Amid a national debate over drinking water fluoridation, Health and Human Services Secretary Robert F. Kennedy Jr. is taking steps to change public oral health policy in the United States.
Utah and Florida have already passed laws to ban the addition of fluoride to tap water by 2025, and several other Republican-led states are considering similar measures.
Kennedy has long believed that fluoride intake is harmful to human health, especially children. “The main benefit of fluoride is local to the teeth, not through ingestion,” he said. He supports people getting fluoride through toothpaste and mouthwash rather than drinking water.
This position is supported by some research. For example, a report from the National Institute of Environmental Health Sciences found that high doses of fluoride may affect children’s brain development, even though the fluoride levels in the study were higher than the average intake of Americans.
But the dental community has expressed serious concerns about this policy shift. Brett Kessler, president of the American Dental Association, warned: “Without fluoridated drinking water, people’s teeth will become more fragile. Not everyone has easy access to fluoridated toothpaste or mouthwash.”
Public health data show that drinking fluoridated water can significantly reduce the incidence of tooth decay. The Centers for Disease Control and Prevention (CDC) listed drinking water fluoridation as one of the top ten public health achievements of the 20th century, saying it can reduce the rate of tooth decay in children by 70% and the rate of tooth loss in adults by 60%.
However, in recent years, some opponents have argued that drinking water should remain pure and the addition of fluoride is an unnecessary intervention. Those who support defluoridation often cite studies from China that point out that high-fluoride groundwater is associated with decreased intelligence.
But dental experts emphasize that these studies have methodological limitations and cannot be equated with the low concentrations of fluoride in the US drinking water system.
Kennedy’s influence is not only reflected at the policy level. He is pushing the FDA to ban the sale of fluoridated children’s tablets and drops, and has planned a public hearing on July 23. At the same time, he instructed the CDC to re-evaluate the benefits of community fluoridation services.
But the opposition is not all from the Democratic camp. Mike Simpson, a Republican congressman from Idaho and a former dentist, pointed out in a congressional inquiry that the removal of fluoride will increase cases of tooth decay, “We will have to train more dentists to deal with the crisis.”
Despite this, Kennedy still sticks to his position: “We now know that almost all the benefits of fluoride come from local effects and do not need to be obtained through drinking water.”
As this controversy continues to heat up, the US oral health system is at a crossroads, determining the direction of the next few decades.