Removing fluoride from water could result in 25 million cavities and $9.8 billion, study estimates

CBS News

02-06-2025

New research suggests that removing fluoride from public water would increase dental care costs and tooth decay for children across the United States.
The study, published Friday in the JAMA Health Forum, used a nationally representative sample of 8,484 children aged 0 to 19 from the U.S. National Health and Nutrition Examination Survey to estimate projected outcomes of stopping water fluoridation in the U.S. — something some states, including Utah and Florida, have already begun doing.
Researchers found removing fluoride was associated with an increase in tooth decay of 7.5 percentage points, or 25.4 million cases, and cost approximately $9.8 billion over 5 years.
These effects would disproportionately affect publicly insured and uninsured children, who are already at the highest risk of unmet dental needs, the authors added.
Fluoride is a mineral that helps strengthen teeth and reduce cavities, according to the Centers for Disease Control and Prevention. It does this by repairing and preventing damage to teeth caused by bacteria in the mouth that produce acid, which in turn dissolves minerals in a tooth's surface and can even lead to tooth loss.
Tooth decay by itself can be painful and costly to treat but left untreated can cause further problems, including infections and abscesses or even sepsis, according to the World Health Organization. Some research has also linked poor oral health to other complications, such as cardiovascular disease due to inflammation and infection.
The addition of low levels of fluoride to drinking water was long considered one of the greatest public health achievements of the last century, but Health and Human Services Secretary Robert F. Kennedy Jr. has brought it into question, claiming fluoride is linked to a slew of health problems. Dental experts have told CBS News they largely disagree.
"Seventy years of research, thousands of studies and the experience of more than 210 million Americans tell us that water fluoridation is effective in preventing cavities and is safe for children and adults," according to the American Dental Association.
Fluoride can come from a number of sources, including most toothpaste brands, but researchers say drinking water is the main source for Americans. Plus, the U.S. Food and Drug Administration announced earlier this year that it is starting the process of removing ingestible fluoride prescription drug products for kids from the market.