Florida is poised to become the second state to ban fluoride in public drinking water despite concerns of dentists and public health advocates who say the mineral is a safe, effective way to protect people of all ages from developing cavities.
Florida lawmakers approved the bill Tuesday after Utah became the first state to pass a ban last month. The Republican-led states are following a push led by US health secretary, Robert F Kennedy Jr, who has railed against the mineral and set the gears of government in motion to stop community water fluoridation.
The Florida measure now goes to the desk of Republican governor, Ron DeSantis, whose administration has advocated against community water fluoridation, arguing high levels could pose a risk to children’s intellectual development.
Fluoride strengthens teeth by replacing minerals lost during normal wear and tear, according to the US Centers for Disease Control and Prevention (CDC). The addition of low levels of fluoride to drinking water is considered among the greatest public health achievements of the last century.
“As dentists, we see the direct consequences fluoride removal has on our patients and it’s a real tragedy when policymakers’ decisions hurt vulnerable kids and adults in the long term,” Brett Kessler, president of the American Dental Association, said in a statement earlier this month.
“Blindly calling for a ban on fluoridated water hurts people, costs money, and will ultimately harm our economy.”
While Florida’s bill does not specifically reference fluoride, it will prevent local governments from using water additives for any purpose other than to meet drinking water standards. Supporters have cast the wide-ranging bill, which also restricts plant-based food labeling, as a consumer protection measure.
“Anything that relates to water quality, removing contaminants, things like that, we’re not touching that,” state representative Kaylee Tuck said. “It’s anything that has to do with health. So fluoride, vitamins, whatever else it is.”
Some local officials in Florida have already voted to remove the mineral from their community water systems, ahead of state lawmakers’ push to ban fluoride. Others have argued to keep fluoride and that local communities should have the ultimate say in whether to keep the mineral.
Kennedy has worked to undermine fluoride addition at the federal level. On 1 April, alongside cuts of roughly 10,000 workers across the federal health department, Kennedy eliminated the office of oral health at the CDC. The office had touted fluoride’s benefits.
The secretary has also cast the National Institutes of Health into turmoil. The federal government’s basic research arm was funding work to advance the understanding of fluoride’s non-dental health effects. However, $2bn in grants that do not align with the president’s agenda have been canceled, nearly one-third fewer new grants have been issued in the first months of the Trump administration (another roughly $2bn), and a leaked budget proposes cutting the agency by 40% – casting into doubt the future of research that could lay to rest the fluoride controversy.
Although the inclusion of fluoride in water is considered a milestone public health achievement, the mineral has long been controversial since the mid-20th century, when the conservative John Birch Society argued it was an effort to socialize medicine.
Fluoride made headlines again this fall when the US National Toxicology Program set off a firestorm when it published a systematic review that found with “moderate confidence” that children exposed to fluoride levels twice those recommended for drinking water (1.5mg per liter versus the recommended 0.7mg per liter) “are consistently associated with lower IQ in children”.
Physicians have tried to explain the virtues of fluoride by pointing to a medical adage: “the dose makes the poison”. The phrase is meant to convey that even beneficial drugs have the capacity to cause harm. The US National Toxicology report was closely followed by a Cochrane Review, which found the benefits of community water fluoridation have likely diminished since 1975, when fluoride toothpaste became widely available.
The CDC reiterated its support for fluoridated community water as recently as May 2024, saying it found no, “convincing scientific evidence linking community water fluoridation with any potential adverse health effect or systemic disorder such as an increased risk for cancer, Down syndrome, heart disease, osteoporosis and bone fracture, immune disorders, low intelligence, renal disorders, Alzheimer disease, or allergic reactions”.
The Miami-Dade county mayor, Daniella Levine Cava, said Tuesday she is “deeply disappointed” by the passage of the bill, adding that it disregards “the overwhelming consensus of dentists, doctors and medical experts and will end a practice that has been in place for decades to protect our health”.
Levine Cava said that ending fluoridation, which is a safe and cost-effective way to prevent tooth decay, will have “long-lasting health consequences, especially for our most vulnerable families.” The mayor said the decision should be left to local communities.
About one-third of community water systems, serving more than 60% of the US population, fluoridated their water, according to a 2022 analysis by the CDC.
The Associated Press and Report for America contributed to this report.
