Fluoride Bans: Who Stands to Lose the Most?
With a growing number of states considering bans on fluoride, the risk of increased cavities and dental expenses is rising, potentially impacting children from low-income families the most.
Utah was the first state to ban the addition of fluoride to drinking water in March, followed by Florida a couple of months later. Similar legislation is under consideration in other states.
A recent study in the JAMA Health Forum modeled the potential consequences of a nationwide halt to water fluoridation. The study revealed a considerable impact on oral health and dental costs: a projected 7.5% increase in tooth decay, equating to roughly 25 million additional cavities, and an estimated $9.8 billion increase in costs over five years for both families and the government via public health insurance.
The researchers also pointed out that children with public insurance or no insurance would be disproportionately affected by these changes.
According to Dr. Lisa Simon, an internal medicine physician and general dentist at Brigham and Women’s Hospital and the study’s senior author, fluoridated water is “an incredible public health tool that comes directly from the tap.”
Simon emphasizes that fluoride benefits everyone, both adults and children. However, those who struggle to access regular dental care benefit the most.
She notes that in the U.S., low-income children and families, those relying on public insurance, or those with difficulties visiting a dentist are more likely to face these challenges.
These state-level fluoride bans coincide with the Trump Administration’s opposition to water fluoridation, largely driven by Robert F. Kennedy Jr., Secretary of the U.S. Department of Health and Human Services (HHS). Kennedy has long criticized water fluoridation, claiming links to conditions like arthritis, bone cancer, and IQ loss. He has also indicated that HHS will cease recommending it. The Environmental Protection Agency is assessing possible health risks associated with fluoride, and the Food and Drug Administration is planning to remove prescription fluoride supplements for children from the market.
Some studies suggest a potential link between fluoride and lower IQ scores, but only at very high exposure levels. The concentration of fluoride added to public water systems, as per federal guidelines, is significantly lower.
The majority of public health experts, and maintain that water fluoridation is a safe and effective method for protecting oral health and preventing cavities and tooth decay.
Dr. Tomitra Latimer, a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago, asserts that it’s considered one of the most successful public health initiatives, comparable to vaccinations.
The U.S. began adding fluoride to public water supplies in 1945, and the Centers for Disease Control and Prevention (CDC) credits this public health measure for the “dramatic decline in cavities” observed since then. The CDC estimates that drinking fluoridated water reduces cavities by approximately 25% in both children and adults.
Though preventable, tooth decay is . According to Latimer, children of color, those from low-income households, children on public insurance plans with limited provider options, and those in rural areas with limited access to care are at increased risk of developing cavities. She also adds that children with autism are prone to have a because they may find it difficult to brush regularly.
Latimer points out that alternative fluoride sources are available for purchase, but the cost may be prohibitive for many families. She emphasizes the importance of fluoridated water as an easily accessible means of protecting the oral health of children who are most vulnerable to cavities, as it has been available directly from the tap for generations.
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