Salt Lake City, March 2025: Utah is poised to become the first U.S. state to prohibit fluoride in its public water systems, a move that follows the appointment of fluoride-critic Robert F. Kennedy Jr. as head of the U.S. Department of Health and Human Services.
Fluoride and Its Benefits
Fluoride is a naturally occurring mineral that strengthens tooth enamel and helps prevent tooth decay. It works by making teeth more resistant to acid-producing bacteria and restoring lost minerals. The introduction of fluoride in community water supplies significantly reduced tooth decay rates in the U.S.
History of Water Fluoridation
In 1945, Grand Rapids, Michigan, became the first city to add fluoride to its water supply. Over 15 years, studies showed a 60% reduction in tooth decay among school children. By the 1950s, the U.S. Public Health Service and the American Dental Association recognized fluoridation’s benefits, leading to its widespread adoption across municipalities.
Fluoridation in the U.S.
As of 2022, about 63% of Americans receive fluoridated water. Costs for fluoridation vary, ranging from 50 cents per person annually in large communities to $3 per person in smaller ones. Most countries do not fluoridate water, opting instead for fluoridated table salt.
Health and Regulation Concerns
The U.S. Public Health Service recommends fluoride levels in drinking water be below 0.7 mg/L, while the Environmental Protection Agency (EPA) sets a legal limit of 4.0 mg/L. Exceeding these levels has been linked to health risks such as bone fractures, thyroid disorders, and neurological concerns. A recent court ruling has instructed the EPA to strengthen fluoride regulations.
Kennedy’s Position on Fluoride
Robert F. Kennedy Jr. has raised concerns over fluoridation, linking it to various health issues, including cancer, despite a lack of conclusive evidence.
Public Health Experts Weigh In
The CDC has called water fluoridation one of the top public health achievements of the 20th century, preventing tooth decay regardless of socioeconomic status. The American Dental Association supports fluoridation, citing studies that show a 25% reduction in cavities among children and adults.
Recent Studies and Controversies
A 2024 Cochrane review questioned fluoridation’s necessity in developed countries, where fluoride is already widely available in toothpaste. A 2025 NIH study linked higher fluoride exposure to lower IQ scores in children, raising concerns for vulnerable populations. However, critics argue the study had methodological flaws and should not dictate public policy.
Future of Fluoridation in the U.S.
With Utah leading the charge, other states may reconsider their fluoridation policies. As debates continue, policymakers must weigh potential health risks against the long-established dental benefits of fluoride in public water systems.
