Utah Could Become the First State to Ban Fluoride in Public Water

New York Times

26-02-2025

Utah could soon become the first U.S. state to ban the addition of fluoride to drinking water.
On Friday, the Utah State Senate approved a bill that prohibits adding the mineral to public water systems. If signed by Governor Spencer Cox, the measure would go into effect on May 7. The governor has not publicly commented on whether he supports the bill.
The passage of the Utah bill comes roughly two weeks after the confirmation of Robert F. Kennedy, Jr., as health secretary. In November, Mr. Kennedy vowed that the Trump administration would 'advise all U.S. systems to remove fluoride from public water.'
In 2022, about 44 percent of Utah residents supplied with public drinking water were drinking fluoridated water. Fluoride is added to drinking water because it prevents cavities, a benefit first observed over a century ago. The Centers for Disease Control and Prevention has heralded water fluoridation as one of the 10 greatest public health achievements of the 20th century.
'The evidence that addition of fluoride to the water reduces cavities and tooth decay is unequivocal,' said Dr. F. Perry Wilson, a physician and chronic disease epidemiologist at the Yale School of Medicine.
Opponents of water fluoridation, including Mr. Kennedy and Utah State Representative Stephanie Gricius, who introduced the bill, argue that the chemical could have harmful neurological effects on fetuses and young children. In a recent review paper, researchers with the National Institutes of Health analyzed the results of 74 studies and concluded that high levels of prenatal or childhood fluoride exposure were linked with lower IQ scores in childhood.
However, the fluoride levels associated with lower IQ scores were twice as high as the water fluoridation levels recommended by the C.D.C. Typically, high levels of fluoride exposure are associated not with community water fluoridation, Dr. Wilson said, but with natural fluoride contamination from water running over rocks and soil.
And some other studies have found no link between fluoride and IQ.
'There is still no evidence that community water fluoridation, with the fluoride levels used in the United States, is associated with any adverse health effects,' said Dr. Scott Tomar, a public health dentist and oral epidemiologist at the University of Illinois Chicago College of Dentistry.
This does not mean such a link could not exist. Among other things, no large, longitudinal studies on the relationship between water fluoridation and IQ have been conducted in the United States.
'We must always be on the lookout for new data and allow that to change our conclusions,' Dr. Wilson said.
And there is no question that some Americans are exposed to higher than recommended levels of fluoride in their drinking water because of natural fluoride contamination. In a 2020 study, researchers analyzed water samples from private wells around the nation. They found that the water in some wells was naturally contaminated with fluoride at levels above four milligrams per liter, the legal fluoride limit for drinking water. That is more than 2.5 times the level at which effects on IQ have been observed.
The new Utah law would ban manually adding fluoride to public water, but it would not apply to well water, nor would it reduce the amount of fluoride residents might be exposed to from natural sources.
'This law would have zero effect on that,' Dr. Tomar said.
Other states and U.S. cities and counties are considering or have implemented similar bans. This month, a bill banning water fluoridation was introduced into the Montana state legislature, though that measure was set aside by a committee on February 25. Some communities in North Carolina, Oregon, and Pennsylvania have recently ceased fluoridation. And lawmakers in other states have filed bills that would leave the decision to fluoridate up to voters or local governing bodies.
Research suggests that fluoridation bans could have negative ramifications for oral health. A 2018 study found that children in the U.S. without access to fluoridated water developed 39 percent more cavities in their baby teeth, and 16 percent more cavities in their permanent teeth, than children in communities where most people had access to fluoridated water.
Dr. Wilson worried, too, that the law would have the largest effect on low-income residents. 'Fluoridation of the water supply has disproportionate benefit to those of lower socioeconomic status, with less access to preventative dental care,' he said. 'This bill will hurt those Utahans most.'