Should Fluoride Be In Public Drinking Water? Osage Beach Is Considering Taking It Out

LAKE OF THE OZARKS, Mo. — The City of Osage Beach is considering whether to stop adding fluoride to its public water supply.

Fluoride has long been added to drinking water with the aim of preventing tooth decay. But across the country, the debate over its use is reaching new heights.

Earlier this spring, Health and Human Services Secretary Robert F. Kennedy Jr. announced plans to direct the Centers for Disease Control and Prevention to stop recommending water fluoridation nationwide. By May 2025, both Utah and Florida had already banned the practice.

“Adding fluoride to drinking water began back in the 1940s. At the time, it was difficult for many to get enough fluoride for quality dental health as fluoride was not readily available in toothpaste, mouth wash, regular dental care, etc.” said Osage Beach Mayor Michael Harmison in a Facebook post.

Harmison explained that the City began adding it in the 1990s, but also mentioned new health concerns over the years and pointed out several European countries don’t add fluoride to their water supply. Yet, he acknowledges, it could be in citizens’ best interest for oral care.

His post was inundated with comments, with a majority of them on the Facebook post supporting fluoride removal. Others say it shouldn’t be a political issue and want to listen to the experts.

“I am in total agreement with Senator Kennedy that our food sources are poisoning use in ways we don’t know about—with the exception of fluoride,” said Ronald Massie, dentist and president of Premier Dental & Oral Health Group in Lake Ozark. He said he was the one who pushed the Board of Aldermen to adopt City water fluoridation in the ’90s. “I could be self-centered here and say to not fluoridate so that it will make more demand for my profession, but that would be nothing short of unethical, immoral, and not fulfill the Hippocratic Oath that I took as a healthcare provider,” Massie said.

So should fluoride be in public drinking water? Here’s a few things to consider…and if you’ve got opinions, take the poll!

What Is Fluoride?

Fluoride is a naturally occurring mineral found in soil, water, and rocks. It is widely agreed upon across health and science sources that it helps prevent or even reverse early tooth decay.

It works by weakening cavity-causing bacteria, strengthening enamel, and promoting remineralization. Common sources include toothpaste, dental products, and foods or beverages made with fluoridated water. About 60% of U.S. intake comes from community water systems, according to the Office of Dietary Supplements. Public health agencies credit water fluoridation with reducing cavities in communities by 40–60%.

In Missouri, the Department of Health reports about 6% of children have fair or poor oral health, and those ages 5–8 with lifelong exposure to fluoridated water are half as likely to develop cavities.

The American Academy of Pediatrics explains that “poor oral health can cause pain, impact children’s performance in school and other activities, and lead to long-term health problems like cardiovascular disease, diabetes, and respiratory issues.”

For water that is not naturally fluoridated, the Indiana Dept. of Health said utilities use three chemicals to add fluoride to drinking water: sodium fluoride, sodium fluorosilicate, and fluorosilicic acid. Fluorosilicic acid — a high-purity byproduct of phosphate fertilizer production — is captured rather than released into the environment, then converted into the other two forms for water treatment. All 40+ water treatment chemicals used in the U.S. are industrial grade and must meet strict National Sanitation Foundation and American Water Works Association standards.

Declining Effectiveness?

According to the CDC timeline, Crest released the world’s first fluoride toothpaste in 1956, which became very common by the mid-1960s.

Half of the U.S. population was also receiving fluoridated tap water by 1980. Since 2015, the U.S. Public Health Service recommends a uniform fluoride level of 0.7 mg/L in drinking water to balance cavity prevention and minimize the risk of dental fluorosis. Water systems nationwide adopted the standard.

A review published in 2024 by the Cochrane Library suggests fluoridating community water is less effective than it was in the 1970s. But the American Dental Association says there were limitations and exclusions in the report.

The 157 studies that were examined only compared communities in high-income countries. The review stated that the impact wasn’t clear in low- and middle-income countries.

According to the CDC and ADA, fluoridated water and fluoride toothpaste complement each other in preventing tooth decay—water maintains a steady level of fluoride in the mouth throughout the day, while toothpaste provides stronger doses at key times like before bed.

“Optimally fluoridated water is accessible to communities regardless of socioeconomic status, education or other social variables,” said ADA President Linda J. Edgar, D.D.S. in a 2024 news release. “Even in an era with widespread availability of fluoride from various sources, other studies show that community water fluoridation prevents at least 25% of tooth decay in children and adults throughout their life span.”

What Other Nations Are Doing

A 2018 National Library of Medicine article notes that most developed nations do not fluoridate their water, while regions in India, China, and parts of Africa with naturally high fluoride levels are working to reduce it due to possible health risks.

A 2025 BBC article by Amanda Ruggeri further explained why some countries choose not to add fluoride or have repealed the practice.

For some regions, it naturally occurs in the water. But other countries have never added it or stopped because:

– of public complaints

– residents getting enough fluoride through other means

– access to quality dental care

Many who advocate for the removal of fluoride in public water present an ethical argument; those who want the mineral can supplement it on their own, but it should be a choice.

Overall, the use of fluoride is practiced around the world. And it’s one that some regions are reclaiming. In 2011, Calgary, Canada, stopped fluoridating its local water supply. In June of 2025 however, it decided to reinstate the practice after a reported rise in tooth decay among children.

There are alternatives to putting it in water as well. Milk and salt are two common ways for countries to provide fluoride to the public, while other nations like Japan distribute fluoride mouth-rinses in schools.

One expert used in the BBC article was Vida Zohoori, a professor in public health and nutrition at the UK’s Teesside University who focuses on researching fluoride.

“Zohoori urges care when looking at the relatively low levels of water fluoridation in Europe as a reason to stop doing it elsewhere. Europe, she points out, doesn’t have a great dental health record,” Ruggeri wrote. “A 2023 WHO report found that Europe had the highest prevalence of major oral disease, including the most caries in permanent teeth, of any region in the world.”

Potential Health Risks

While fluoride is widely recognized for its dental health benefits, some studies and health agencies have examined potential risks.

According to the National Toxicology Program, high levels of fluoride exposure—particularly from multiple combined sources—have been linked in some studies to potential neurodevelopmental effects, like reduced IQ in children. The NTP notes that most of these findings are based on areas with naturally high fluoride levels, often much higher than U.S. water fluoridation standards.

In one 2012 Harvard study (prior to the DHHS lowering the recommended level to 0.7 mg/L) about fluoride toxicity to brain development, adjunct professor Philippe Grandjean said, “Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain. The effect of each toxicant may seem small, but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us.”

The authors of the Harvard report noted that while potential risks have been studied in China (in areas substantially above 1 mg/L), they have received far less attention in the U.S., and they recommended further research on how fluoride exposure levels affect early development.

It’s understandable why concerned individuals might not want to have it added to the public water supply for everyone, especially when it’s not an option for many to have a private well.

The ODS says excessive fluoride can lead to dental fluorosis, a condition causing visible white spots or streaks on teeth, especially in children during tooth development. In extreme cases, a rare condition called skeletal fluorosis can occur, leading to joint pain and stiffness.

Concerns about cancer risk have also circulated for years, but the American Cancer Society states that decades of research have not shown a clear link between community water fluoridation and increased cancer rates, including osteosarcoma.

Researchers and health experts like Johns Hopkins University stress that most risks occur at high doses over time, and that regulated fluoridation levels in the U.S. are well below thresholds associated with harmful effects. Still, they note that ongoing review of new evidence is important as fluoride exposure also comes from toothpaste, mouth rinses, and certain foods and beverages.

Serious systemic toxicity from fluoride would require an acute dose of about 5 mg per kilogram of body weight (~375 mg for a 165-pound person, ie 141 gallons of water in a short period), according to the NLM article. This would be nearly impossible to reach through drinking water or toothpaste with standard fluoride levels.

Parents should keep an eye on kiddos to make sure they don’t swallow toothpaste with fluoride, like eating it from the tube. Too much can cause upset stomachs and eventually leave white streaks on their teeth. Something containing calcium can help ease tummies because it binds with fluoride!

Government Overreach 

For people today, it comes down to trust. Why should the government artificially add fluoride in the public water supply? It’s involuntary, and is ingesting small amounts worth it?

The National Library of Medicine article pointed out that the “only known association with low fluoride intake is the risk of dental caries.” But the article notes that dental care is costly worldwide, so preventative measures become more crucial for oral health.

It’s estimated that more than 400 million people worldwide, across 25 countries, fluoridate their water. A few of them give it to more than 50% of the population, including the U.S., Australia, Israel, Chile, and Ireland.

While health and dental experts around the world would argue fluoride is worth it as a safe and proven public health benefit, there are many proponents against it.

Candace Owens, a political commentator and author, voiced her opposition to fluoridation on a podcast, saying, “the government just believes that small amounts of the poison (fluoride) are good for your teeth… I’d rather have a cavity than a small dose of poison if I’ve got the option.” She also argued that fluoride’s introduction came during a shady period in government history.

The Fluoride Action Network is an advocacy group dedicated to ending water fluoridation and reducing fluoride exposure worldwide. According to FAN, its mission is to broaden public awareness about what it sees as the harmful effects of fluoride, citing studies that question its safety and necessity. The organization challenges pro-fluoridation policies and pushes for government transparency.

With all the opposition to water fluoridation, the NLM article suggested that “perhaps it is better to deliver fluoride directly to the tooth instead of ingesting it,” even though some of those applications are not universally affordable.

As a democracy, maybe it’s up to the people’s—hopefully informed—vote.

What’s Next For Osage Beach 

If the City intends to modify the fluoridation of its water supply, or in this case eliminate it, officials must notify the Dept. of Natural Resources, Dept. of Health and Senior Services, as well as the residents at least 90 days prior to any vote on the matter.

“We will file all the necessary paper work to begin this 90 day process,” Mayor Harmison said. “We will also be doing our due diligence to notify the public of the possible change to our water supply, and we will also hold a public hearing so that the citizens can voice their concerns or support.”

Afterwards, Harmison plans to bring it back to the board for voting. If fluoride was removed, it would save Osage Beach about $10,000 per year he said.

“However, this is about safety concerns and not the money,” Harmison said. “I, for one, am in favor of eliminating fluoride from our water supply for the health of our community.”