Fluoridation lawsuit, amalgam focus of ADA letter to EPA

The ADA is urging the Environmental Protection Agency to continue its fluoridation appeal, exercise caution when reforming its dental office wastewater pretreatment standard and maintain the U.S. position on dental amalgam. 

In a March 4 letter to Lee Zeldin, administrator of the EPA, the ADA stated the agency should prioritize these policy issues, emphasizing the importance of oral health’s role in overall health.  

“Oral health is a critical component of overall health and addressing the challenges in this area will lead to significant improvements in the well-being of millions of Americans as well as supporting the $478 billion annual economic impact of the nation’s economy,” reads the letter, signed by ADA President Brett Kessler, D.D.S., and Interim Executive Director Elizabeth Shapiro, D.D.S.  

The letter urged the EPA to continue its appeal of a September 2024 court order directing the agency to further regulate the fluoridation of public water systems. The decision sets a concerning precedent that could force the agency to regulate substances without proper risk assessment, according to the letter.  

“This ruling places judicial interpretation above the EPA’s scientific expertise, creating unnecessary regulatory exposure. Appealing this case is essential to avoid unnecessary regulation whenever a citizen petition is filed, based on scientifically unsubstantiated claims,” Drs. Kessler and Shapiro wrote. 

The ADA also urged the EPA to “proceed cautiously” if considering reforms to its dental office wastewater pretreatment standard, noting that sudden regulatory changes “could lead to financial and operation disruptions of dental practices.” The EPA requires dental offices that use dental amalgam to use amalgam separators, which are filters that capture any unused filling material that goes down the drain. The pretreatment standard aims to filter the dental office’s wastewater before it ends up at the wastewater treatment utility, where wastewater is cleaned before reentering the main water supply. 

“The EPA’s pretreatment standard calls for dental offices to use amalgam separators to reduce discharges of dental amalgam into public wastewater systems. The ADA supported this standard — which was adopted during President Trump’s first term — as a balanced, effective way to help wastewater treatment facilities capture dental amalgam,” Drs. Kessler and Shapiro wrote. 

The dental leaders also urged the EPA to maintain the U.S. position on dental amalgam in the Minamata Convention on Mercury, a global environmental agreement that aims to limit mercury emissions. The U.S. has long supported a phasedown of dental amalgam, according to the letter, by increasing prevention efforts, researching viable alternatives, using other restorative materials and following best practices for handling amalgam waste properly.  

“The U.S. approach allows dentists to make the best clinical decisions for patients while ensuring responsible environmental stewardship. It is also consistent with the EPA’s pretreatment standard for dental office wastewater,” the dentists said in the letter.