San Antonio's history with water fluoridation amid brewing battle
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Incoming Health and Human Services chief Robert F. Kennedy Jr. vows to remove fluoridation from city water systems.
Why it matters: Like most major American cities, San Antonio fluoridates its water to reduce tooth decay — but it wasn't always that way, and it was a long road to get there.
By the numbers: In 2023, the San Antonio Water System (SAWS) spent roughly $165,240 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.
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: San Antonio voters approved an ordinance in 2000 that directed all city suppliers to fluoridate water, and SAWS started adding fluoride by 2002.
- Before then, San Antonio was the largest U.S. city to not fluoridate its water, per the Express-News.
Flashback: Fluoridation proved controversial before voters approved it in 2000 — they had turned it down in the mid-1980s, long after other cities had added fluoride (Austin did so in 1973, and others in the '50s and '60s).
What they're saying: "Fluoride already occurs naturally in San Antonio's water," SAWS spokesperson Anne Hayden tells Axios. "SAWS adds enough fluoride to increase levels to those recommended by the ADA (American Dental Association) to prevent tooth decay."
- SAWS does not add additional fluoride to water from the Trinity Aquifer, which is naturally fluoridated close to the recommended levels, per Hayden.
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.
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.
- Hayden says SAWS follows local ordinance.
The bottom line: How the battle over fluoride plays out could be a litmus test of how much influence a Trump White House can exert on local city halls.