Under President Trump, fluoride will be removed from the public water supply in the United States, according to Robert F. Kennedy Jr.

The claim comes from a post on X, shared by Kennedy on Saturday, just days before the 2024 presidential election.

“On January 20, the Trump White House will advise all U.S. water systems to eliminate fluoride from public water,” Kennedy wrote. “Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease. President @realDonaldTrump and First Lady @MELANIATRUMP want to make America healthy again.”

In a follow-up jobKennedy called fluoride a “dangerous neurotoxin.”

Water fluoridation, or adding fluoride to drinking water, is a decades-old practice in the United States, but Kennedy’s claims have sparked questions about the safety of fluoride in drinking water and about what would happen if it were removed from the United States water supply. Here’s what you need to know.

Fluoride is a natural mineral that can help prevent tooth decay and strengthen bones. Fluoride is often found in water and in various dental products, including toothpaste and mouthwash, to prevent dental caries.

Almost all water contains naturally occurring fluoride, but usually not enough to support dental health. That’s why local governments began adding fluoride to water systems in the 1940s. In 2020, more than 72% of the total U.S. population, or approximately 290 million people, received fluoridated water through a community water system.

Water fluoridation is not required by law, and it is up to state and local governments to decide whether or not to add fluoride to their water supplies. The U.S. Department of Health and Human Services (HHS) has set the optimal concentration of fluoride in drinking water at 0.7 milligrams of fluoride per liter of water. Although water fluoridation typically involves adding fluoride, communities can actually remove fluoride if the natural level is too high.

According to the Centers for Disease Control and Prevention (CDC), drinking fluoridated water reduces cavities by about 25% in children and adults, leading to fewer cavities. mouth painfewer fillings or tooth pulling and fewer days missed from work and school. Of note, a Cochrane review published in October 2024 found that the benefits of community water fluoridation on tooth decay have diminished since the 1970s, when fluoride toothpaste became more widely available.

Experts say it’s a tricky question: Research shows that the health risks associated with fluoride depend on the level of exposure.

“The science of fluoride is very interesting because fluoride in small amounts is beneficial while fluoride in large doses is toxic. » Athanasios Zavras, DDS, MS, DMSctold Delta Dental of Massachusetts, professor of public health and community service at Tufts University School of Medicine and chair of the school’s department of public health and community service. Health.

But as of now, there are no confirmed health risks from fluoride at optimal levels. “There is no evidence to support claims that 0.7 mg/L of fluoride leads to any of the conditions mentioned,” Zavras said.

That said, fluoride has been linked to some adverse health effects at higher levels, according to Ashley Malin, Ph.D.assistant professor of epidemiology at the University of Florida College of Public Health and Health Professions.

Fluoride and neurodevelopment

Malin primarily studies the effect of fluoride on neurodevelopment, and some evidence points to a link between the two.

In August, a report from the National Toxicology Program found that higher levels of fluoride exposure, such as drinking water containing more than 1.5 mg of fluoride per liter (mg/L), are associated with lower IQ lower in children.

Most of the studies included in the report were conducted in countries outside the United States with higher levels of fluoride exposure. But the report found that nearly 2 million Americans have water that naturally contains at least 1.5 mg/L of fluoride – the upper limit set by the World Health Organization – and that one million Americans have naturally fluoridated tap water at 2 mg/L or more. .

The report was also cited in a lawsuit filed against the Environmental Protection Agency by a nongovernmental organization and other plaintiffs. A federal court in California ruled in favor of the plaintiffs, who claimed that levels of fluoride in U.S. drinking water posed a risk to human health.

Although the court ruling did not find that current levels of fluoride in water were dangerous to public health, the EPA must now strengthen its regulations on fluoride in drinking water due to “substantial evidence and scientifically credible evidence establishing that fluoride poses a risk to humans. health.”

Opponents of the decision, such as the American Academy of Pediatrics (AAP), have questioned the validity of the research highlighted in this case, notably scrutinizing the NTP report on the link between fluoridated water and IQ.

“There is nothing in the current decision that changes my confidence in the safety of optimally fluoridated water in the United States,” Charlotte W. Lewis, MD, MPH, FAAP, member of the AAP Section on oral health, said in a statement. “Water fluoridation is a public health policy based on solid evidence. When new research is published, health experts review it to ensure it meets high standards for public safety.

Fluoride and oral health

Dental fluorosis is a well-established concern regarding exposure to high levels of fluoride in young children: too much fluoride during tooth growth can cause tooth discoloration, including spots, stains, or lines white.

In the United States, cases of dental fluorosis are mostly mild and cosmetic, meaning they do not affect dental function and are not painful. Children are no longer at risk of dental fluorosis around age 8, when the enamel of permanent teeth is fully formed.

Fluoride and other health problems

In his article on thyroid.

Although high levels of fluoride can weaken bones, in severe cases causing a condition known as skeletal fluorosis.—bone cancer has not yet been conclusively linked to fluoride exposure. A National Research Council study raised concerns about the risk of bone cancer based on preliminary research and animal studies, but Malin said there have been no rigorous studies in the United States. United on low exposure.

Some research has shown a link between fluoride exposure and an increased risk of bone fracture, Malin said. Most studies have tested higher levels of fluoride, but a recent Swedish study showed that exposure to fluoride at levels similar to those in the United States was associated with an increased risk of major osteoporosis and fracture of the hip. hip in postmenopausal Swedish women.

As for arthritisOverall, studies on the association of fluoride with increased risk of arthritis have not reached strong conclusions. A study of residents of Tongyu County in China found that excessive exposure to fluoridated water can increase osteoarthritis risk, but only at levels above the recommended 0.7 mg/L.

Thyroid disease is not yet closely linked to fluoride exposure. Malin said the association is plausible and that a Canadian study found an increased risk of hypothyroidism in pregnant women with low levels of fluoride exposure from drinking water, but more rigorous studies in the United States are needed.

The National Sanitation Foundation has approved three chemicals for fluoridation of drinking water: hydrofluosilicic acid, sodium fluorosilicate, and sodium fluoride. “These may be byproducts of phosphate fertilizer production,” Malin said, perhaps explaining what Kennedy meant when he called fluoride “industrial waste.”

Two of these fluoride additives contain heavy metals, Malin said. A 2014 study found arsenic, lead, and aluminum in hydrofluorosilicic acid, as well as aluminum and barium in sodium fluoride, noting that all samples tested contained a “surprising amount of aluminum”.

The study only used a few samples, but Malin also warned that these two chemicals can have a harmful effect when combined with disinfecting agents like chlorine found in plumbing lines.

“When combined, disinfectant agents can leach lead from leaded pipes into community drinking water, which can increase lead exposure,” Malin said. “Often people think it’s medical grade fluoride, or similar to naturally occurring fluoride, but these chemicals are, from my point of view, very different.”

The largest and most immediate impact would be a significant increase in dental caries, particularly among children.

“Water fluoridation is often called a ‘public health miracle’ because it helps many people across all socioeconomic groups avoid the devastating effects of dental disease,” Zavras said. “Groups that consume high levels of carbohydrates will bear the burden of such an increase disproportionately. »

However, Malin said there is evidence to suggest that water fluoridation is no longer essential for preventing tooth decay, with fluoride toothpaste becoming widely accessible. “It appears that the demonstrated benefits have diminished over the years,” Malin added. “There is more evidence to support topical application.”

Fluoride recommendations have already been changed. HHS initially set the optimal range for water fluoridation at 0.7 to 1.2 mg/L. In 2015, the agency updated its recommendation to the current optimal concentration of 0.7 mg/L due to increasing amounts of fluoride in foods treated with fluoridated water. “We need to remember that community drinking water is not the only source of fluoride exposure,” Malin added.

Whether or not Kennedy is responsible for America’s health initiatives, the EPA will need to address the health risks of water fluoridation, according to the federal court’s ruling.

“I think it makes sense to further regulate this chemical to mitigate the risk,” Malin said. “Whether this means reducing the concentration or eliminating it completely from the water supply remains to be determined.”