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Fluoride fight brewing: Experts warn of cavity surge and billion-dollar costs if water fluoridation stops
The benefits of adding fluoride to public drinking water, a longstanding practice credited with dramatically improving dental health, are being questioned, and bans are cropping up. Experts are pushing back, warning of significant health and economic consequences.
A new study published in JAMA Health Forum paints a stark picture: removing fluoride from US water systems could lead to a staggering 25.4 million more decayed teeth in children and adolescents within five years, costing $9.8 billion. These numbers double after ten years, projecting nearly 54 million excess cavities and a $19.4 billion price tag. That’s like giving one cavity to every three children in the US.
Dr. Lisa Simon, a physician at Brigham and Women’s Hospital and study co-author, emphasizes that low-income families and those relying on Medicaid would bear the brunt of these consequences, as they benefit most from fluoridated water.
Fluoride, found naturally in some foods and groundwater, strengthens tooth enamel, protecting against decay. Since its introduction to US water systems in 1945, the CDC has hailed it as a major public health achievement.
Currently, about two-thirds of the US population receives fluoridated water. However, HHS Secretary Robert F.
Kennedy Jr. has stated his intention to advise the CDC against recommending water fluoridation. Furthermore, both Utah and Florida have enacted bans this year.
The new study utilized data from the National Health and Nutrition Examination Survey to project the impact of fluoride removal. Currently, roughly 1 in 5 children aged 2 to 5 have cavities, along with over half of children aged 6 to 12 and teens. Removing fluoride could increase these rates by over 7%.
The American Dental Association has strongly condemned any move to stop water fluoridation. ADA President Dr. Brett Kessler emphasized that optimal oral health depends on proper nutrition, oral hygiene, and optimally fluoridated water – a fact, he says, that can’t be altered by political rhetoric or misinformation.
Kennedy has referred to fluoride as “industrial waste,” linking it to various health issues, including cancer. These claims have been refuted by the American Cancer Society and the CDC. However, the HHS and EPA are reviewing potential health risks associated with fluoride in drinking water, focusing on a recent government study suggesting a link between higher fluoride levels and lower IQ in children.
The new study notes that only about 1.5% of US children were exposed to potentially harmful fluoride levels in 2016, while 40% had optimal levels for cavity prevention. The study did not address neurocognitive effects, citing current federal guidance that finds no association at levels used in public water.
Dr. Simon explains that the projected costs represent not just financial burdens, but also pain, difficulty eating, missed school, and potential long-term dental problems.
She points to Calgary, Canada, where fluoride removal in 2011 led to increased cavities in children. Calgary is reinstating fluoridation this year.
Simon fears the US could face even greater challenges due to existing disparities in access to dental care.
She underscores the importance of recognizing the long-term success of water fluoridation, a practice so effective that its benefits have become easy to overlook.