Utah’s governor recently signed a bill into law banning the addition of fluoride into Utah’s public water systems.
Local city councils in Missouri such as those in Rolla and Hannibal have also proposed banning fluoride in their water supplies due to health speculation raised by the U.S. Secretary of Health and Human Services, Robert F. Kennedy Jr. A few cities in Missouri have already stopped adding fluoride in their water, such as Branson in 2023 and Houston in 2018.
Pediatric dentist and president of the American Fluoridation Society Johnny Johnson has argued for the use of fluoridation for more than 11 years.
“Fluoridated water helps reduce at least 25% to 50% of cavities for kids and adults if they don’t change a single thing in their day,” Johnson said. “If they don’t change brushing habits, eating habits or anything else, they get the right amount of fluoride for everybody in the community, and it is cheap.”
The consumption of fluoride helps protect teeth from tooth decay, which, according to the National Institute of Dental and Craniofacial Research, “remains the most prevalent chronic disease in both children and adults, even though it is largely preventable.”
Dr. William Moorkamp is a dentist for Moorkamp and Arthur Family Dentistry in Rolla, and he said fluoridation is especially important for children under the age of six. The fluoride can strengthen their tooth enamel once their permanent teeth begin to grow in.
People advocating against fluoridation have cited a research article by Kyla W. Taylor, an epidemiologist in the Integrative Health Assessment Branch at the Division of Translational Toxicology (DTT) at the National Institution of Environmental Health Sciences (NIEHS). There are about 74 other studies, most of which are from China, that say high exposure to fluoride affects children’s IQ.
Taylor’s article says higher exposure to fluoride was associated with lower IQ scores for children. But when fluoride concentration is less than 1.5 milligrams per liter, there was limited data and uncertainty in the association.
Last year, no Missouri community’s water system averaged more than 1 milligram per liter of fluoride concentration levels.
There is a concern about overconsumption of fluoride in areas like China, India and Iran because of a naturally high concentration of fluoride in their water systems. High consumption of fluoride can cause severe dental fluorosis and skeletal fluorosis.
Severe dental fluorosis causes white and brown spots to form on the teeth and holes to form on the outer layer. Skeletal fluorosis can cause bone fractures, spinal deformities, mild cognitive impairment, and other symptoms. Neither of these diseases are common in the United States, where less than 1% of people aged 6 to 49 have severe dental fluorosis according to the U.S. Centers for Disease Control and Prevention (CDC).
The U.S. Environmental Protection Agency (EPA) sets the maximum limit of fluoride concentration in water at 4.0 milligrams per liter. Developing fluorosis is possible when fluoride concentration is above that limit.
“That doesn’t happen from water fluoridation, and skeletal fluorosis in this country (United States) is extremely low,” Johnson said.
Fluoride is a naturally occurring compound found in rocks, soil, plants, food and water in different amounts of concentration.
The recommended level of fluoride in drinking water by the CDC is 0.7 milligrams per liter to maximize dental benefits.
The bill Utah’s governor signed allows for pharmacists to prescribe fluoride supplements as a substitute to water fluoridation. But Johnson said he’s concerned that children and adults might not take the supplements properly or that dosages might not be appropriate in relation to how much fluoride is naturally in their water.
“It’s way more expensive,” Johnson said. “Fluoridated water is usually anywhere from $0.35 to $2.00 a person depending on the size of the community per person per year.”
Some have suggested that fluoridated toothpaste be used as another substitute to stop the need for fluoridation, but Johnson said fluoridated water and toothpaste are meant to work together in a complementary fashion.
The state of Missouri cannot prohibit or force the addition of fluoride to be added to local water supplies and has left the decision to local governments.
St. Louis was the first city to fluoridate their water in Missouri back in 1954. A majority of the state followed, as according to the Missouri Department of Health and Senior Services website, “fluoridation is the least expensive and most effective way to reduce tooth decay.”
“The implication, ‘Everybody's doing it, why don’t we?’ is not a good reason to take 70 years of effectiveness out,” Moorkamp said.
More information about the amount of fluoride in your community's water is available at “My Water’s Fluoride” on the CDC website.
