A decades-old public health measure is facing renewed scrutiny as Robert F. Kennedy Jr., President-elect Donald Trump’s nominee for health and human services secretary, calls for an end to water fluoridation across the United States.
The debate intensified after a federal judge ordered the Environmental Protection Agency to draft new regulations regarding fluoride levels in response to concerns about potential risks to pregnant women and children’s IQ. This ruling prompted Abilene, Texas, to cease water fluoridation in September 2024.
Currently, more than 70% of Americans receive fluoridated drinking water, a practice the CDC considers one of the top 10 public health achievements of the 20th century. Studies show fluoridated water can reduce cavity prevalence by 25%, though its impact has diminished since the 1950s due to widespread availability of fluoride in toothpaste and other dental products.
The controversy centers on recent research suggesting possible links between high fluoride levels and lower IQ in children. A 2019 JAMA Network study found associations between fluoridated water consumption during pregnancy and lower IQ scores in young children. However, dental experts emphasize there’s no evidence linking fluoride to cancer and maintain that water fluoridation remains safe and effective.
Some public health experts, including former Baltimore health commissioner, Leana Wen, acknowledge that while fluoridation’s safety has been demonstrated through decades of research, emerging studies warrant careful consideration of risks to specific populations like pregnant women.
Dental professionals argue that eliminating fluoridated water would have serious consequences, particularly for vulnerable populations. They emphasize that fluoridated water provides unique benefits that toothpaste cannot replicate, especially during tooth formation in children.
The issue has also become a matter of personal choice, with some experts arguing that abundant alternative fluoride sources make water fluoridation unnecessary. However, supporters counter that it remains an essential, equitable public health measure that benefits all communities regardless of access to dental care.
Currently, fluoridation is required in large communities across 12 states, though local entities typically make decisions about water fluoridation. Recent federal guidelines recommend fluoride levels of 0.7 milligrams per liter, reduced from the previous 1.2 milligrams per liter in 2015.
Read more: ’Times have changed’: Debate over fluoridated water resurfaces across U.S.
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