Utah is set to become the first U.S. state to ban the addition of fluoride to public water systems, after Governor Spencer Cox confirmed he would sign the legislation.
Water fluoridation, a widely used public health measure to prevent dental caries, has been a topic of political and scientific debate for decades.
The ban, which takes effect in early May, comes amid growing discussions about fluoridation policy at the federal level. Newly appointed U.S. Health Secretary Robert F. Kennedy Jr., an opponent of public water fluoridation, has indicated that the Trump administration may seek to end the practice nationwide.
Policy and Public Health Considerations
Governor Cox, a Republican, described the bill as one he does not feel strongly about but intends to sign. "It's not a bill I care that much about, but it's a bill I will sign," he told Utah television station ABC4.
Currently, only two of Utah's 29 counties fluoridate their water. According to the bill's sponsor, Representative Stephanie Gricius (R), the legislation allows pharmacists to prescribe fluoride supplements for individuals who wish to continue using fluoride for dental health.
"I believe in individual choice when it comes to what prescriptions we put into our bodies, and fluoride is federally regulated as a prescription," Gricius stated in an email. "Community water fluoridation and informed consent, which is foundational to good health care, cannot coexist."
The American Dental Association (ADA) has urged Governor Cox to veto the bill, citing public health data. Approximately 50% of Utah’s residents live in counties with fluoridated water. The Utah Department of Health and Human Services has reported an increase in dental disease in non-fluoridated regions and a decline in areas with fluoridation.
The ADA also referenced estimates from the CDC, which suggest that water fluoridation saves approximately $6.5 billion annually in dental treatment costs.
Scientific Debate and Health Considerations
Opponents of fluoridation argue that it is linked to various health risks, including cancer and cognitive effects in children.
The American Cancer Society states that while most scientific reviews have not found strong evidence linking fluoride to cancer, further research is warranted.
In January, a meta-analysis conducted by the NIH examined 74 studies across 10 countries and reported an association between higher fluoride exposure and lower childhood IQ scores. However, an editorial accompanying the NIH report highlighted methodological limitations and cautioned against using the findings to drive public policy decisions.
A 2023 federal court ruling in California directed the EPA to enhance fluoride regulations, citing concerns about its potential risks to children at typical exposure levels. The EPA under the Biden administration has since appealed the decision.
Global and National Context
As of 2022, approximately 63% of Americans receive fluoridated water, per CDC data. Internationally, most countries do not fluoridate public water supplies; some instead add fluoride to table salt, while others have naturally occurring fluoride in their water sources.
