Florida health official advises communities to stop adding fluoride to drinking water: shot

Florida Surgeon General Joseph Ladapo on Friday advised local governments across the state to stop adding fluoride to their local water supplies. He called it “public health malpractice” despite widespread consensus among public health experts that fluoridation has dramatically improved dental health in the United States, saved billions in dental costs and prevented millions of childhood cavities.

Ladapo held a press conference Friday morning in Winter Haven, a small town east of Tampa where officials earlier this month voted to stop fluoridating water. The Florida Department of Health followed up with one announcement and new guidance.

Ladapo cited research that suggests chronic exposure to high levels of fluoride can have harmful neurological effects on children, such as lower IQ and higher rates of ADHD.

Fluoride is a chemical that occurs naturally in water, soil, food and other sources. It helps strengthen the teeth and protects them from decay.

For decades, many American communities have added fluoride to their drinking water, which the Centers for Disease Control and Prevention hails as one of them “10 Major Public Health Interventions of the 20th Century” due to the dramatic decline in cavities.

The guidance from Ladapo comes after Robert F. Kennedy, Jr., President Donald Trump’s pick for Secretary of Health and Human Services, announced plans to take similar steps nationwide if he is confirmed for the job.

When a reporter asked Ladapo about the timing during Friday’s press conference, he said this was an issue he had been working on “for months” but was delayed by the recent hurricanes that hit the state.

What the studies say

“Community water fluoridation is one of the most effective and affordable public health measures we can implement to protect the oral health of our residents,” said Dr. Jeff Ottley, president of the Florida Dental Association.

Decades of scientific research prove the safety and effectiveness of fluoridation, he said.

“Adding optimal amounts of fluoride to our community’s water supplies can prevent at least 25% of tooth decay in children and adults, reducing the need for expensive dental treatments,” Ottley said.

The National Toxicology Program published a systematic review in August of research on the link between fluoride exposure and neurodevelopment and cognition. It concluded that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liters, is associated with lower IQ in children.

This is twice as much as the 0.7 milligrams of fluoride per liters of water that US health authorities recommend for local water supplies.

“The decision about lower IQs in children was based primarily on epidemiologic studies in non-US countries such as Canada, China, India, Iran, Pakistan, and Mexico, where some pregnant women, infants, and children received total fluoride exposures of more than 1, 5 mg fluoride/l drinking water,” the NTP noted in the report.

Researchers added that there was “insufficient data” to determine whether the lower level recommended in the US has a negative effect on children’s IQ. The NTP added that there was no evidence that fluoride exposure had adverse effects on cognition in adults.

But Ladapo said he found the results “appalling” and believes the risk outweighs any dental benefit. He said there are other ways people can access fluoride now, such as in certain toothpastes, mouthwashes and foods.

“In this day and age, with the additional sources of fluoride that people have access to, it is a public health mistake to continue to add fluoride to community water systems that pregnant women and children have access to,” he said during the news conference.

Ladapo was joined by Ashley Malin, an assistant professor in the University of Florida’s Department of Epidemiology who has studied the effects of fluoride in pregnant women.

She led an investigation published in May that was based in Los Angeles and suggested that fluoride exposure during pregnancy was associated with an increased risk of neurobehavioral problems in children.

“Even though this issue has been politicized recently, I don’t see this as a political issue; I see this as a human rights issue and a public health issue,” Malin said.

The Florida Department of Health estimates that about 70 percent of residents in community water systems receive fluoridated water.

Collier County voted to stop fluoridates water in February, while the city of Winter Haven did so on November 12. Ladapo urged Floridians to demand policy makers in their local communities follow suit.

“It is clear that more research is needed to address safety and efficacy issues regarding community water fluoridation,” Ladapo said.

Major health groups support adding fluoride to water

Organizations such as the CDC, the World Health Organization, the American Dental Association, and the American Academy of Pediatrics support the addition of fluoride to local water supplies. They say it helps extend dental coverage to low-income people who may not be able to afford other types of dental care.

In September, US District Judge Edward Chen ordered the US Environmental Protection Agency to strengthen its fluoride regulationsconcluding recent research suggests there is “unreasonable risk” that 0.7 milligrams per liter may not be low enough to protect children from harm. Although he also noted that his ruling “does not conclude with any certainty that fluoridated water is harmful to public health.”

The Florida Dental Association said it continues to support community water fluoridation.

“Water fluoridation is one of the tools we have in our toolkit to help children achieve healthy oral health,” Ottley said. “If we remove that, then we are placing the children in these communities with higher levels of caries at an earlier age.”

The Florida Department of Health also raised concerns in its guidance about the risk of a rare condition known as skeletal fluorosis from exposure to fluoride, which can increase the risk of bone fractures. The EPA requires that water systems not exceed 4 milligrams of fluoride per liters of water to prevent skeletal fluorosis.

CDC says health experts “have not found compelling scientific evidence linking community water fluoridation to any potential adverse health effect or systemic disorder, such as an increased risk of cancer, Down syndrome, heart disease, osteoporosis and bone fractures, immune disorders, low intelligence, kidney disease, Alzheimer’s disease, or allergic reactions.”

Surgeon General Ladapo shared other recommendations to support dental health in his guidance, including expanding community access to dental services and promoting healthy habits such as reducing sugar consumption.