EPA initiates accelerated review of fluoride in drinking water
ADA deploys Grassroots Alert, urges ‘objective, evidence-based’ process
The U.S. Environmental Protection Agency has initiated an accelerated review of fluoride in drinking water under the Safe Drinking Water Act. The action marks the first step in an expedited process to evaluate potential health effects associated with fluoride exposure and could inform future regulatory decisions related to drinking water standards for the entire country.
The expedited review follows a 2024 federal court ruling that directed the EPA to strengthen its consideration of potential risks associated with fluoride in drinking water, including potential effects on children’s IQ. Under the Safe Drinking Water Act, the EPA is required to review drinking water regulations every six years.
As part of the review, the EPA released a Human Health Toxicity Assessment Preliminary Assessment Plan and Literature Survey outlining how the agency will identify, screen and evaluate scientific evidence related to fluoride. The agency stated that its final toxicity assessment will inform potential revisions to fluoride drinking water regulations and will also support the Centers for Disease Control and Prevention’s recommendations regarding fluoride in drinking water.
According to EPA officials, the assessment will focus on potential adverse effects of fluoride exposure, including impacts on brain development and tooth development. The agency stated that the review will only consider potential harmful effects and will not evaluate the well-documented benefits of fluoride for preventing dental caries. The review will include a 30-day public comment period and external peer review of the draft assessment.
The ADA said in a statement that it remains committed to the oral health benefits of optimally fluoridated water, urging EPA Administrator Lee Zeldin to implement “an objective, evidence-based process utilizing all the latest peer-reviewed, valid and reproducible research on IQ and neurocognition to reach an objective conclusion.”
According to the Association, the EPA’s exclusion of recently published studies that refute the claim that there is a negative association between optimally fluoridated water and cognitive abilities is not only concerning but also jeopardizes the validity of the scientific methodology.
The ADA sent a Grassroots Alert Feb. 6 encouraging members to contact the EPA about the need to use gold standard science and not studies that cannot stand up to the rigors of peer-reviewed standards. The Grassroots Alert included steps on how to provide formal comments to the EPA and an example message to send. The Association emphasized the importance of not letting the latest review impact the state and local governments’ ability to provide the most “effective, efficient and equitable way for dental disease prevention by discouraging fluoridation practices.”
“We need to show this administration that the oral health community trusts the long-standing comprehensive body of peer-reviewed research demonstrating optimal levels of fluoride in Americans’ water are safe, beneficial and necessary in the United States,” the alert said.
The ADA has consistently supported community water fluoridation as a safe and effective public health measure, stressing that decades of research have shown that community water fluoridation reduces tooth decay by more than 25% in children and adults, regardless of age, income or access to dental care. The Association, which submitted written comments to the EPA last year and is planning to submit additional information this year, said it will continue to monitor the EPA’s actions as the assessment moves forward.
“While this is the preliminary stage assessment, the ADA is hopeful that the EPA will use peer-reviewed, scientifically tested evidence rather than biased, mischaracterized studies that use flawed datasets and do not stand-up to scientific rigor during the next assessment phase,” said ADA President Richard Rosato, D.M.D.
