The fluoride debate: will Trump change water fluoridation policies?

Opposition to adding fluoride to drinking water is growing in the United States, fueled by new evidence linking exposure to possible negative effects on children's brain development. Now, the future of this practice may be in question

Water fluoridation, the addition of fluoride ions to public drinking water as a measure to prevent dental disease, has been contentious for decades. While many countries, including the United States, have had ongoing fluoridation programs in place, the controversy is again rising, with the Trump administration fanning the fire through a very lively debate about the risks and benefits of fluoride in public water supplies.

Found naturally in water, soil, plants, rocks, and even the atmosphere, fluoride was first identified as a cavity-preventing agent in the late 1930s. In 1945, Grand Rapids, Michigan, became the first city to fluoridate its water supply. Fluoride levels have since been adjusted to what is best for cavity prevention.

Today, though, the debate about water fluoridation is expanding, and with Robert F. Kennedy Jr. as Secretary of Health and Human Services, federal policy could change.

Why fluoride is added to water

Water fluoridation involves the addition of fluoride ions to public water supplies to maintain a concentration that prevents the occurrence of dental diseases, particularly cavities.

From Chile to Brazil, and from South Africa, fluoridation is routine in the majority of countries, with proven benefits in the reduction of tooth decay.

Fluoridation is less common in Europe. England and Ireland have compulsory programs of fluoridation. Germany, Sweden, and the Netherlands, however, have abandoned the practice, opting instead for alternatives like fluoridated salt or milk, and oral hygiene education schemes.

The United States controversy and changing regulations

Anti-fluoridation is growing in the United States, driven by the contention that exposure to fluorine may damage children’s brain development. And it gets worse:

“Fluoride is an industrial waste byproduct linked to arthritis, bone fracture, bone cancer, loss of IQ, neurodevelopmental disorders, and thyroid diseases.”

The National Toxicology Program previously concluded with “moderate confidence” that higher levels of exposure to fluoride could be linked with lower IQ in children. It was concluded based on studies measuring fluoride levels around two times higher than the recommended limit for drinking water. Earlier research has also reached the same conclusions, like a 2019 study in which it was found that higher exposure to fluoride during pregnancy resulted in the lowering of IQ in children.

Major public health organizations continue to endorse water fluoridation, such as the American Academy of Pediatrics, the American Dental Association, and the Centers for Disease Control and Prevention (CDC). The CDC also included water fluoridation on a list of ten greatest 20th-century public health accomplishments, citing a dramatic decline in tooth decay since the implementation of water fluoridation.

As a result, water fluoridation remains one of the most contentious global public health measures, with differing opinions about its oral benefits and potential overall health risks. With Trump as president now, the anti-fluoride movement might achieve a breakthrough.