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Children’s dental health imperilled by US fluoride bans

The ongoing fluoride bans in various US states stands to not only dramatically increase child tooth decay but also incur a substantial financial cost. (fizkes/Adobe Stock).

Thu. 5 June 2025

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BOSTON, US: Among the countless controversial aspects of Donald Trump’s current tenure as the US president, the commitment by Secretary of Health and Human Services Robert F. Kennedy Jr. to remove fluoride from the national water supply is not only a deeply misguided one but will also generate a range of damaging effects to the population’s oral health. Two American states, namely, Utah and Florida, have already instituted the ban, and others are set to follow. A study published this month by Boston-based researchers, however, outlines the calamities that await should the entire country follow suit.

The data upon which the study is based was drawn from the National Health and Nutrition Examination Survey, conducted every year by the Centers for Disease Control and Prevention to record what people eat and their blood work, doctor’s examinations and, importantly, dental visits. Utilising data within this survey from 8,484 children from birth to age 19, the researchers devised a model to examine two prospective realities: one in which fluoride was banned completely from the US water supply, and another where fluoride levels were maintained at the levels deemed optimal by various government agencies.

While maintaining fluoride in the water system stands to ensure a range of oral health benefits for children, something almost unanimously agreed upon in the scientific literature, its outright nationwide ban would be catastrophic both dentally and economically. In terms of immediate oral health impacts, the study predicted that children in the US could expect to develop 25.4 million more cavities within the next five years, which is the equivalent of a decayed tooth in one out of every three children. In the next ten years, the number of cavities would more than double to 53.8 million.

The financial dimension of this political lurch is similarly worrying. The abundant caries that will result from removing fluoride from the US water supply will also have significant negative economic effects. The authors of the study estimate that treating this preventable caries would cost approximately US$9.8 billion (€8.7 billion*) within five years and US$19.4 billion within a decade. In these cases, it is invariably low-income, vulnerable and disadvantaged groups who are most exposed to these risks compared with other sectors of the population, since they experience the greatest difficulty affording proper dental care. Speaking to NBC News, co-author Dr Lisa Simon stated unequivocally that “it harms everyone to eliminate fluoride, but harms those children and families the most”.

The study, titled “Projected outcomes of removing fluoride from US public water systems”, was published in the May 2025 issue of JAMA Health Forum.

Editorial note:

* Calculated on the OANDA platform for 30 May 2025.

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