Florida is poised to become the second state to ban the long-standing practice of adding fluoride to public water systems. State senators have already cleared a bill that would prohibit community water fluoridation, and Florida’s House is expected to vote on a similar bill in the coming week.
The word “fluoride” isn’t found anywhere in the Florida Farm Bill, but it would be included because the legislation aims to ban “the use of certain additives in a water system” throughout the state.
If Gov. Ron DeSantis, a Republican, signs the bill, Florida will become the second to ban fluoride from water supplies. Utah’s Gov. Spencer Cox, also a Republican, signed a bill in late March that prohibits any person or government entity from adding the cavity-fighting mineral from the state’s water systems. The Utah rule will go into effect on May 7.
Similar legislation is making its way through other states, including Kentucky, Massachusetts and Nebraska.
In Wisconsin, nearly 80 communities have already voted to stop adding fluoride, according to the state’s Department of Natural Resources, and others in the state are considering a ban. And Union County in North Carolina voted last year to remove fluoride from drinking water.
Like the anti-vaccine movement, the push to pull fluoride from water has been gaining momentum for several decades. It’s grown more powerful with Robert F. Kennedy Jr. as head of the Department of Health and Human Services. Earlier this month, Kennedy said he was planning to tell the Centers for Disease Control and Prevention to stop recommending fluoride be added to water supplies.
The agency doesn’t make official recommendations on fluoride, however. Those come from the U.S. Public Health Service, composed of members from various federal health public health agencies.
He also said at the event, without providing evidence, that “we know that there is no systemic advantage” to preventing tooth decay by drinking fluoridated water. “You can achieve that benefit from brushing teeth.”
Water fluoridation has long been heralded as one of the top public health initiatives of the last century for its ability to drive down tooth decay.
While defending fluoride in a Florida Senate debate on April 16, Sen. Tina Scott Polsky, a Democrat, said, “Find me a dentist who thinks we should get rid of fluoride.” The bill passed the Senate on April 16. The Florida House is controlled by Republicans and is expected to vote against fluoridation.
Lorna Koci, head of the Utah Oral Health Coalition, an advocacy group that promotes oral health initiatives among Medicaid beneficiaries, said the movement against fluoride has nothing to do with health and science. “It really is a political issue,” she said.
Kennedy, who has no training in medicine or dentistry, has previously referred to fluoride as “industrial waste” on the social media platform X and said on MSNBC that the faster the mineral goes away, the better.
A ‘four-letter word’
Historically, dentists and other oral health experts would have been vocal defenders of fluoride. Now, many feel that they’re in a losing battle against the anti-fluoride movement and worry about speaking publicly in favor of the mineral.
“It’s like a four-letter word,” a public health dentist in the Southeast said. The mere mention of fluoride, even in the context of public education, is forbidden by superiors, the staffer said.
“We can’t defend the science we believe in,” said another public health dentist in the Upper Midwest. Opposition to both fluoride and vaccines has become more vocal locally because of what’s happening on the national level, he said. “It’s basically giving them a boost.” Public health dentists work with a state or county to increase dental care access in underserved communities and promote oral health overall.
Last month, the Trump administration pulled more than $11 billion earmarked for state public health departments. As part of the mass layoffs at health agencies ordered by Kennedy, HHS gutted the CDC’s oral health division, which provides funds to states and local jurisdictions to promote good dental health practices, including the use of fluoride.
Dentists argue that while fluoridated toothpaste is critical in preventing cavities, underserved communities may not be able to afford it. Many, they say, are unable to go to a dentist for fluoride treatments.
Dr. Johnny Johnson, a pediatric dentist and president of the American Fluoridation Society, a fluoride advocacy group, said legislators opposed to water fluoridation “need to be skewered over total disregard for our residents’ health.”
An HHS spokesman didn’t respond to a question about how the federal government might address those disparities.
Speaking publicly about the benefits of the mineral might result in a target on the backs of health departments already strapped for cash, fluoride advocates say.
A year ago, “fluoride was fine to bring up” in discussions with public health leaders, said Koci.
Now, “I think many people in public health are feeling like they need to just lay low. It’s probably very risky to be taking a position on a topic that is so political and controversial.”
Major public health groups, including the American Dental Association, the American Academy of Pediatrics and the CDC, support the use of fluoridated water. All cite studies that show it reduces tooth decay by 25%.
Before the Florida Senate vote, more than a dozen jurisdictions in the state, including Seminole County, had banned water fluoridation despite decades of the mineral being safely used in the water supply and evidence that it fights cavities.
In November 2024, the state’s surgeon general, Joseph Ladapo, said communities should stop adding fluoride to drinking water because of what he called “neuropsychiatric risk.”
At least one of those bans has been overruled. Miami Mayor Daniella Levine Cava promised to veto her county commissioners’ vote to remove fluoride.
“While it may be relatively simple to stop adding fluoride as directed in the resolution, the long-term effects of doing so are anything but simple, and so we must consider the long-term consequences,” Levine Cava said during a news conference earlier this month. “Ending fluoridation could have real and lasting harm, especially for children and families who cannot afford regular dental care.”
Similar to the anti-vaccine movement, which has focused on widely debunked research associating the mumps, measles and rubella shots with autism, groups opposed to fluoride tend to seize on a study that suggests the mineral is a neurotoxin that lowers children’s level of intelligence.
A study published in 2019 suggested that IQ levels were slightly lower in kids whose mothers had higher measures of fluoride in their urine during pregnancy. The research was far from conclusive.
Other studies looking at how fluoride affects children’s brains have been called “low quality” by health scientists and were conducted in other countries.
Another public health dentist said that faced with extensive funding cuts for any public health measures, fluoride isn’t “the hill they want to die on.”
Dentists predict they’ll see a jump in dental decay, especially among kids, in the coming years.
Dr. Tom Reid, president of the Wisconsin Dental Association, said that within the next three to five years, those towns can expect to see a significant increase in rates of tooth decay.
“It’s disheartening,” Reid said. Dentists aren’t pushing for fluoride for their own benefit, he said. “We’re really trying to act in what is the best for the health of our patients, for the health of our communities.”
It’s what happened in the Canadian city of Calgary, for example, after leaders there voted to remove fluoride from public water in 2011. A decade later, they voted to reinstate community water fluoridation amid a significant rise in cavities among kids.
In Seminole County, Florida, which voted earlier this month to get fluoride out of the water system, utilities director Johnny Edwards said during the meeting that it would save the county at least $100,000.
When asked whether the county would set aside that money to treat a potential increase in cavities, Chris Patton, a spokesman for the county, chuckled. No, he said, it will simply be reabsorbed into the county’s utilities department.
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