Federal agencies are taking misguided anti-fluoride steps that will harm the public's health, says American Fluoridation Society

WASHINGTON, Aug. 12, 2025 /PRNewswire/ -- Tooth decay is the most common chronic disease of U.S. children and adults. Health and Human Services Secretary Robert F. Kennedy Jr. said he wants federal health agencies to be "dedicated to disease prevention and fighting chronic disease." Unfortunately, health officials are taking several misguided steps that could block access to fluoride, a mineral proven to prevent tooth decay.

The mouth is the gateway to the human body, so poor oral health can impact overall health. Tooth decay is a transmissible disease that can result in sepsis, brain abscesses, lung infection and collapse, heart infection, and death. Fluoride is a mineral that exists naturally in lakes, rivers and groundwater, and it is proven at the recommended level to make tooth enamel more resistant to decay.

Nearly 12 million U.S. residents have enough natural fluoride in their drinking water to prevent decay. Other communities adjust their fluoride level to the optimal level, which reduces decay by at least 25% for adults and children over their lifetimes.

Considering these facts, it is deeply concerning that the Environmental Protection Agency (EPA) recently announced that it will conduct a scientific review of fluoride "in coordination with Secretary Kennedy and HHS." Given that Kennedy has called for the end of water fluoridation, can the EPA conduct a review jointly with him that will truly be impartial? It's a reasonable question to ask.

The administration's attacks on fluoride and fluoridation are based on a misrepresentation of the evidence. For example, the Make America Healthy Again (MAHA) report raises safety concerns about fluoride by citing what it called "74 high-quality studies" that were reviewed by the National Toxicology Program (NTP). This is false. NTP reported that 70% of the studies "were rated as low quality (high risk of bias)."

NTP's report found no link between lower IQ scores and the low concentrations of fluoride present in America's fluoridated tap water. The only link to IQs that the NTP reported — and with only "moderate confidence" — was to fluoride levels above 1.5 milligrams per liter. That level is more than double the level used for water fluoridation.

Peer review is a vital process, separating robust scientific insights from weaker research. The MAHA report neglected to inform the public that NTP's report twice failed to clear the peer review process. After two rounds of peer review, the National Academies of Sciences wrote that NTP failed to provide "clear and convincing" evidence to back up its conclusions about fluoride. The National Academies also urged NTP to revise its report to clarify that its findings do not question the safety of water fluoridation in the United States.

After receiving this negative review, the NTP abandoned its peer review relationship with the National Academies—one of the most respected scientific bodies in our country. Instead, NTP found a new set of peer reviewers.

Many of NTP's studies used a flawed method to measure fluoride exposure during pregnancy. A recent research analysis concluded that spot urine samples are not a valid way to determine an individual's exposure.

"An expectant mother typically urinates more than 1,400 times during pregnancy," said Dr. Johnny Johnson, President of the American Fluoridation Society. "To take only one to three urine samples out of 1,400 is not a reliable way to measure someone's fluoride exposure. When it comes to research, this approach is an example of garbage in, garbage out."

The Food and Drug Administration (FDA) is another agency that appears to be headed toward a decision that could block access to fluoride. The FDA is proposing to ban fluoride supplements. In communities where the water lacks sufficient fluoride, parents are often prescribed fluoride supplements for their children. These supplements are designed to mimic the amount of fluoride that children would receive if they had access to fluoridated water.

At an FDA hearing in July, opponents of fluoride cited the NTP report while ignoring or downplaying the report's serious flaws. During this hearing, opponents also claimed that topical exposure is the only way in which fluoride benefits teeth. This is false. A 2003 study showed that developing teeth benefit from exposure to fluoride even before they are visible in the mouth. The authors of this study wrote that without the ingestion of fluoride, "there was no significant prevention of [decay]."

At the July hearing, an FDA official stressed that the decision on whether to ban fluoride supplements would be based on "data" and "science". If this is the case, it should carry tremendous weight that fluoride supplements are recommended by the U.S. Preventive Services Task Force. In its 2021 recommendation, the Task Force explained the importance of its recommendation, noting that tooth decay "in early childhood is associated with pain, loss of teeth, impaired growth, decreased weight gain, negative effects on quality of life, poor school performance, and future dental caries."

Instead of relying on the Task Force's recommendations, the FDA official cited partial findings of the 2011 Cochrane review of fluoride supplements — stating that they found no benefit to primary (baby) teeth, while leaving out that they also found a 24% reduction in permanent teeth.

The FDA's proposed ban on fluoride supplements is driven significantly by the FDA Commissioner's worry that because fluoride can inhibit plaque bacteria on teeth, it "may also kill intestinal bacteria important for a child's health." However, experts in this field have dismissed this concern. Microbiologists recently told Science News that they do not have concerns about fluoride's impact on the gut microbiome. Gary Moran, a microbiologist at Trinity College Dublin, said, "There is no convincing evidence to support a stance that fluoride use in childhood has a detrimental effect on microbiome development." Moran gave a presentation at the FDA's July hearing.

Will the FDA base its decision about fluoride supplements on the science? Probably not. In fact, the FDA's announcement of this proposed ban included this made-up-my-mind quotation from Kennedy: "Ending the use of ingestible fluoride is long overdue."

Researchers projected that if all U.S. states stopped water fluoridation, it would lead to 25 million additional decayed teeth over the next five years. One of Canada's largest cities learned a tough lesson after it stopped water fluoridation. Tooth decay in the city of Calgary increased significantly afterward. After fluoridation ended, the rate of children in Calgary whose teeth required urgent dental treatment under general anesthesia rose by 78%. This deterioration in health recently prompted Calgary to resume fluoridation.

Behind every statistic is a story. Behind every number is a name. So much is at stake for people's health if Kennedy's opinions prevail over the evidence.

Learn more about fluoride and fluoridation by visiting AmericanFluoridationSociety.org.

Contact: Dr. Johnny Johnson at 727-409-1770 or [email protected]

SOURCE American Fluoridation Society