Utah is set to become the first state in the U.S. to ban the addition of fluoride to public water supplies after Governor Spencer Cox announced his intention to sign a bill prohibiting the practice. The law, expected to take effect in early May, has reignited long-standing debates over water fluoridation, with public health advocates emphasizing its benefits and opponents arguing for personal choice.
Fluoride is commonly added to municipal water to strengthen tooth enamel and prevent cavities, but its use has been politically controversial for decades, writes The New York Times.
The passage of the Utah bill comes roughly two weeks after the confirmation of Robert F. Kennedy, Jr., as health secretary. In November, Mr. Kennedy vowed that the Trump administration would “advise all U.S. systems to remove fluoride from public water.”
In 2022, about 44 percent of Utah residents supplied with public drinking water were drinking fluoridated water. Fluoride is added to drinking water because it prevents cavities, a benefit first observed over a century ago. The Centers for Disease Control and Prevention has heralded water fluoridation as one of the 10 greatest public health achievements of the 20th century.
“The evidence that addition of fluoride to the water reduces cavities and tooth decay is unequivocal,” said Dr. F. Perry Wilson, a physician and chronic disease epidemiologist at the Yale School of Medicine.
Opponents of water fluoridation, including Mr. Kennedy and Utah State Representative Stephanie Gricius, who introduced the bill, argue that the chemical could have harmful neurological effects on fetuses and young children. In a recent review paper, researchers with the National Institutes of Health analyzed the results of 74 studies and concluded that high levels of prenatal or childhood fluoride exposure were linked with lower IQ scores in childhood.
However, the fluoride levels linked to lower IQ scores were twice the concentration recommended by the CDC for water fluoridation. Dr. Wilson noted that such high fluoride exposure is typically not the result of community water fluoridation but rather natural contamination from water flowing over rocks and soil.
Republican Representative Stephanie Gricius, who sponsored the bill, framed it as a matter of individual autonomy. She pointed out that fluoride is federally regulated as a prescription and argued that people should have the right to decide whether to consume it. The new law will allow residents to obtain fluoride tablets from pharmacists if they wish to continue using it.
Currently, only two of Utah’s 29 counties fluoridate their water, yet they account for about half of the state’s population. Public health experts warn that removing fluoride could lead to an increase in dental disease. The American Dental Association urged Governor Cox to veto the bill, citing Utah Department of Health data showing higher rates of dental issues in non-fluoridated areas. The CDC estimates that water fluoridation saves about $6.5 billion annually in dental treatment costs nationwide.
Utah’s decision could influence other states considering similar legislation, particularly amid growing skepticism toward government-mandated public health policies. Whether the ban will lead to noticeable public health consequences or spark efforts to overturn it remains uncertain.
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