ADA calls for EPA to appeal on fluoride

The ADA and 12 other groups are urging the Environmental Protection Agency to appeal a court ruling for the agency to further regulate the fluoridation of public water systems.

A group of citizen petitioners sued the EPA after it denied a petition to stop community water fluoridation. The petitioners claim it diminishes neurocognitive health, and the U.S. District Court for the Northern District of California ruled in their favor Sept. 24, with Senior District Judge Edward M. Chen ordering the EPA to “engage with a regulatory response.” 

“Given the seriousness of reduced IQ, and the ample support in the record that the United States population is at risk of experiencing IQ decrements of over four IQ points, the severity of the hazard at issue weights in favor of finding the risk at issue unreasonable,” reads the ruling, which notes that the finding did not “conclude with certainty” that fluoridated water is harmful to public health.

The court ruling reflects a “fundamental misunderstanding and misapplication of the prevailing scientific literature on the safety of fluoride and community water fluoridation,” according to a Jan. 10 coalition letter. The letter also stated that the ruling has far-reaching implications for the EPA’s ability to regulate substances under the Toxic Substances Control Act. 

“[The ruling sets] a dangerous precedent that could hinder evidence-based policy making. Namely, [the] EPA could be forced to regulate other substances without regard to the agency’s own risk evaluation determinations — based on a judicial misunderstanding and misapplication of science,” the coalition wrote. 

In the letter, the coalition said the court’s decision was based largely on an August 2024 report from the federal National Toxicology Program. The report, titled “Monograph on the State of Science Concerning Fluoride Exposure and Neurodevelopment and Cognition,” claimed that exposure to fluoride at more than twice the level recommended limit for community water fluoridation is “consistently associated” with lower IQ in children.

“The report hinges on only 19 studies that rely on atypical fluoride exposure levels, invalid biomarkers, and insufficient sample sizes,” the letter reads. “The agency also changed peer reviewers after the original peer reviewers reported the first two drafts would not survive scientific scrutiny.” 
   
“These and other issues raise serious concerns about the report’s reliability, transparency and adherence to established scientific standards,” the letter adds.

In a Sept. 25 statement, the ADA said it remains “staunchly in support” of community water fluoridation at optimal levels to help prevent tooth decay. 

“The district court ruling against the Environmental Protection Agency provides no scientific basis for the ADA to change its endorsement of community water fluoridation as safe and beneficial to oral health,” read the release.

Community water fluoridation has been hailed by the Centers for Disease Control and Prevention as one of the 10 great public health achievements of the 20th century, the coalition wrote, and is one of the safest methods of reducing tooth decay in the population by at least 25%.

“It would be regrettable to compromise nearly 80 years of public health success due to challenges in effectively communicating the science, which often extends beyond the simplicity of a sound bite,” the letter concludes. 

For more information about fluoride, visit ADA.org/Fluoride.