Public health fighting back against attacks on fluoride

Public health experts are expressing concern as high-ranking federal officials question the value of community water fluoridation — a practice recognized as one of the 20th century’s greatest public health achievements.

Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services told the Associated Press April 7 that he plans to direct the Centers for Disease Control and Prevention to stop recommending community water fluoridation. 

Kennedy’s comments came as Lee Zeldin, administrator of the U.S. Environmental Protection Agency, said his agency will review recent findings on water fluoridation. In its announcement, EPA cited an August report that found fluoride exposure at 1.5 milligrams per liter may lower IQ in children — but failed to note that is more than twice the recommended level.

“These actions come at a time when 70 million people in the U.S. lack dental insurance, 23 million face potential cuts to Medicaid dental coverage, and recent HHS layoffs have scaled back vital oral health programs at the federal level,” said Melissa Burroughs, senior director of public policy for CareQuest Institute for Oral Health, in an April 8 news release. “Our nation is at risk of losing critical layers of protection for basic oral health access.”

Removing fluoride from water supplies will derail 80 years of disease prevention, oral health experts say. Since 1945, community water fluoridation has been a milestone of American public health, preventing tooth decay and avoiding suffering from tooth loss. Children and adults in communities with fluoridated water have 25% less tooth decay, helping them to retain their teeth throughout their lives.

In the U.S., it is usually up to communities to decide whether to fluoridate their water supplies, with about one-third currently opting to do so — to the benefit of 200 million Americans. If the mineral is removed, people in low-income communities will suffer most, experts say.

“Because underrepresented and underserved populations are less likely to have access to affordable quality oral health services, fluoride plays an important role in supporting better oral health in these communities, which in turn leads to better overall health,” Karen West, DMD, MPH, CEO of the American Dental Education Association, said in an April 9 news release.

Kennedy and Zeldin made their statements while in Utah, a state that recently came out against community water fluoridation. Utah’s governor signed a measure into law last month that will ban community water fluoridation in the state beginning in May. Other states have also taken action recently, including Florida, where legislators are also pushing for a statewide ban.

Zeldin credited Kennedy’s advocacy for EPA’s decision to revisit fluoridation. Kennedy, a known science skeptic well before he was appointed to HHS in February, called fluoride a "dangerous neurotoxin” last year. 

If federal plans to reassess community fluoridation progress, officials should use credible, science-based experts in their work, advised Robert Steinbrook, MD, health research group director at Public Citizen.

“If Kennedy is serious about reviewing the federal guidance, he should ask the National Academy of Medicine to convene an independent expert panel without conflicts of interest and abide by its conclusions,” Steinbrook said in a news statement.  

Water fluoridation is the just latest public health measure under attack by the Trump administration, noted APHA Executive Director Georges Benjamin, MD, in an April 9 news statement. In recent weeks, public health has seen a takeback of over $10 billion in funding meant for state and local health departments, cuts to more than 10,000 jobs across HHS and an undermining of vaccine science.

In the wake of the secretary’s new comments on fluoridation, Benjamin called for Kennedy’s removal from office.

“As a physician, I pledged to first do no harm and to speak up when I see harm being done by others,” Benjamin said. “I ask my colleagues to join me and speak up. Sec. Robert Kennedy is a danger to the public’s health and should resign or be fired.”

Photo by Yamasan, courtesy iStockphoto