Dentists are struggling to counter RFK Jr. on fluoride

Politico

11-07-2025

'Fluoride's predominant benefit to teeth comes from topical contact with the outside of the teeth, not from ingestion,' an HHS spokesperson told POLITICO. 'There is no need, therefore, to ingest fluoride.'
The impact the retreat from fluoridation has on oral health will show whether dentists are right, that a cavity crisis will follow, or whether Kennedy's view, that Americans can get the fluoride they need in toothpaste and mouthwash, will bear out.
The Centers for Disease Control and Prevention, an agency within HHS, has held out fluoridation as one of the 10 greatest public health achievements of the 20th century, citing data that it reduces tooth decay by as much as 70 percent in children and tooth loss by as much as 60 percent in adults.
But Kennedy nonetheless believes the case to remove fluoride is urgent because of evidence that it can curtail children's brain development. It's a position bolstered by a report from the National Institutes of Environmental Health Sciences during the Biden administration and an Obama-appointed federal judge last year — though the levels of fluoride they examined were higher than what Americans consume.
Dentists see it otherwise.
'This is revving up an anti-science narrative,' said Brett Kessler, the president of the American Dental Association, the country's leading dentists' group. 'There are ways to get fluoride in toothpaste, some of the foods we eat, some of the drinks we drink, topical fluoride mouthwashes. … But without fluoridated water you're already behind the eight ball because you've got vulnerable teeth.'
Dentists' case
Opposition to adding the cavity-fighting mineral to water — based on a mishmash of reasoning around the purity of the drinking supply, concerns about side effects and conspiracy theories — has long been a cause of some on the left.
Before Utah and Florida's moves, residents of Hawaii, New Jersey and Oregon were the least likely to have fluoride in their water, according to a review of 2022 data by the United Health Foundation, a philanthropy started by the insurer UnitedHealth Group to promote better public health.
(The same study found 79 percent of Floridians and 43 percent of Utahns drank fluoridated water.)
Health researchers have mostly found that low levels of fluoride, including the amounts found in drinking water systems across the U.S., are safe and can help fortify teeth against decay and other ailments.
Many communities began to fluoridate their water in the mid-1900s at the behest of voters and their local and state governments. In 1962, HHS started providing guidance on fluoride in drinking water, and the Environmental Protection Agency invoked the Safe Drinking Water Act years later to enforce these standards, though fluoridation is still done at states' discretion.
But research, much of it in China, has since prompted the Trump administration to question those standards. The findings suggest higher levels of fluoride in groundwater are linked to neurobehavioral issues and reduced IQ in children, but those results are not definitive due to study designs and methodology.
Opponents of fluoridation in blue jurisdictions like Portland, Oregon, and Hawaii, historically have made the case that the best water is the least touched by human hands.
'The attitude was, 'don't ruin our pure water,'' said Barry Taylor, the executive director of the Oregon Dental Association. He says the Chinese studies have only made convincing Oregonians otherwise harder because they've added 'a new element of doubt.'
Kessler contends the studies are not applicable to the U.S. because of the difference in fluoride levels and confounding variables. 'It could be lower IQ parents. It could be a lack of special foods that could help brain development. And it could just be DNA or genetics,' Kessler said.
Dental health advocates also see a flaw in Kennedy's case that mouthwash and toothpaste are all people need. They argue that some Americans don't use the products, either because they can't get to a store, can't afford them or because they choose not to, putting them at risk.
'This is a lot of forces coming together to undermine oral health for particularly people that are lower income or in areas that may not have as many resources to get the oral health care they need,' said Melissa Burroughs, senior director of public policy at CareQuest, an oral health advocacy group aligned with the dentists.
The American Dental Association's Kessler says the battle is far from over, pointing to the ADA's success this year in persuading state lawmakers to reject bills that would have banned fluoridation or otherwise impeded fluoridation efforts in 16 states across the political spectrum, including Hawaii.
Kennedy's campaign
Kennedy traveled to Salt Lake City in April to praise Utah for becoming the first state to ban fluoride in a state's water. The rule took effect in May.
'It makes no sense to have it in our water supply,' Kennedy said at a news conference with state lawmakers. 'I'm very, very proud of this state for being the first state to ban it, and I hope many more will come.'
Kennedy hasn't withdrawn Centers for Disease Control and Prevention guidance encouraging fluoridation but he's threatening to do so.
Earlier this year, he directed the CDC to reconvene the Community Preventive Services Task Force, an independent panel of experts, to study the issue.
And his concerns about fluoride are filtering into other agencies' agendas. The Food and Drug Administration has announced it plans to ban ingestible fluoride pills and drops marketed to children. It's convening a public meeting on the issue on July 23.
The response has not always followed partisan lines.
When Kennedy appeared before a House Appropriations subcommittee in May, Rep. Mike Simpson of Idaho, a Republican and a dentist, said he'd seen the benefits of fluoride during his 22 years taking care of patients' teeth.
'If you are successful in banning fluoride, we better put a lot more money into dental education because we're going to need a whole lot more dentists,' Simpson said.
Kennedy didn't back down. 'We now know that virtually all the benefit is topical, and we can get that through mouthwashes,' he said.