It’s not just RFK Jr — Opposition to fluoride in drinking water grows

Opposition to the US practice of adding fluoride to drinking water supplies has been growing as more evidence accumulates linking fluoride exposure to potential harmful brain impacts in children. Now, the future of the practice could be in doubt, with Thursday’s confirmation of Robert F. Kennedy Jr. as President Trump’s Secretary of Health and Human Services (HHS).

Kennedy, an environmental health lawyer, has been calling for an end to fluoridation in public drinking water for years. And though it is the US Environmental Protection Agency (EPA) that has regulatory oversight of fluoride levels in water supplies, the HHS plays a role in policy by publishing recommendations for fluoridation that many states follow.

An HHS task force currently recommends fluoridation based on “strong evidence of effectiveness in reducing tooth decay.”

But that could change. In his new role, Kennedy is widely expected to push for guidance against fluoridation.

Since Kennedy posted on X on November 2, 2024, that Donald Trump would end fluoridation if elected, it opened a floodgate of attention to the issue, said Chris Neurath, science research director with the anti-fluoridation group Fluoride Action Network.

That, combined with a high profile recent court case that ordered the EPA to re-evaluate the safety of fluoridation, and accumulating evidence of harm, have all caused a “snowball effect” of attention, according to Neurath.

“This elevation of the issue into the mainstream really is unique in the last 80 years,” Neurath said. Though evidence of harm keeps growing, he said, “the facts haven’t really changed — but the awareness of them has.”

Fluoridation practices vary across the US as determinations about whether or not to add fluoride to drinking water are made by local and state officials. An estimated 200 million people are on drinking water systems with added fluoride, according to the Centers for Disease and Control.

Several public health bodies, including the American Dental Association (ADA), continue to support the practice, asserting that there is no evidence of harm at doses associated with water fluoridation. The ADA states on its website that the “scientific weight of sound evidence around the benefit of community water fluoridation is clear and compelling.”

But since September 2024, dozens of towns and municipalities have moved to stop adding fluoride to water supplies, including the cities of Hillsboro, Oregon; Abilene, Texas; and Kingston, Ontario, and small towns that include Peshtigo, Wisconsin; Rolla, Missouri; and Clearfield, Pennsylvania.

In November, Florida State Surgeon General Joseph Ladapo announced guidance recommending against community water fluoridation “due to the neuropsychiatric risk associated with fluoride exposure.”

While proponents of the practice argue that fluoride is an important tool in promoting dental health, there is growing evidence that chronic ingestion of the substance – even at low doses associated with fluoridation – might negatively impact the brain health of infants, young children, and fetuses.

Last month, a meta-analysis authored by government scientists and published in JAMA Pediatrics found that the vast majority of the 74 studies examined reported a link between fluoride exposure and decreased IQ, including at the lowest range of exposure.

This paper also found an apparently linear dose-response relationship between fluoride exposure and IQ decrements, with no known lower limit.

Numerous other studies have found similar cause for concern, including a May 2024 paper published in JAMA Network Open  that found higher levels of fluoride in the urine of pregnant women was associated with more neurobehavioral problems in their kids.

“We concluded based on these findings that it’s advisable that there be recommendations in place to limit fluoride exposure during pregnancy,” said study lead author Ashley Malin, a researcher at University of Florida.

Bruce Lanphear, an expert on environmental neurotoxins and a health sciences professor at Simon Fraser University in Vancouver, said the research provides a turning point in the scientific and public understanding of the practice.

“The evidence [is] quite convincing that fluoride is toxic down to the levels that are found routinely in fluoridated communities,” said Lanphear. “The more people will look at the evidence it will become obvious that we need alternative ways to protect children against tooth decay and water fluoridation is not a good way to do that. We can no longer afford to sweep this under the carpet.”

Last year, a federal judge concluded after a seven-year-long court case that the EPA needed to take regulatory action to eliminate the “unreasonable risk” that water fluoridation presents.

US District Judge Edward Chen found that current allowable fluoridation levels at 0.7 parts per million in drinking water “poses an unreasonable risk of reduced IQ in children.”

The studies “challenge the notion that the low fluoride levels measured in people living in optimal fluoridated areas are safe,” said Christine Till, a professor at York University who studies environmental health and neuropsychology.

Till co-authored a 2020 study in Environment International that followed 398 mother-child pairs and found that an increase in water fluoride concentration roughly equivalent to the difference between fluoridated and non-fluoridated communities was associated with a nine point IQ decrease in children who drank formula made from fluorinated tap water. In children who were breast-fed by mothers drinking the fluorinated water, the decline was six points.

Corey Basch, a public health researcher at William Paterson University, said with the accumulation of scientific studies she expects to see “greater public debate and scrutiny about this as it is re-evaluated.”

(Featured image by Lia Bekyan via Unsplash+)