The recent Ninth Circuit ruling on fluoride changed the legal trajectory of the case, but it did not resolve the scientific debate. If anything, it exposed how badly the country now needs something it still lacks: an independent, trusted evaluation of the totality of evidence on fluoride’s risks and benefits.
Population strategies are among the most powerful tools public health has. Clean water, vaccination, sanitation, and reductions in lead exposure have saved millions of lives and improved health on a scale that clinical medicine alone could never achieve. But precisely because these strategies operate across entire populations, their safety and effectiveness must be evaluated with exceptional rigor. If a population strategy is not safe—or no longer as effective as once believed—that power itself becomes part of the problem.
The recent Ninth Circuit decision only heightens that urgency. The appeals court did not conclude that fluoride is safe, nor did it reject the growing body of studies linking higher fluoride exposure with lower IQ in children. Instead, the court ruled that Judge Edward Chen went too far procedurally when he delayed the case to await newer scientific evidence—including the National Toxicology Program review—and then incorporated that evidence into a second phase of the trial. In short, the appellate court concluded that the case should have been decided using the original trial record rather than newer evidence that emerged afterward.
That is why this moment demands something more than prolonged regulatory delay or courtroom battles over procedure. We urgently need an independent evaluation by the National Academies of Sciences, Engineering, and Medicine—one that brings together toxicologists, epidemiologists, neurologists, dentists, exposure scientists, and risk assessors without financial or political stake in the outcome.
The goal should not be to “win” the fluoride debate. It should be to honestly evaluate the totality of evidence: neurodevelopmental risks, effectiveness for preventing tooth decay in the modern era, potential effects on bone and thyroid function, susceptible populations, biomarkers of exposure, and the implications of cumulative fluoride intake from multiple sources. Public trust depends not on certainty, but on transparency, independence, and a willingness to follow the evidence wherever it leads.
Original article online at: https://blanphear.substack.com/p/the-fluoride-ruling-was-vacatedbut