ADA president, AAPD past president pen editorial warning public health risks of removing fluoride
Editorial published in JAMA Health Forum
ADA President Brett Kessler, D.D.S., and Scott D. Smith, D.D.S., immediate past president of the American Academy of Pediatric Dentistry, issued a warning against efforts to eliminate community water fluoridation in a Sept. 5 editorial, stating such decisions could unravel decades of progress in public oral health.
In the Journal of the American Medical Association Health Forum editorial, “Removing Fluoride From Water? An Oral Health Crisis Will Unfold,” Drs. Kessler and Smith emphasized that fluoride is a cornerstone of preventive dental care, especially for vulnerable populations like children enrolled in Medicaid.
The editorial comes amid recent efforts to stop community water fluoridation at the state and federal level. Two states, Utah and Florida, have banned the practice, and others are considering following suit. Additionally, the Centers for Disease Control and Prevention’s oral health division was eliminated in April, with Health and Human Services Secretary Robert F. Kennedy Jr. having long believed fluoride is unhealthy.
“Today we risk reversing the progress made for our service members and coming generations. This would not be through neglect but by design if we eliminate one of the twentieth century’s most effective public health interventions — community water fluoridation,” Drs. Kessler and Smith wrote. “While community water fluoridation has been part of our readiness infrastructure, it silently protects people throughout the lifespan — perhaps most importantly, children who cannot regularly visit a dentist or do not have toothpaste or toothbrushes.”
Drs. Kessler and Smith said fluoride’s safety and efficacy has been “misrepresented in the media and at the pulpits of some national leaders.” They noted that recent legislative efforts to ban or restrict water fluoridation are being driven by flawed studies and public confusion — despite the support of virtually every major health organization, including the ADA, American Medical Association, American Academy of Pediatrics, American Academy of Pediatric Dentistry and World Health Organization.
They also highlighted the disproportionate impact fluoridation has on low-income communities, where children are more likely to experience untreated dental caries and have less access to dental care. If today’s Medicaid funding allows comprehensive dental care for 1,000 children, Drs. Kessler and Smith wrote, increased decay from the removal of community water fluoridation means that budget might only cover 700, thus cutting care for 300 kids.
“That is not just a budget cut. It is a values decision masquerading as policy neutrality. It quietly withdraws care from the most vulnerable, while pretending nothing has changed,” reads the editorial.
Citing data from cities like Juneau, Alaska, where cavity-related treatment costs increased by 47% after fluoride was removed from public water, the dentists emphasized that the public health and financial consequences of eliminating fluoridation are well documented and far-reaching.
Drs. Kessler and Smith called on readers to take an active role in defending fluoridation policies at the local level and to advocate for science-based decision-making. Those interested in championing water fluoridation can also join the ADA’s Fluoride Ambassador program. For more information, visit this webpage.
“The decision to maintain — or remove — fluoride from public water systems is not a scientific one alone. It is a policy choice with generational consequences,” they wrote. “If we are serious about protecting children’s health and creating a healthier workforce, then preserving community water fluoridation is not optional — it is essential.”
Read the full editorial in JAMA here.
