Utah Becomes First State to Ban Fluoride in Public Drinking Water

Utah is the first state in the nation to ban fluoride from public drinking water. This move has been met with opposition by dentists and health organizations, who warned that the decision would lead to medical issues disproportionately affecting low-income areas.

Republican Gov. Spencer Cox has signed a bill that prevents cities and towns from adding the mineral to water systems.

Florida, Ohio, and South Carolina have considered similar measures. In New Hampshire, North Dakota, and Tennessee, however, legislators rejected them. The Kentucky State Senate has blocked a bill to make fluoridation an optional practice.

The American Dental Association criticized Utah’s law for its “wanton disregard” of the health and wellbeing of its constituents.

The ADA has noted that cavities are the most prevalent chronic disease in children. According to the U.S. Centers for Disease Control and Prevention, fluoride can strengthen teeth and reduce cavities by replacing minerals that are lost through normal wear and use.

As a father and dentist, I find it disheartening that a public health policy that has proven to be effective in improving the oral health of an entire population was dismantled on the basis of distorted pseudoscience, according to Denver dentist Brett Kessler.

Ban effective May 7th brings mainstream the concerns about fluoridation, which for years were considered fringe views.

This comes just weeks after Robert F. Kennedy Jr., a water fluoridation critic, was appointed as U.S. Health Secretary. Kennedy stated in November that Donald Trump’s administration would recommend that water systems remove fluoride.

Cox, who was raised and has raised his children in a community that does not have fluoridated drinking water, recently compared the situation to being medicated. Utah lawmakers said that the ban is a personal choice, and adding fluoride to water would be too expensive.

Florida’s surgeon-general last year advised against community water fluoridation due to what he termed its “neuropsychiatric risks.” This guidance was issued after a federal court ordered the U.S. Environmental Protection Agency (EPA) to regulate fluoride levels in drinking water, as high levels can pose a threat to children’s intellectual development.

Last year, federal officials concluded “with moderate certainty” that higher levels of fluoride exposure were linked with lower IQ among children. The National Toxicology Program, however, based its conclusions on studies that involved fluoride levels about twice as high as the recommended limit in drinking water. According to federal guidelines, the amount of fluoride added to drinking water is below levels that are considered problematic.

National Institutes of Health say that very high fluoride doses can be caused by rare accidents. These include unintentional ingestion of fluoride from dentists or children who are given supplements they shouldn’t have. According to the agency, it is “virtually unattainable” for a standard dose of fluoride added to toothpaste or water to cause toxicity.

Fluoride is naturally present at higher levels in some water sources, so communities may exceed the recommended level. In 2011, the U.S. government reported that two out of five adolescents in the country had some degree of tooth staining or spots due to too much fluoride.

Federal health officials have recommended a level of fluoridation of 0.7 milligrams of fluoride per liter of water since 2015. Before that, the upper limit was 1.2 mg/l. The World Health Organization set a limit of 1.5 milligrams in drinking water.

The addition of low fluoride levels to drinking water is considered to be one of the greatest achievements in public health of the last century. It’s also one of the most cost-effective methods to prevent tooth decay on a large scale.

Federal officials began promoting water fluoridation in 1950 to prevent tooth decay. They continued this promotion even after fluoride-containing toothpastes hit the market several decades later. Nearly two-thirds (200 million) of Americans receive fluoridated water.

According to the Utah Dental Association, fluoride in water can reduce dental caries by at least 25 percent for all age categories. The opponents of the Utah legislation that limits fluoridation claim it will negatively affect low-income residents, who may depend on fluoridated drinking water as their sole source of dental prevention.

The sponsor of Utah’s legislation, Republican state Rep. Stephanie Gricius, acknowledged that fluoride had benefits but stated it was a matter of “individual decision” whether or not it should be in water.

An analysis revealed that only 66 of the 484 Utah systems that reported data for 2024 fluoridated their drinking water. Salt Lake City, the largest municipality in Utah, had the highest fluoridation rate.

According to CDC data, Utah will be ranked 44th nationally in 2022 for the percentage of residents who receive fluoridated drinking water.