The debate over fluoridating public water supplies in the United States has resurfaced, driven by new scientific findings and shifting public attitudes. Advocates call it a great achievement in public health, while critics have raised concerns about potential health risks and individual autonomy.
Introduced in the 1940s to combat tooth decay, around 63 percent of the U.S. population receives fluoridated water, according to the National Institute of Dental and Craniofacial Research (NIDCR), though this is not federally mandated.
Experts say the practice has benefited millions of Americans, but questions about its potential risks and necessity have intensified, dividing public opinion and policymakers.
Incoming Health Secretary Robert F. Kennedy Jr. has been vocal in his opposition to the inclusion of fluoride in America’s water sources, previously describing it as “an industrial waste.”
What Is Fluoride?
Fluoride is a naturally occurring mineral commonly found in various sources such as rocks and water.
In the realm of dental health, fluoride is recognized for its ability to prevent dental caries (tooth decay) by strengthening tooth enamel, thereby making it more resistant.
This has led to its widespread addition to public water supplies—a practice known as water fluoridation—and its inclusion in dental products like toothpaste and mouthwash.
Fluoride’s ability to prevent cavities was first identified in Colorado Springs, where naturally high fluoride levels correlated with fewer cavities, although there were signs of discoloration in teeth. The success of the discovery led to widespread fluoridation, with Grand Rapids, Michigan, becoming the first U.S. city to formally adopt the practice.
By the 1960s, the practice was widespread across the nation.
Yet the practice has faced resistance, with some critics arguing that fluoridation imposes a one-size-fits-all public-health measure that disregards individual choice.
“It wasn’t whether fluoride was good or bad,” said one county commissioner in North Carolina after voting against adding fluoride to the local water supply .
“The real deciding factor for my vote was a matter of consent.”
Should Fluoride Be In US Water?
While at high doses, fluoride can cause bone issues and tooth discoloration, experts and health bodies largely continue to champion the positive effects of fluoride at the much smaller doses it is delivered through water systems.
Recent studies have added fuel to the debate.
A 2025 analysis suggested a potential link between elevated fluoride exposure and reduced IQ levels in children.
Prominent anti-fluoride movements have been pushing for the removal of fluoride.
One such group, Fluoride Action Network told Newsweek: “Water fluoridation is obsolete. [The] U.S. is an extreme outlier when it comes to the use of fluoridation chemicals. More people drink artificially fluoridated water in the U.S. than the rest of the world combined.
“This means that over 95 percent of the world’s population is fluoridation-free, including 98 percent of the population in Europe. Meanwhile, according to World Health Organization data, fluoridated countries DO NOT have less dental decay than non-fluoridated countries.”
In September, a federal judge ordered the Environmental Protection Agency (EPA) to further regulate fluoride in drinking water due to possible links between it and developmental risks in children, although the judge was careful to note that any connection was not entirely certain, per The Associated Press.
“Our hope is that [Kennedy Jr.] ensures that the EPA follows the judge’s ruling and the federal guidelines currently in place on toxic substances,” Fluoride Action Network told Newsweek.
The EPA has appealed against the ruling.
Dental experts told Newsweek that fluoride was safe at the current levels seen in American water supplies.
“There is no question that fluoride improves dental health,” Abinash Achrekar, vice chair of medicine at the University of New Mexico, who has also served as deputy secretary of the New Mexico Department of Health, told Newsweek.
“The question is too high of a fluoride level. Can that cause other medical or behavioral compromises? Are there any proven risks with the levels typically found in public supplies currently?
“No, there’s not.”
Steven Levy, with the University of Iowa’s College of Dentistry and Dental Clinics told Newsweek: “Community water fluoridation is the most efficient and cost-effective way to provide dental caries prevention to population groups.
“One reason is that it provides benefits passively just from drinking the water. One does not need to do special things to have and use a toothbrush and fluoridated toothpaste or mouthrinse or go to the dentist for office-based topical fluoride treatments.”
And major health organizations, including the Centers for Disease Control and Prevention and the American Dental Association, continue to endorse water fluoridation as a safe and effective public-health measure for preventing tooth decay.
“Because of (…) almost everybody using fluoride and toothpaste, we may be getting sufficient levels of fluoride through other means than the municipal water supply. So I think it’s not unreasonable to look at these data again,” Achrekar said.
“That’s how science moves forward, you know, it’s an iterative process.”
“?I think collecting more data to find out what those toxic levels are and if there are any health consequences is very important,” he added.
Original article online at: https://www.newsweek.com/fluoride-us-water-experts-rfk-2020215