The Case of the Cavity: Should We Keep Fluoride in Our Water?

On Thursday, November 14th, 2024, President-elect Donald J. Trump announced that he was nominating Robert F. Kennedy Jr. to oversee the Department of Health and Human Services (HHS). This nomination came as no surprise since Trump has continuously voiced that Kennedy would play a role in his upcoming administration by helping him make “America healthy again.” 

Despite RFK Jr.’s vaccine skepticism and rather unconventional views on medicine, there is still a decent chance that his nomination gets confirmed by the Senate as only a simple majority—51 votes—is needed and the GOP now holds 53 of the 100 seats in the Senate. With RFK’s potential confirmation on the horizon, Americans should begin thinking about what the country’s state of health, specifically for the country’s children, will look like over the next four years.

One change that RFK Jr. plans to implement as HHS Secretary is the removal of fluoride from America’s drinking water. According to RFK Jr., fluoride is “an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease,” but it should be noted that RFK Jr. lacks a medical background and has a history of spreading misinformation based on conspiracy theories. 

According to the Centers for Disease Control and Prevention (CDC), fluoride is a naturally occurring mineral and when it combines with outer tooth enamel it makes teeth stronger and more resistant to decay. In other words, the addition of fluoride in America’s drinking water helps ensure the health of citizens as the mineral helps prevent the formation of cavities. The federal government first began endorsing water fluoridation in 1950 and the passage of the Safe Drinking Water Act in 1974 designated water fluoridation as a state, not federal, responsibility. Water fluoridation is therefore not federally mandated, rather state and local governments decide on whether to implement water fluoridation in their communities. 

The CDC considers water fluoridation a cornerstone strategy for preventing cavities in the U.S. as it is a “practical, cost-effective, and equitable way for communities to improve their residents’ oral health regardless of age, education, or income.” Studies have also shown that fluoridated water reduces cavities by about 25 percent in both children and adults which provides multiple benefits such as “less mouth pain, fewer fillings or teeth pulled, and fewer missed days of work and school.” Additionally, the CDC estimates that communities that have implemented water fluoridation save about $32 per person a year since there is less of a need to pay for cavity treatments.

Although small amounts of fluoride in our water are beneficial, large amounts of the mineral over a long period of time can lead to the development of dental fluorosis in children, which is a condition that affects the appearance of teeth by causing the outer enamel layer to have white flecks, spots, or lines. While concerns over this condition are warranted given the increasing number of sources that contain fluoride including toothpaste, mouthwash, and even some beverages, HHS released a guidance in 2015 that accounted for these increased risks and advised community water systems to adopt a uniform concentration of 0.7 mg/L of fluoride in drinking water which ensures cavity prevention benefits while also minimizing the risk of dental fluorosis. 

In August of this year, HHS released a report that found higher levels of fluoride exposure, such as drinking water containing more than 1.5 mg/L, are associated with lower IQ in children. The agency has stated that the study “does not, and was not intended to, assess the benefits of fluoride” and that there is a need for further research to better understand whether there are health risks associated with low fluoride exposure.

If RFK Jr. does get confirmed, communities across the U.S. will see an end to water fluoridation. Drinking water will still contain a minimal amount of naturally occurring fluoride, but the amount is so small that Americans will cease to see any oral health benefits and instead are going to see an increase in their dental bills.  

Leave a Reply

Your email address will not be published. Required fields are marked *