Last year, Utah lawmakers passed the first statewide ban on fluoridating water in public water systems. The law also includes a provision that makes fluoride supplements more accessible to people without the need to visit a dentist.
This would make fluoride available by individual choice, rather than through “mass water fluoridation,” as stated on a portion of the Utah House of Representatives website – part of the growing rhetoric of skepticism that led to the rollback of water fluoridation, an effective method for reducing tooth decay.
“This is what I like to call a win-win for both sides, right?” said Speaker Mike Schultz during another episode of the House Rules podcast in Utah. “Those who want fluoride can now get it more easily, and those who don’t want fluoride in drinking water don’t have to have it.”
However, even as critics point to fluoride supplements as an alternative – along with fluoride toothpaste, mouth rinses, and varnishes – many people create barriers to these very products.
Under the oversight of the U.S. Health and Human Services Secretary Robert F. Kennedy Jr., the FDA notified four companies about their supplements for children and released new guidelines for healthcare professionals.
In Texas, Attorney General Ken Paxton launched an investigation into two large companies over their advertising of fluoride toothpaste to parents and children.
And changes to Medicaid in the so-called “one big, beautiful bill” of President Donald Trump threaten to make access to any dental care even less accessible, especially for the most vulnerable populations, and even more so for fluoride procedures in the dentist’s office.
Effects and Public Sentiment
Most, experts say, the alarming rhetoric from high-ranking officials is seeping into the public, causing more and more people to doubt whether any form of fluoride – whether in drinking water or by other methods – is beneficial.
Scott Tomar, a professor and associate dean of the University of Illinois at Chicago College of Dentistry, is among those monitoring with concern how the fluoridation debate is shaping the discussion and fueling public fears.
“I am confident that the overall outcome of all this will be greater caution on the part of parents and providers in prescribing fluoride supplements.”
The availability of fluoride in drinking water contributed to a sharp decline in cavities, but doubts about its use have intensified in recent years, partly due to Kennedy’s authority and influence as the country’s top medical official.
“The evidence against fluoride is extremely compelling,” he said at a press conference in Salt Lake City last April, alongside Utah lawmakers.
Although the scientific data supporting his conclusions are limited, he argued that fluoride could “cause a decrease in IQ, a profound decrease in IQ” and linked water fluoridation to ADHD, hypothyroidism, osteoarthritis, and kidney and liver problems.
Lee Zeldin, who heads the Environmental Protection Agency, also spoke at the Utah event, praising Kennedy for helping initiate a review of fluoride standards in drinking water. An EPA spokesperson stated that “the next analysis of new scientific information about potential health risks from fluoride in drinking water was not supposed to occur until 2030, but this agency is moving at Trump’s pace.”
Additionally, the FDA is collaborating with other federal agencies on the so-called “fluoride research program.” As part of a series of drastic budget cuts this year, the Office of Oral Health at the Centers for Disease Control was eliminated.
In response to inquiries, a spokesman for HHS said that the main benefit of fluoride for teeth lies in contact with the tooth surface, not in swallowing it. Therefore, “you don’t need to ingest fluoride.”
Opponents of fluoridation point to the controversial National Toxicology Program 2024 briefing document, which allegedly links fluoride exposure to reduced IQ in children. An assessment of the report’s limitations indicates the study was conducted outside the United States under different water conditions and fluoride levels that exceed U.S. requirements. The report itself notes that it does not define the full exposure to fluoride added to drinking water at the recommended levels in the United States and Canada, associated with measurable impacts on IQ.
In this climate, support for water fluoridation fluctuates even in Michigan, where the practice has been in place for more than 80 years. Florida has also joined Utah in banning water fluoridation at the state level. Initiatives similar to such bans have appeared in other states, and local discussions are becoming louder.
Utah dental professionals are concerned about how to avoid harming oral health as fluoridation declines, as has happened in other communities after fluoridation ended.
“We are worried about the situation,” said James Becker, a pediatric dentist and former president of the Utah Dental Association, “and together with colleagues they are looking for ways to offer other forms of fluoride treatment to Utah residents. But many vulnerable children from underserved populations, who have no choice and no voice, will suffer.”
“Now that fluoride is largely absent from Utah’s water, it is extremely important to provide supplementation through other means.”
After the fluoridation ban, the FDA began actions to limit the sale of certain forms of fluoride for children. In a press release, the agency linked this to impacts on the gut microbiome, thyroid disorders, weight gain, and potential IQ decline.
More than 4,600 educational comments were submitted to the FDA, many from people worried about losing access to supplements while forgoing fluoridation of water.
“Now that fluoride has been removed from a large portion of Utah’s water, it is extremely important to provide supplements through other means.”
In response to inquiries, doctors were advised by the FDA to consider local fluoride application as an alternative, specifically toothpaste. However, this tactic faced criticism: the Texas Attorney General’s office launched an investigation into Colgate-Palmolive and Procter & Gamble over their fluoride toothpaste campaigns.
“Marketing for parents and children is misleading, deceptive, and dangerous.”
A Colgate-Palmolive spokesperson noted that “we already provide instructions on our packaging in accordance with U.S. FDA requirements for the use of fluoride toothpaste for children.” Procter & Gamble responded that “the Texas Attorney General acknowledged in the settlement that our products meet all statutory and regulatory requirements for usage instructions.”
Another fluoride treatment option is varnishes applied during dental examinations, which may be provided free of charge or at a reduced cost through insurance programs. However, even with medical insurance there are barriers that often hinder access to this therapy. Recent studies have shown that denials of coverage for fluoride varnishes can add another layer of difficulty for patients and healthcare providers.
Additional fluoride procedures are limited compared with the effectiveness, coverage, and cost of fluoride in drinking water. “Nothing replaces fluoridated water. Nothing comes close.”
“Nothing replaces fluoridated water. Nothing comes close.”
Original article online at: https://mezha.net/eng/bukvy/utah-first-state-to-ban-water-fluoridation-sparking-health-debate/amp/