Policy Alert: HHS to Review Guidance on Fluoride in Drinking Water

Action: The US Department of Health and Human Services (HHS) will convene an independent panel of health experts to make a new recommendation on putting fluoride in drinking water. The Environmental Protection Agency will also review new scientific information on the potential health risks of fluoride in drinking water in coordination with HHS. Fluoride has been added to drinking water since the middle of the twentieth century, beginning in Grand Rapids, Michigan in 1945, to prevent tooth decay in the population. HHS Secretary Robert F. Kennedy Jr. opposes the addition of fluoride to public water systems, claiming that water fluoridation at US levels is associated with numerous health issues.

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Scientists in the early twentieth century found that people who lived in areas where community water supplies had naturally occurring high levels of fluoride had teeth with greater resistance to decay. Not long after Grand Rapids added fluoride to the city’s water supply, the US Public Health Service and the American Dental Association in the 1950s acknowledged the success of water fluoridation in reducing cavities. Major medical associations, including the American Academy of Pediatrics and the American Dental Association, support adding fluoride to drinking water in order to prevent tooth decay.
The decision to fluoridate water is typically made by municipal governments, city councils, or local water authorities. No Federal law mandates the fluoridation of a locality’s water supply. The US Public Health Service recommends that fluoride remain below 0.7 milligrams per liter, as levels above 1.5 mg/L are known to increase health risks such as bone fractures, thyroid disease, and nervous system damage. According to the CDC, approximately 63% of the US population receives fluoridated water.
On March 27, Utah became the first state to ban fluoride in public water systems. The bill signed by Governor Spencer Cox will go into effect May 7. “You would think you would see drastically different outcomes with half the state not getting it and half the state getting it. I’ve talked to a lot of dentists. We haven’t seen that,” said Cox. In 2022, about 44% of Utah’s population received fluoridated water. “So it’s got to be a really high bar for me if we’re going to require people to be medicated by their government,” said Cox.
Miami-Dade Mayor Daniella Levine Cava on April 11 vetoed legislation that would ban fluoride from drinking water. The Miami-Dade Board of County Commissioners is considering an override of the veto.

Policy Alert: HHS to Review Guidance on Fluoride in Drinking Water

April 16, 2025

Key Insights

Scientists in the early twentieth century found that people who lived in areas where community water supplies had naturally occurring high levels of fluoride had teeth with greater resistance to decay. Not long after Grand Rapids added fluoride to the city’s water supply, the US Public Health Service and the American Dental Association in the 1950s acknowledged the success of water fluoridation in reducing cavities. Major medical associations, including the American Academy of Pediatrics and the American Dental Association, support adding fluoride to drinking water in order to prevent tooth decay.

The decision to fluoridate water is typically made by municipal governments, city councils, or local water authorities. No Federal law mandates the fluoridation of a locality’s water supply. The US Public Health Service recommends that fluoride remain below 0.7 milligrams per liter, as levels above 1.5 mg/L are known to increase health risks such as bone fractures, thyroid disease, and nervous system damage. According to the CDC, approximately 63% of the US population receives fluoridated water.

On March 27, Utah became the first state to ban fluoride in public water systems. The bill signed by Governor Spencer Cox will go into effect May 7. “You would think you would see drastically different outcomes with half the state not getting it and half the state getting it. I’ve talked to a lot of dentists. We haven’t seen that,” said Cox. In 2022, about 44% of Utah’s population received fluoridated water. “So it’s got to be a really high bar for me if we’re going to require people to be medicated by their government,” said Cox.

Miami-Dade Mayor Daniella Levine Cava on April 11 vetoed legislation that would ban fluoride from drinking water. The Miami-Dade Board of County Commissioners is considering an override of the veto.

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