Fluoride in Water Was Hailed a ‘Great Public Health Achievement’ by the CDC — Here’s Why

The nomination of Robert F. Kennedy Jr. as head of the U.S. Department of Health and Human Services has raised a lot of questions about the politician’s controversial views on healthcare. That includes one aspect he’s been very vocal about lately: fluoride in public drinking water. 

Kennedy wrote on X in early November that the Trump administration will recommend that U.S. water systems remove fluoride from public water once the president-elect takes office. “Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease,” Kennedy wrote in his post.

Florida’s surgeon general Joseph Ladapo also recommended in late November that local governments stop adding fluoride to their community water supplies, calling it a “public health malpractice.” The Florida Department of Health followed that up with new guidance that recommended against adding fluoride to public water supplies. 

But the American Dental Association (ADA) and Centers for Disease Control and Prevention (CDC) continue to back adding fluoride to tap water, raising a lot of questions about why this is done in the first place. Here’s what you need to know. 

What is fluoride?

Fluoride is a mineral and an element that’s naturally found in rivers, lakes, and oceans, along with some foods and drinks, according to the ADA. Fluoride helps to strengthen teeth, with the ADA referring to it as “nature’s cavity fighter.”

Fluoride is often added to toothpaste and other dental products to help lower the risk of developing cavities. 

How did fluoride end up in tap water?

Municipalities in the United States began adding fluoride to drinking water in 1945 in an attempt to support good tooth health in children, according to the CDC. Since then, research has found that adding fluoride to water lowers the amount of tooth decay in young kids by 35%. Because of this, the CDC calls fluoridation “one of 10 great public health achievements of the 20th century.”

It’s important to point this out: The decision to add fluoride to public drinking water is made on a regional — not federal — level, with municipalities determining whether or not to do this. 

What does fluoride in your water do — and is it safe?

Water fluoridation, which is the act of adding fluoride to drinking water to reach a recommended level, is designed to help prevent cavities, the ADA explains. The ADA refers to this as a “cost-effective public health method” to prevent cavities. 

The ADA, the American Medical Association (AMA), the World Health Organization (WHO), and many other public health organizations support fluoridation of community water supplies. “Public water fluoridation is seen as one of the leading public health measures, saving millions of dollars in dental care and decay and pain in people of all ages,” says Mark S. Wolff, D.D.S., Ph.D., dean of the School of Dental Medicine at the University of Pennsylvania. 

There is a lot of data to support the safety of adding fluoride to water — and the National Institutes of Health (NIH) has a robust breakdown of it online. Gerald Kauffman Jr., director and associate professor at the University of Delaware Water Resources Center, stresses that the practice of adding fluoride to water is “really safe,” adding, “I’m 100% for fluoridation.”

Why do some people criticize fluoride in water?

The topic of adding fluoride to water has been criticized in the past, with some people calling the element poisonous. It is possible to overdose on fluoride, but this is incredibly rare. In fact, the ADA points out that people would need to drink five liters of water for every kilogram of body weight at once to overdose on fluoride. That amount of water is toxic, the ADA notes. 

But the conversation around fluoride in water heated up again this summer when a government report determined that fluoride in drinking water at twice the recommended limit is linked with lower IQ in children. Again, that’s twice the recommended limit. The report found with “moderate confidence” that there is a link between high levels of fluoride and lower IQs in children. 

Research has determined that fluoride is a neurotoxin at high levels. That encouraged federal health officials in 2015 to make recommendations to lower the amount of fluoride in drinking water supplies from 1.2 milligrams per liter. 

Currently, federal health officials recommend a fluoridation level of 0.7 milligrams per liter of water. It’s not clear what level of fluoride may impact IQ in children, but the Environmental Protection Agency (EPA) says online that it’s “highly unlikely” that children who drink tap water are getting too much fluoride. 

Kauffman stresses that too much of anything can be harmful — and that water systems are required to inform you if the levels of fluoride in your water are too high. “Water fluoridation has to be below the established limits,” he says. “But it’s done a lot for the health of the U.S. public.”

How to find a community’s fluoride information

To learn more about the fluoride in your community’s water, it’s best to consult your water supplier for details. However, the CDC has a map online that shows states that add fluoride to their water supplies, as well as those that don’t. 

And, if you’re particularly concerned about fluoride in your water, Kauffman points out that you can always use a special water filter to remove it.