Deciphering the debate: Why local governments are banning water fluoridation

By Stephanie Srakocic | Fact-checked by Davi Sherman
Published April 16, 2024

Key Takeaways

  • Several communities throughout the country have removed fluoride from their water supply in the past few years.

  • Local governments in other cities are debating whether to take similar actions.

  • Fluoridation opponents have raised concerns about safety.

  • The American Dental Association (ADA) Centers for Disease Control and Prevention (CDC), and other major nationwide health organizations still consider water fluoridation safe and effective

Fluoridating water in the US has been considered a public health triumph. Grand Rapids, MI, became the first US city to fluoridate its water supply in 1945.[]

Five years later, studies found that children in Grand Rapids experienced less tooth decay than children from surrounding communities. Fluoridation began to spread throughout Michigan and then the rest of the country. Even today, when fluoridated dental products such as toothpaste and mouthwash are widely available, fluoridated drinking water has been shown to reduce tooth decay by around 25% in children and adults.[]

However, fluoride in drinking water is controversial. Communities across the country have removed the mineral from their drinking water. Additional communities are debating whether to follow in their footsteps.[]

Safety concerns

The pushback against fluoride is tied to beliefs that fluoride is harmful to humans. Fluoride opponents claim that it can cause a range of health issues, including acne, heart conditions, thyroid disease, bone cancer, and more. Additional claims have linked fluoride to developmental delays or lower IQ scores in children.[] 

The American Dental Association (ADA), Centers for Disease Control and Prevention (CDC), and other national health organizations have disputed these claims. Decades of research have shown that fluoride is safe, and claims linking it to major health complications aren’t backed by reliable data or studies. For instance, although a 2019 Canadian study linked fluoride exposure during pregnancy with lower IQ scores, the data relies on self-reporting and has been widely criticized.[][][]

Jennifer Meyer, PhD, MPH, CPH, RN,  is an assistant professor of Public Health at the University of Alaska Anchorage and the author of research that has examined the 10-year effect of fluoride removal in the water of certain Alaskan cities. In a 2022 Anchorage Daily News op-ed, Dr. Meyer states that opposition to fluoride is based on safety concerns without evidence.[] 

“Much like the well-financed anti-vaccine apparatus, opponents of fluoridation are very active online, questioning fluoridation’s benefits and attacking its safety. For example, they wrongly claim that fluoridation at modern levels lowers IQ scores, but this has not been proven,” Dr. Meyer wrote.

Evidence does show that consuming very large amounts of fluoride can cause side effects, including nausea, vomiting, diarrhea, bone pain, teeth discoloration, muscle loss, and nerve pain. It can even be fatal in extremely rare cases.[] 

The dosage of fluoride in drinking water isn’t associated with these risks. About 73% of people in the US have access to drinking water with this concentration of fluoride. 

A nationwide conversation 

In many states, communities are required to fluoridate their drinking water, but this policy is not universal. Some metropolitan areas, including Portland, OR, and Wichita, KS, have repeatedly rejected proposals to fluoridate their water. Residents of these cities have never had water fluoridation. In other communities across the country, residents have voted to remove fluoride from their drinking water.[] 

In the past two years, local governments in State College, PA, Brushy Creek, TX, Union County, NC, and Collier County, FL, all banned or stopped adding fluoride to their drinking water. In California, a federal lawsuit is calling on the Environmental Protection Agency (EPA) to regulate fluoride as a toxin. The California suit was brought forth by Food and Water Watch and anti-fluoridation advocacy groups.[] 

The debate isn’t one-sided. Other lawmakers and community members are pushing back against anti-fluoride arguments. Residents of Buffalo, NY, for example, sued the city after it stopped fluoridating water without informing its residents.[] 

Data and debate in Alaska 

In Juneau, AK, lawmakers voted to remove fluoride from water in 2007. Since then, Dr. Meyer has been working to raise awareness of the link between fluoride removal and increases in dental issues and costs, as well as to educate lawmakers in other Alaskan cities, including  Anchorage, where the removal of fluoride has been debated. 

“As decades of earlier research suggested, Juneau children suffered from more cavities without fluoridated water, and taxpayers paid more for procedures that could have been prevented,” Dr. Meyer states in her op-ed. “In public health, our job is to protect and promote the health of everyone, not just certain groups. Across Alaska, policymakers should not be distracted by false claims about the benefits and safety of fluoridation.”[]

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