The brewing battle over water fluoridation
Add Axios as your preferred source to
see more of our stories on Google.
Illustration: Sarah Grillo/Axios
As incoming Health and Human Services chief Robert F. Kennedy Jr. vows to remove fluoridation from city water systems, Austin officials say they're committed to the practice.
Why it matters: Like most major American cities, Austin fluoridates its water to reduce tooth decay.
By the numbers: In the 2024 fiscal year, Austin's three water treatment plants spent roughly $262,000 on fluoride, per information obtained by Axios through a public information request.
What they're saying: In early November, Kennedy posted on X: "On January 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water."
- He called the chemical "an industrial waste," linking it to cancer and neurodevelopmental disorders.
The other side: "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," Diana Winters, deputy director at the Resnick Center for Food Law and Policy at UCLA School of Law, told Axios last month.
Context: In 1945, U.S. cities began adding fluoride to drinking water to fight tooth decay.
- Follow-up studies in these communities over 13-15 years showed a 50-70% reduction in cavities, per the U.S. Centers for Disease Control.
Catch up quick: Following the passage of a 1972 referendum in favor of fluoridation, Austin Water began adding fluoride to the water in February 1973.
- In 2011, Austin City Council voted to continue fluoridating, in keeping with recommendations from federal and city public health officials.
Flashback: When in 2015 then-Council Member Don Zimmerman tried to stop the practice, he got little support from other city officials.
- "Many local residents lack dental insurance or face other barriers to securing dental care, and tap water is what gives these individuals immediate access to fluoride that helps them reduce the risk of tooth decay," then-city of Austin medical director and health authority Philip Huang said at the time.
Between the lines: A federal judge in September ordered the U.S. Environmental Protection Agency (EPA) to take additional measures to regulate fluoride in drinking water because of a possible risk that higher levels of the mineral could affect children's intellectual development.
- "We are closely following the EPA's review of fluoridation safety," Amy Petri, a spokesperson for Austin Water, told Axios via email. "We will evaluate and adjust our treatment protocols based on their regulatory requirements."
Reality check: Despite Kennedy's aims, federal authorities have little say on whether local water systems add fluoride.
- "The HHS makes recommendations about fluoride, but that's all," Mark Duvall, principal at the environmental law firm Beveridge and Diamond PC, told E&E News.
- Petri did not respond to questions about what Kennedy's pledge would mean for the health of Austin and whether Austin Water would consider ending its fluoridation process.
The bottom line: How the battle over fluoride plays out could be a litmus test over how much influence a Trump White House can exert on local city halls.