Utah and Florida have banned fluoride in public water amid claims of risks to children's brain development
A national rollback could result in 7.5% more children with cavities and $9.8 billion in dental costs
Experts fear science is being overshadowed by politics in the fluoride debate
As some U.S. states move to eliminate fluoride from public water systems, a new study estimates that a nationwide rollback could lead to millions more cavities and nearly $10 billion in additional dental costs over five years.
The shift comes as Robert F. Kennedy Jr., now serving as health secretary, fulfills a promise to discourage water fluoridation. He has claimed that fluoride harms children's brain development—an assertion at odds with decades of scientific consensus. Utah and Florida have already enacted bans, with other states potentially following suit.
Researchers behind the new study, published in JAMA Health Forum, used national data to model the likely effects if water fluoridation were halted across the country. They found that 7.5% more U.S. children under 20 would develop cavities, affecting more than 25 million additional teeth. The projected financial burden: $9.8 billion in treatment and related costs.
“This paper really brings home what the consequences would be,” said Mark Moss, a dental epidemiologist at East Carolina University, who was not involved in the research, in a STAT report. “We know a lot about the benefits of fluoride.”
Fluoridation has been a hallmark of public health since the 1940s, credited with slashing cavity rates and helping generations of Americans retain their teeth into old age. Yet the practice has long attracted conspiracy theories, from Cold War fears of communist mind control to modern-day concerns about neurological harm—fueled recently by Kennedy and his allies.
The study, published this week, did not account for unproven IQ-related concerns but focused instead on well-documented dental outcomes. Outside experts cautioned that the estimated costs might actually be conservative, since they do not include hospital visits, lost work for parents, or workforce demands on an already overburdened dental system.
“We don’t have the capacity to manage that kind of surge,” Moss warned.
Lisa Simon, a study author and physician at Brigham and Women’s Hospital, emphasized that fluoride especially helps those without regular access to dental care. “We know it works,” she said. “It’s a public health tool that reaches everyone, regardless of insurance or income.”
Agencies reversing course
Despite the data, some federal agencies have begun reversing course. The FDA recently pulled fluoride tablets from the market, and the Texas attorney general is investigating toothpaste manufacturers.
A spokesperson for HHS pointed to recent studies questioning fluoride’s safety and said a new review is underway.