On Friday, Florida Surgeon General Joseph Ladapo announced that communities in the state should not add fluoride to drinking water because of what he called “neuropsychiatric risk associated with fluoride exposure.”
Fluoride has long been shown to reduce tooth decay by strengthening teeth, which Ladapo acknowledged in the guidance.
However, he added that there are also potential “safety concerns associated with systemic exposure to fluoride,” including reductions in IQ. While some studies have suggested possible links, the research is considered preliminary and far from definitive.
THE American Dental Associationthe American Academy of Pediatrics and the Centers for Disease Control and Prevention support the use of fluoridated water, calling it one of the top 10 public health achievements of the past century. All cite studies showing it reduces tooth decay by 25%.
Once its benefits were proven, fluoride was also added to toothpaste and some mouthwashes. Dentists began giving children fluoride treatments. Some communities are restoring fluoride to their water systems after seeing an increase in children’s cavities.
The anti-fluoride drumbeat has gotten louder in recent years. Communities are increasingly choosing not to add it to water, citing potential health risks.
There is ongoing, active research into safe levels of fluoride exposure.
“The caries rates are absolutely alarming,” said Dr. Bruce Lanphear, professor of health sciences at Simon Fraser University in Canada. “But science is evolving. There is growing evidence to suggest that fluoride may not be as safe as previously thought.”
Lanphear is the author of a 2019 study published in JAMA Pediatrics found that mothers who drank fluoridated water while pregnant were more likely to have children with lower IQ levels.
He and his colleagues concluded that pregnant women may want to avoid fluoride, but stopped short of advocating its removal from water systems.
About 70 percent of Florida’s community water systems receive fluoridated water, according to the surgeon general’s release.
“It is clear that more research is needed to address safety and efficacy concerns about community water fluoridation,” Ladapo said in the release.
Katelyn Jetelina, an epidemiologist who tracks diseases on her website, Your local epidemiologistreacted to Ladapo’s announcement on Friday. “Substituting the social good for individualism is a slippery slope,” he said.
Ladapo has been criticized in the past for going against basic public health measures. Pediatricians were outraged in February, for example, when Ladapo left it up to parents to decide whether to quarantine children amid a massive measles outbreak. He has questioned the effectiveness of Covid vaccines and threatened criminal charges against television stations in Florida that aired an ad supporting the abortion rights ballot measure until a federal judge issues a temporary restraining order against him.
He is rumored to be on a list of people who could play a major role in health in the next administration. Robert Kennedy Jr., President-elect Donald Trump’s choice for Secretary of Health and Human Services, said he would advise against adding fluoride to the US. water systems.
He calls for the reintroduction of fluoride
Despite fluoride skeptics, some communities are actively working to reintroduce the mineral into their water supply.
When residents of Buffalo, New York realized in January 2023 that fluoride had been missing from their water supply since 2015 — was revealed by a local reporter — demand to put the cavity-fighting mineral back into their drinking water was rapid.
Parents said their children’s teeth were full of cavities despite regularly drinking and brushing with what they believed for years to be fluoridated water.
“There are many stories of young children who have ended up in the hospital needing emergency dental work,” said Robert Corp, an attorney who filed a class action lawsuit on behalf of the Buffalo parents. NBC affiliate WGRZ.
City leaders acted. Less than two years later, at the end of Septemberfluorine once again flowed from the Buffalo faucets.
Other cities, such as Abilene, Kansas, and McVille, North Dakota, have done the same, according to the American Dental Association.
“Helping the most vulnerable”
According to the CDC, Children in lower-income families have almost three times higher rates of untreated tooth decay than children in higher-income families.
There are several reasons. Just 1 in 3 dentists in the US they treat Medicaid patients. And nearly half of US children don’t get regular dental care, according to the National Institute of Dental and Craniofacial Researchpart of the National Institutes of Health.
Adding fluoride to water systems “mitigates the impact of disparities in access to dental care,” said Jetelina, the epidemiologist. “That’s one of the beauties of public health — a largely invisible population intervention, helping the most vulnerable.”
However, the audit continues.
In September, a federal judge in California ruled that even though he could not conclude with certainty that fluoridated water poses a risk to public health, the US Environmental Protection Agency should strengthen water fluoridation regulations.
Another report resulting from this decision, looking specifically at children’s IQ levels, is expected early next year.
