Our next potential leader of US health policy, Robert F. Kennedy Jr, wants to ban adding fluoride to public drinking water — a practice that experts agree has remarkably elevated teeth health for millions of Americans at little cost.
In a country where many people don’t have access to dental care, a widespread crackdown on this naturally occurring mineral could be a disaster. To see how, we turn to the sobering case of Juneau, a city in Alaska that voted to stop fluoridating its water in 2007, citing many of the same fears that RFK touts today.
In a 2018 study published in the journal BMC Oral Health, researchers examined the dental records of adolescents in the Alaska community who sought Medicaid dental care in the years surrounding either side of the ban.
They divided them into two treatment groups: a 2003 group, when public drinking water had optimal levels of fluoride, and a 2012 group, well after the fluoride ban.
The results were damning. On average, the 2012 group had a significantly higher number of cavity-related procedures for adolescents than the 2003 group. Similarly, the odds of someone 18 years-old or younger undergoing the same type of procedure was 25 percent higher in 2012.
Children born after the fluoride ban were the hardest hit age group, receiving not only the most tooth decay treatments, but also having the most expensive treatments on average.
Additionally on the economic side of things, the researchers found that dental care costs for adolescents soared by 73 percent as a result of the fluoride policy, even after adjusting for inflation. In sum, it seems clear cut that removing fluoride caused tooth rot to surge — and with it, medical costs.
Today, nearly three-quarters of the US population has access to fluoridated water, reducing tooth decay in children and adults by an estimated 25 percent. The US Centers for Disease Control has hailed fluoridation as one of the top ten greatest public health interventions in history.
So why does RFK, who was nominated by president-elect Donald Trump to be the head of the Department of Health and Human Services, want to ban it? Well, according to him and other critics, fluoride is dangerous “industrial waste” that’s associated with everything from IQ loss to cancer.
While fluoride does have its complications, RFK’s criticisms haven’t been proven or are overblown — and most of fluoridation’s drawbacks come from doses that are extremely high compared to the amount added to public water.
According to Scientific American, at three times the recommended level in water, fluoride can cause a condition called dental fluorosis, which damages — typically cosmetically — the developing teeth of young children. It can also cause more serious and painful skeletal fluorosis, but that’s exceedingly rare.
As far as the effects on a child’s mental acuity goes, the evidence is highly disputed. A 2024 review conducted by the US National Toxicology Program linked high levels of fluoride to lower IQs in children — but the study only focused on the effects of fluoride at twice the recommended level in the US, and couldn’t draw as strong a link at reasonable fluoride concentrations. It also failed to pass scientific review twice, and bypassed independent review on its most recent version, per SciAm.
In short, there’s not nearly enough evidence yet to justify a nationwide ban on fluoridation — and plenty of evidence to show it’d be a bad idea.
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