The effects of water fluoridation have been heavily debated this year after new research questioned its impact on people's health.
The U.S. Public Health Service has recommended adding fluoride to local drinking water since 1962. USPHS currently recommends 0.7 mg fluoride per liter of drinking water. It is estimated that about 75% of U.S. households are served by fluoridated community water systems.
Several other organizations also support water fluoridation, including the American Dental Association, the World Health Organization and the American Academy of Pediatrics.
Community water fluoridation began being contested this year after the National Toxicology Program concluded in a report that higher levels of fluoride exposure are associated with lower IQ in children.
The National Institute of Dental and Craniofacial Research noted that the NTP's study does not claim water fluoridation at 0.7 mg/L has any effect on IQ. The NIDCR added that future research will help clarify the effects of fluoride at various levels.
Since the NTP report's release, the effects of fluoride have been questioned at the state and federal level.
Here is a timeline of activity related to water fluoridation in 2024:
August
1. The NTP's report is released, concluding there is "moderate confidence" in the scientific evidence showing an association between higher levels of fluoride and lower IQ in children. The report was mostly based on epidemiology studies in non-U.S. countries where some pregnant women, infants and children received total fluoride exposure amounts higher than 1.5 mg fluoride per liter of drinking water, which is the current safe limit recommended by WHO.
The ADA called for revisions to the NTP's third draft of this report in 2023. The ADA's recommendations aimed to enhance the report’s scientific integrity, clarity, transparency and timeliness. The dental agency also noted that its revisions support the scientific literacy of the public and elected officials who oversee water fluoridation policies.
2. The ADA reiterated its support for water fluoridation after the NTP report was released. The organization reviewed the NTP's monograph and said the findings do not provide any new or conclusive evidence that should necessitate changes in current community water fluoridation practices.
3. The American Academy of Pediatrics also reiterated its support for the use of fluoride after the NTP report was released.
September
1. The American Dental Hygienists Association reaffirmed its support for community water fluoridation. The organization said Sept. 10 that the USPHS' current recommended fluoride levels is safe and effective at reducing the risk of tooth decay.
2. Several nonprofit environmental groups took the U.S. Environmental Protection Agency to court after a petition to ban fluoride was denied in 2017. A federal judge ruled that EPA must address the impact fluoride has in drinking water. The judge did not specify what EPA's response must be, but rather that EPA has to make some kind of response. The judge also said his ruling does not "conclude with certainty" that fluoridated water is harmful, but that EPA must respond due to the potential risks.
October
1. The Connecticut State Dental Association voiced its support for water fluoridation after the federal judge's ruling.
2. The ADA came out once more to back water fluoridation, stating that the NTP's review "does not present any new or significant findings on the subject." Former ADA President Linda Edgar, DDS, pointed to other studies showing that community water fluoridation prevents at least 25% of tooth decay in children and adults even with the widespread availability of various fluoride sources.
The ADA's National Fluoridation Advisory Committee also pointed out several issues with the review, including a lack of high quality studies, criteria limitations and the omission of significant findings, such as studies showing the negative impacts on public health after fluoride is removed from water supply.
3. The New York State Dental Association came out in support of water fluoridation, strongly recommending that towns do not change their pro-fluoridation policies over the federal court ruling.
November
1. Robert Kennedy Jr., President-elect Donald Trump's pick for secretary of Health and Human Services, said Mr. Trump would aim to remove fluoride from public water sources once he is in office.
Mr. Kennedy claimed in a post on X that fluoride is associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders and thyroid disease, but did not cite any evidence or studies.
2. The Minnesota Dental Association cited decades of scientific research and endorsements from other healthcare organizations to back up its support for water fluoridation, calling it "a critical measure in combating dental disease."
3. Financial experts predicted that ending water fluoridation could boost sales for suppliers of dental hygiene products and increase dental visits as consumers seek to improve their oral health.
CNBC reported that Dentsply Sirona, Envista and Henry Schein experienced share growth on Nov. 18, adding that Henry Schein was poised for its best trading day since July.
4. Lawmakers in Arkansas filed legislation to repeal a state law requiring fluoride in drinking water. The repeal would allow local voters to decide whether their community should have fluoride in its water.
Senate Bill 2 would remove a section of state statute that currently states: "The company, corporation, municipality, county, government agency, or other entity that owns or controls a water system shall control the quantity of fluoride in the water so as to maintain a fluoride content established by the Department of Health."
Senate Bill 4 would allow a city governing body or county quorum court to call an election. If an election did occur, a subsequent election would not be allowed for at least four more years.
5. Florida Surgeon General Joseph Ladapo, MD, PhD, recommended against community water fluoridation due to the potential neuropsychiatric risk associated with fluoride exposure. He cited several recent studies that found negative health impacts linked to high fluoride exposure, particularly on vulnerable populations such as children and pregnant people.
The surgeon general said he recommended against community water fluoridation due to the potential health risks and the wide availability of existing alternative sources of fluoride, including toothpaste, mouthwashes and fluoride applications.
6. The American Dental Association expressed its opposition to Dr. Ladapo's comments.
"The ADA believes in the use of proven, evidence-based science when making public policy decisions," ADA President Brett Kessler, DDS, said Nov. 23. "For Dr. Ladapo to call community water fluoridation 'medical malpractice' and call on all municipalities to end its practice is a dangerous statement that stands to harm the oral and overall health of all Floridians."