What do we know about fluoridated water?

Nov 09, 2024

Getty Images/Kemal Yildirim

• 4 min read

Now that Donald Trump has won the presidential election, he could start a campaign to make America’s tap water fluoride-free again.

Federal health officials have been recommending fluoridating water since 1950, as there’s copious evidence that moderate fluoride exposure reduces tooth decay. But Robert F. Kennedy Jr.—who is a member of the president-elect’s transition team and is expected to take on a health role in his administration—has said that the next Trump administration will urge localities to consider removing the mineral from their water supply.

RFK Jr. claims the substance is “an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.” While the former environmental lawyer has promoted fringe health claims rejected by the medical community, many experts share his concern about some of the potential risks of fluoride.

The NIH said that more research is needed to determine the effects on adults, and whether the recommended levels can also be harmful to children. In the meantime, health advocates, scientists, dentists, and conspiracy theorists continue to debate the impact of fluoride in our water.

Almost two-thirds of Americans have the candy-counteracting elixir running in their tap. The dental health gains that have come from the low-cost intervention—with one study showing it shaves off $6.8 billion from US dental expenses annually—led the CDC to list the fluoridation of water among the Top 10 major public health wins of the 20th century.

But almost 2 million Americans receive water with at least double the recommended level of fluoride, since it can form in groundwater naturally. That could be a cause for concern:

Anti-fluoride sentiment goes back to the 1950s when some people erroneously believed that fluoridated water was a communist conspiracy.

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Many data-informed arguments for fluoride removal cite a lack of research on its risks and the difficulty dosing intake when it’s in the drinking water. They also point to the fact that most toothpaste contains the substance, so anyone who remembers to brush their teeth with an American Dental Association-endorsed product gets exposed to it anyway. Indeed, a recent study showed that the dental benefit of fluoridated water has declined modestly after it became a fixture of commercial tooth care products in the 1970s (though the authors of the study caution against interpreting it as an anti-fluoride argument, as removing fluoride also has its pitfalls).

Meanwhile, the American Dental Association has been among the loudest defenders of fluoridation, arguing that it delivers benefits to people who might not be able to brush twice a day with recommended products. A recent study showed that dental decay rates in baby teeth went up after fluoride was nixed from the taps in Calgary, Alberta, in 2011.

Several US municipalities like Abilene, TX, and Somers, NY, have stopped fluoridating their water, and some states are trying to drop laws mandating the practice, leaving the decision up to cities and towns. This puts them in line with much of Western Europe, where only Ireland, Spain, and the United Kingdom have communities with fluoridated taps.

Looking ahead…the Trump administration might struggle to get municipalities to remove fluoride from the tap, since water decisions are made on a local and state level. But it may try to mandate a countrywide removal via the Environmental Protection Agency, a policy that would likely face court challenges and fierce opposition from advocates, according to Politico.—SK

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