What to know about fluoride in water amid RFK Jr.'s bid to remove it
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Robert F. Kennedy Jr. has called for an end to the public health practice of putting fluoride in water.
Why it matters: If he's confirmed as secretary of the Department of Health and Human Services in the new Trump administration, public health experts worry the conspiracy-tinged ideas about fluoride in water could have widespread impacts.
State of play: RFK Jr. said earlier this month that "the Trump White House will advise all U.S. water systems to remove fluoride from public water" on Inauguration Day.
- He called fluoride "an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease."
- But health experts have called fluoridation one of public health's greatest achievements and have said claims it's unsafe are unsupported by science.
What they're saying: "The facts are that it's an enormous public health innovation and achievement over the past century in reducing dental disease, especially in children and especially in populations that don't have access to regular dental care," said Diana Winters, deputy director at the Resnick Center for Food Law & Policy at UCLA School of Law.
What is fluoride?
Fluoride is a mineral that occurs naturally in water. It is also often added in the water supply to reach optimal amounts to help prevent tooth decay.
- The recommended fluoride concentration in drinking water is 0.7mg of fluoride per liter of water, according to the Centers for Disease Control and Prevention (CDC). That's about three drops of water in a 55-gallon barrel.
- Fluoridated water helps strengthen a tooth's surface, making it more resistant to decay.
- Fluoridation systems saved an estimated almost $6.8 billion in dental expenses in one year, or $32 per person for 211 million people.
Is water fluoridation safe?
Water fluoridation in U.S. started in 1945 and 72% of the U.S. population served by community water systems receives fluoridated drinking water.
- "Seventy years of research, thousands of studies and the experience of more than 210 million Americans tell us that water fluoridation is effective in preventing cavities and is safe for children and adults," according to the American Dental Association.
Concerns over water fluoridation include fluorosis, when growing teeth are exposed to too much fluoride and develop white flecks or spots, and reduced IQ in children.
- There is some evidence that high fluoride exposure is connected with lower IQs in kids, though in higher concentrations than routinely found in drinking water, per a report from the National Toxicology Program.
- But studies have continuously shown that widespread community water fluoridation is not associated with lower IQ scores in children, and rather prevents cavities and saves money for both families and the health care system, per the CDC.
- Leading health organizations continue to support community water fluoridation at the current low levels in drinking water.
In September, a federal court in California ruled against the Environmental Protection Agency (EPA) and ordered action be taken over concerns of potential health risks from currently recommended levels of fluoride in drinking water.
- The American Dental Association responded to the ruling, saying it "provides no scientific basis for the ADA to change its endorsement of community water fluoridation as safe and beneficial to oral health."
Who regulates fluoride in drinking water?
State and local governments decide whether to add fluoride to municipal water systems.
- While there's no federal mandate to put fluoride in water, there are recommendations from the Public Health Service, which encompasses the CDC.
- Most state and local municipalities follow the federal government's recommendation, Winters said.
- Some states have laws that require water systems to provide fluoridated water. In other areas, the level of naturally occurring fluoride in water is already at a level proven to prevent cavities, per the CDC.
History of fluoride being controversial
The movement opposing fluoride gained prominence in the 1950s and 1960s, due in part to the John Birch Society.
- The group, which promoted conspiracy theories, argued putting fluoride in the water of American cities was a dangerous communist plot.
- The Ku Klux Klan also took up the anti-fluoridated water campaign.
Can the federal government remove fluoride from drinking water?
Short answer, no. They can only provide a recommendation.
- "The federal government's not saying, 'put it in,' and so they can't say, 'take it out,'" Winters said.
- A route to prohibiting fluoride could be through the EPA, she added. The agency could determine it to be a toxic substance, which, under the Toxic Substances Control Act, would mean it could no longer be added to drinking water.
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