Since 1945, local governments have added fluoride to public drinking water supplies to reduce the rates of tooth decay. Now, over 207 million people in the U.S. received fluoridated drinking water. That’s nearly three-quarters of the population served by community water systems.

Hailed as a major public health accomplishment of the 21st century, community water fluoridation has led to significantly less tooth cavities. Thanks to fluoridated products like toothpaste and mouthwash, we’ve also seen similar reductions in countries that don’t fluoridate drinking water.

The benefits of fluoride in preventing tooth decay are well documented, but it’s time to revisit community water fluoridation in light of new research. To that end, scientists are coming together to raise the alarm about fluoridated drinking water. The data show fluoride consumed from drinking water may have adverse neurological health impacts — especially among children.

It’s why Food & Water Watch, alongside groups including Fluoride Action Network and American Academy of Environmental Medicine, filed a petition in 2016 asking the U.S. Environmental Protection Agency (EPA) to limit or ban fluoridation. We’ve since taken them to court.

When science is constantly under attack, we need to hold our public health agencies accountable. We can ensure they review new research and make science-based decisions to protect our communities.

The Risks to Children Outweigh the Benefits of Water Fluoridation

Mounting scientific evidence suggests fluoride could have harmful neurotoxic effects. That’s especially true among formula-fed infants, the elderly, African Americans, and the undernourished. These risks include a decrease in average IQ in children, ADHD, and cognitive impairment in older populations. 

Studies in Canada and Mexico, for example, found associations between fluoride concentrations in pregnant women and health problems for their children. Those problems include lower IQ and greater risk of ADHD and inattention.

Another Canadian study found formula-fed infants in regions with fluoridated drinking water had lower non-verbal intelligence scores compared to those living in non-fluoridated regions. Because formula-fed infants consume more water than breastfed infants, and therefore more fluoride when living in fluoridated areas, they tend to be at greater risk of elevated fluoride exposure.

Additionally, regions where more people receive fluoridated drinking water have seen higher rates of ADHD in children and teens, even after adjusting for socioeconomic differences. 

The EPA Hasn’t Considered the Neurotoxic Effects of Fluoridation

Despite the emerging science, existing limits and recommendations from the EPA and the U.S. Department of Health and Human Services (HHS) for fluoride in drinking water aren’t based on the potential neurotoxicity of fluoride. They’re only based on impacts to teeth and the skeletal system.

However, several studies have found neurological effects from consumption of fluoride at concentrations considered acceptable by the EPA — less than 4 mg/L. Average IQ reductions have been observed where fluoride levels fall below EPA’s limits.

Even at lower fluoride concentrations where drinking water is “optimally fluoridated” to prevent tooth decay (0.7 mg/L), formula-fed infants could experience adverse IQ outcomes. Considering the benefits but not the drawbacks, as EPA has done with fluoridation, isn’t sound science or good policymaking.

Community water fluoridation has been a hotly controversial issue since it started over a half a century ago. What shouldn’t be controversial is the commitment to making science-based decisions to protect public health.

When the growing body of science indicates community water fluoridation may put the public at unreasonable risk, we need to assess the threat seriously. And when safer alternatives to preventing tooth decay exist, we can’t take a fluoridation ban off the table.

For more information about fluoride in drinking water, read our FAQ.