come down. Fortunately, EPA Administrator Lee Zeldin has already indicated he will make this change.
Opponents of fluoridation argue that a more aggressive approach is needed to prevent harm to children’s brains. But the science here is debated. It is notoriously difficult to measure both IQ and fluoride consumption, and the NTP report has earned criticism for including low-quality studies with a high risk of bias. Also, many other factors can affect a child’s brain development. So the potential link between fluoride and IQ, while concerning, deserves more research. It doesn’t justify upending decades of public health policy.
Nonmainstream voices such as Kennedy’s can be useful in government to question the status quo. After all, policies that made sense a few decades ago might be outdated. But any revisions to long-standing practice should be based in fact and not stand in the way of progress.
Original article online at: https://www.washingtonpost.com/opinions/2025/05/22/fluoride-water-kennedy-utah-florida-ban/