Are RFK Jr.'s Views on Flouride Really So Eccentric?

Before Donald Trump assumed office, Robert F. Kennedy Jr. sparked concern among public health experts by announcing plans to advocate for the removal of fluoride from U.S. drinking water. Kennedy claimed that Trump supported this initiative, making it a key priority for his administration.

In a post on X (formerly Twitter), Kennedy stated, “On Jan. 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water.” He referred to fluoride as “an industrial waste” and linked it to various health issues, including arthritis, thyroid disease, and lower IQ in children.

This move raised alarm among public health officials and Democratic lawmakers, particularly after Kennedy was nominated to head the Department of Health and Human Services (HHS). Critics were dismayed by the appointment of someone known for controversial views on vaccines and food safety to oversee agencies responsible for drug safety, medical research, and public health. They warned that his leadership could undermine public health efforts.

Despite his often unconventional views, Kennedy’s stance on fluoride is more complex than it appears, according to some health experts.

What Is Fluoride?

Fluoride is a naturally occurring mineral widely recognized for its role in preventing tooth decay. It helps reverse damage caused by acidic bacteria in the mouth, strengthening dental enamel and preventing cavities. Since the 1950s, federal health officials have endorsed water fluoridation as a means to protect dental health, even as fluoride toothpaste became common.

Water remains the primary source of fluoride for most Americans, and the Centers for Disease Control and Prevention (CDC) credits water fluoridation with reducing cavities by approximately 25%. It is considered one of the most significant public health achievements of the 20th century. The CDC recommends a fluoride concentration of 0.7 milligrams per liter in drinking water, a level shown to be effective in preventing tooth decay.

Dr. Aaron Yancoskie, associate dean at Touro College of Dental Medicine, emphasized the strength of the data supporting fluoride's safety and efficacy in a CBS News interview. Studies from Alaska and Canada also show a rise in cavities among children after the cessation of fluoridation programs.

However, fluoride is not without risks. Excessive exposure can lead to tooth discoloration, bone deformities, and thyroid issues. In response, the CDC lowered its recommended fluoride levels in drinking water in 2015 to reduce the prevalence of fluorosis, a condition that causes white or brown splotches on teeth.

Recent studies have also raised concerns about the potential impact of fluoride on brain development. In August, the National Toxicology Program found "moderate confidence" that elevated fluoride exposure could lower IQ in children. This conclusion was based on studies where fluoride levels were about twice the recommended limit for drinking water.

Additionally, a 2023 Canadian study revealed that girls exposed to higher fluoride levels had worse cognitive flexibility and executive function. Research from Mexico also suggested that fluoride intake during pregnancy could lead to significant drops in IQ and other cognitive issues in children.

A Global Divide on Fluoridation

In contrast to the U.S., where about 73% of the population receives fluoridated water, many European countries do not fluoridate their water, relying instead on fluoride toothpaste and other dental products. Countries like Germany, the Netherlands, and most of Scandinavia maintain low cavity rates without water fluoridation. Proponents of this model argue that cavity prevention can be achieved without fluoridating the water supply.

Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University, suggested that ending fluoridation in the U.S. might align the country with global peers. While this could lead to a slight increase in tooth decay, she argued it might also reduce prenatal fluoride exposure, potentially benefiting public health.

However, the experience of Calgary, Canada, where water fluoridation was discontinued in 2011, offers a cautionary example. Since the change, the city has seen a rise in dental surgeries for severe cavities among children, according to University of Calgary data.

In the U.S., only Hawaii has banned fluoridation, while other states leave the decision to local governments. Cities like Portland, Oregon, and Wichita, Kansas, have consistently rejected fluoridation proposals, and recently, more communities in North Carolina, Florida, Pennsylvania, and Texas have chosen to discontinue the practice.