Fluoride and Your Health: The Good and the Bad

The debate around fluoride never seems to go away. Is the mineral good for us? Bad for us? Is adding it to drinking water a sensible public health policy? Or oppressive, forced medication?

The current White House administration seems to side with the more dubious of these opinions. In April, Robert F. Kennedy Jr., the US’s Secretary of Health and Human Services, announced that he will direct the US Centers for Disease Control and Prevention (CDC) to recommend against fluoridating water.

With a fluoride skeptic now steering US health policy, let’s take a closer look at the facts on fluoride.

A brief history of fluoride

Fluoride is a mineral, naturally present in soil and rocks.

Its dental benefits were discovered in the early 1900s by a particularly investigative dentist called Dr. Frederick McKay. Upon opening his practice in Colorado Springs, he was astonished to find that most of the town’s children had discolored brown teeth (dental fluorosis) but no signs of dental decay (caries).

Driven by a suspicion of the town’s water supply, McKay began to gather water samples across the nearby Colorado communities and document the prevalence of tooth discoloration in the children living there.

By 1931, with the help of colleagues and testing carried out by the aluminum manufacturer Alcoa, McKay proved that the drinking water of affected towns was naturally high in fluoride.

It was thus deduced that fluoride could a) turn children’s teeth brown and b) protect the teeth from decay. It seemed an invaluable asset to dental hygiene had just been uncovered.

To learn more, the fluoride-research baton was passed into the hands of one Dr. H. Trendley Dean, head of the Dental Hygiene Unit at the National Institute of Health , who began running studies to find the ideal amount of fluoride in water that would protect against caries but not lead to brown discoloration.

“Dean conducted research in 21 cities and identified a level of 1 ppm [parts per million] of fluoride as a balance of benefits of protection against dental decay and acceptable levels of dental fluorosis,” Loc Do, a professor in dental public health and director of research at the University of Queensland’s School of Dentistry School, told Technology Networks.

With this ideal level set, work gradually got underway to introduce fluoride into US public water sources that were naturally low in the mineral. Finally, in 1945, Grand Rapids, Michigan, became the first city in the country – and the world – to implement water fluoridation.

And that’s when people started to object.

A brief history of fluoride opposition

“Forced medication” was un-American, according to some pundits. Other critics went further, likening the public health policy to a communist plot.

It wasn’t long before this kind of rhetoric spread to other countries.

In Ireland, one plaintiff argued that water fluoridation infringed on their right to bodily integrity. The country’s Supreme Court ultimately held in 1965 that fluoridation did no such infringing. Over in the Netherlands, however, the Dutch Supreme Court declared fluoridation of drinking water unauthorized in 1973.

Fast forward to 2025 and the same libertarian arguments (and occasional conspiracy theory) are still being made, and gaining sway. Utah recently became the first US state to ban fluoride in drinking water, with Florida following as a close second.

Outlining the state’s new stance against the mineral, Florida Governor Ron DeSantis said his local government was prioritizing individual liberty.

“Yes, use fluoride for your teeth, that’s fine, but forcing it in the water supply is basically forced medication on people,” he said in May during a news conference on the state ban.

And yet most other US states and many other countries still champion water fluoridation and its public health benefits.

So, whose argument wins out? Let’s take a look at the research.

Is fluoride good for us?

As demonstrated all those years ago in Colorado Springs, fluoride can reverse the progression of dental caries and stimulate new bone formation.

This quality makes the mineral valuable in preventing and treating caries in children, whose bones and teeth are more vulnerable as they grow.

This, say many experts, is why public water fluoridation is so vital: it can help prevent children getting caries in the first place.

Research largely supports this argument.

Published in JDR Clinical & Translational Research in 2019, one review of 32 studies found that children who lived in areas with fluoridated water tended to have lower levels of caries than those who didn't.

“It protects against dental decay just by drinking water, a physiological act,” Do told Technology Networks.

Crucially, these dental benefits don’t appear to come at any health cost during childhood. Published in Public Health in 2023, one meta-analysis on the cognitive effects of fluoride exposure on children found the mineral was not associated with lower IQ scores.

“The current evidence is clear that water fluoridation is safe,” Do stressed.

“This passive delivery mode [water fluoridation] ensures that everyone in the population benefits from dental decay protection, regardless of their socioeconomic status and abilities.”

This last point is a salient one, as children growing up in deprived areas can have a three-times higher risk of developing caries than children from less deprived areas.

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Is fluoride, in any way, bad for us?

Clearly, though, the mineral still has at least one downside: a risk of causing dental fluorosis.

Is this effect anything to be concerned about? Not according to Do.

“The only confirmed risk of fluoride at this level is dental fluorosis,” he said, “which is developed when young children consume fluoride from different sources.”

Cases of dental fluorosis have gone up in the US since the introduction of water fluoridation and fluoride-containing toothpaste. The CDC has estimated that, between 1999 and 2004, the condition affected a significant proportion of teenagers (41%) and a minority of older adults (8.7% of those aged 40–49).

Most of these cases, however, were deemed mild (white spots on tooth enamel) and far from the severe cases (brown spots) first witnessed by McKay in Colorado Springs.

“The levels of dental fluorosis in populations with fluoridated water are mostly very mild to mild, and do not negatively impact health and quality of life,” Do added.

The future of fluoride

Seemingly, though, those that decry fluoridated water aren’t even interested in its potential cosmetic drawbacks. Instead, opponents like Governor Desantis and Stephanie Gricius – the Utah representative who introduced the bill to ban fluoridated water in the state – argue that individual liberty should always override any policy of “forced medication”.

But, as outlined by the relevant research and experts, this highly libertarian sentiment comes at the risk of children’s dental health.

“The developments in the US are examples of when health decision-making processes are politicized,” Lo told Technology Networks.

“A simulation study estimated that cessation of public water fluoridation in the US would increase dental decay and health system costs. Such increases will more likely impact those populations at higher risk of having dental diseases.”

This scenario has already played out in other jurisdictions, notably Calgary, Canada.

Back in 2011, the city’s council voted to remove fluoride from its drinking water. Since then, the rate of caries in children has significantly increased. Published in Community Dentistry and Oral Epidemiology in 2021, one study found that 64.8% of children sampled in the city had carries, compared to 55.1% of children sampled in the city of Edmonton (which still fluoridated its water).

In light of research like this, Calgary City Council reintroduced fluoride into the city’s drinking water on June 30, 2025.

Whether Utah and Florida mirror this Canadian case study remains to be seen.