With no noticeable taste or smell, fluoride has been the silent partner in drinking water across the United States since the 20th century. Beginning with the fluoridation of Grand Rapids, Michigan, on Jan. 25, 1945, the addition of the chemical compound to drinking water systems quickly became popular across the country.
Now, 80 years later, concerns have arisen over whether fluoridated water could have negative health effects. Gainesville Regional Utilities fluorates water at a rate of 0.41 parts per million, with a range detected of 0.23 to 0.64 ppm, according to a GRU water quality report. The Centers for Disease Control recommends a level of 0.7ppm or lower in community fluoridation systems.
What is fluoride?
Fluoride is defined as a form of the element fluorine, which is attributed to ending tooth decay. Fluoride is naturally present in drinking water but can also be added in an attempt to increase health benefits; it is also present in many toothpastes.
Despite benefits to oral health, residents of many cities across the U.S. have made a case to end fluoridation in recent months due to concerns linking fluoride to neurobehavioral issues in children.
With a new bill passed Feb. 21, Utah is getting ready to set a precedent as the first state to fully ban fluoride in drinking water, according to an AP News article. The bill follows comments from Robert F. Kennedy Jr., the U.S. secretary of health and human services, who said President Donald Trump intends to call for an end to water fluoridation.
In Florida, the fight on whether to fluoridate water picked up momentum on Nov. 22 with a statement from the Florida Department of Health, which characterized fluoride as a “neuropsychiatric risk.” On the same day, Florida Surgeon General Joseph Ladapo called community fluoridated water a “public health malpractice.”
Concern about fluoride has resulted in 13 Florida cities discounting the practice as of Feb. 6, according to the Miami New Times.
Opponents of fluoride
In May, a UF study showed a connection between fluoride exposure and neurobehavioral issues in young children. The research found that increased fluoride levels present in pregnant women’s urine was associated with nearly double the odds of children scoring in the clinical or borderline clinical range for neurobehavioral problems at age 3.
The findings show there should be a recommendation in place for limiting fluoride exposure during pregnancy, said Ashley Malin, the study’s lead investigator and an assistant professor in the department of epidemiology in the UF College of Public Health and Health Professions and the UF College of Medicine.
“The developing brain is known to be particularly vulnerable to environmental toxicant exposures in general,” she said.
There’s still a lot of uncertainty in how much fluoride, if any, is safe for consumption, she said.
According to a National Toxicology Report, there’s a consistent association of lower IQ levels in children when fluoride levels exceed the World Health Organization’s guidelines of 1.5 milligrams per liter; however, the same report said it’s currently inconclusive whether lower levels of fluoride could have the same effect.
Additionally, a Cochrane study from 2024 suggested the dental benefits of adding fluoride into water have diminished with the increase in widely available fluoridated toothpaste, meaning fluoridated water may no longer be necessary.
The decision of whether or not to fluoridate water is currently being debated across the U.S. because of new scientific evidence, Malin said.
“Is this many IQ points or this many neurobehavioral problems…worth saving that quarter of a tooth?” She said. “I think that's kind of what's being debated right now, along with the question of … who gets to decide whether the benefits outweigh the risks?”
Community fluoridation needs to end, said Scott Kiley, associate director of local advocacy for Stand for Health Freedom. Stand for Health Freedom is a global nonprofit that deals with matters of “health freedom,” such as informed consent, parental rights, religious freedom, freedom of speech and privacy.
The organization is active throughout the state of Florida, advocating for an end to fluoride in drinking water, Kiley said.
People should get to choose to have fluoride if they feel it’s necessary in the form of toothpaste, he said, and it shouldn’t be forced upon citizens’ water supply.
“It's not like people will lose their access to fluoride,” he said. “There's also the argument of the unethical nature of forcing a medication on the public without informed consent and without a risk benefit analysis and without the ability to opt out.”
Fluoride is only a topical treatment, Kiley said, and ingesting fluoride only harms the individual.
Proponents of fluoride
Julie Thaler, a former dentist and Gainesville resident, said she saw firsthand how communities suffer without fluoridated water when she was in dental hygiene school in Tallahassee.
“I realized that kids had rampant decay, and adults did, too,” she said. “I was wondering about that, and I was told at the time that Tallahassee did not have fluoride in the water.”
Keeping fluoride in the water is the easiest and safest way to protect dental health, she said. It's for the good of the public, she said, and it's “categorically untrue” that the current mandated fluoride levels cause harm.
To Rafael Garcia, a 21-year-old UF microbiology senior and UF College of Dentistry research assistant, fluoridated water shouldn’t be a debate.
Fluoride is already naturally occurring in water, he said, and the added fluoride helps prevent dental disease. Fluoride, like any chemical, can be harmful in large amounts, he said, but with the current restrictions, the alarm around anyone who thinks fluoride is harmful is misguided.
The current levels were determined through rigorous testing, Garcia said. Unless there's a dramatic increase in a health issue like cancer, of which there is not substantial evidence linking it to fluoride, there's no reason to get rid of community fluoridation, he said.
“It's easy to say that if I tested fluoride at really high concentration, I can publish an article saying that fluoride causes or can cause cancer,” he said. “But if I'm not making it clear in my headline that I'm using a concentration that's well above average, then the common person that isn't used to these kinds of things can think that that is indeed the fact.”
If fluoride is used at the recommended safety levels, there should be no concern, he said, and anyone who thinks differently has fallen victim to misinformation.
Gainesville dentist Bertram Hughes has previously spoken at GRU meetings in favor of continuing fluoridation. If you look at the science, fluoride isn’t “medicating them,” he said, it’s helping prevent cavities.
In his line of work, Hughes said he can easily see which patients come from communities without fluoridated water due to the prevalence of dental disease.
Children seen without fluoridated water have dental cavities and need root canals, he said, procedures they shouldn't have to experience at such a young age.
Fluoridated systems are one of the greatest public health achievements when at the optimal level, he said.
“There's parts of this world, or even in our country, that are naturally fluoridated above the optimum levels,” he said. “In these areas, we don't see the effects that the people are out talking about without any scientific evidence.”
Contact Morgan Vanderlaan at mvanderlaan@alligator.org. Follow her on X @morgvande.
Morgan Vanderlaan is a second year political science major and a Spring 2025 metro general assignment reporter. She has previously worked on the enterprise desk as a political reporter and on the county and city commission beat. When she's not on the clock she can be found writing, reciting and watching theatre!
