Florida surgeon general calls for halting fluoride in water, echoing RFK Jr. (WaPo)

Our City of St. Augustine, Florida rejected 1960s efforts to add fluoride to public water supplies.  Wise choice.  On this occasion, I agree with Dr. Ladapo and RFK, Jr. Of course, a stopped clock is right twice a day.  The New York Times Magazine reported on fluoride's feculent history as an additive.  The proof seems irrefragable.  What do you reckon?

Florida surgeon general calls for halting fluoride in water, echoing RFK Jr.

The state’s top health official cited controversial studies that suggest the widely hailed public health practice poses a risk to developing brains.

5 min

Florida surgeon general Joseph A. Ladapo is recommending fluoride be removed from the state's water. (Chris O'Meara/AP)

By Fenit Nirappil

 and 

Dan Diamond

Updated November 22, 2024 at 4:15 p.m. EST|Published November 22, 2024 at 4:11 p.m. EST

The top health official of the nation’s third-largest state called Friday for a halt to adding fluoride to Florida’s water, citing controversial studies that suggest the widely hailed public health practice poses a risk to developing brains.

Surgeon General Joseph A. Ladapo issued a recommendation citing “the neuropsychiatric risk associated with fluoride exposure, particularly in pregnant women and children,” and noting the availability of alternative sources of fluoride in toothpaste and mouthwash.

“It is clear more research is necessary to address safety and efficacy concerns regarding community water fluoridation,” Ladapo said in a statement. “The previously considered benefit of community water fluoridation does not outweigh the current known risks, especially for special populations like pregnant women and children.”

Ladapo’s announcement comes three weeks after Robert F. Kennedy Jr., who is President-elect Donald Trump’s choice to lead the Department of Health and Human Services, said the Trump administration plans to issue a similar recommendation nationwide next year. Kennedy’s remarks drew rebukes from public health experts who say that the practice has helped protect Americans’ teeth, particularly in vulnerable communities where children might not regularly brush their teeth.

“It’s madness,” said Kurt Ferré, a retired Portland, Oregon, dentist and longtime pro-fluoridation activist. He said Florida’s seniors especially benefit from fluoride because of the oral health issues that come with age and medical care for older adults.

The Centers for Disease Control and Prevention has long recommended putting fluoride in Americans’ drinking water, hailing it as one of the 10 great public health achievements of the 20th century and citing data that the practice reduces cavities by about 25 percent in children and adults. The water systems of more than 200 million Americans are fluoridated, according to CDC data.

Fluoridation has been a key public health strategy for decades, and proponents have pointed to studies showing oral health problems declining in cities that added the mineral and rising in communities that removed it.

The U.S. Public Health Service in 1962 recommended adding small amounts to drinking water to strengthen teeth and replace minerals lost to routine wear and tear. The decision to add fluoride to drinking water generally rests with local communities.

“Decades of sound scientific research proves the safety and effectiveness of fluoridation and underscores the importance of continuing community water fluoridation for the well-being of Florida residents,” Jeff Ottley, president of the Florida Dental Association, said in a statement responding to Ladapo.

The anti-fluoride movement has gained traction in recent years, including in Florida, as voters and politicians have rebelled against the addition of the mineral to drinking water. City commissioners in Winter Haven in Central Florida voted this month to remove fluoride. Naples, Florida, is poised to stop fluoridating its water after the city council voted 4-3 this month in a preliminary action to end the practice.

Rick North, a board member of Fluoride Action Network, a national organization that opposes fluoridation, said Ladapo’s move marks a major milestone in the movement: the first time a state health leader has come out against fluoridation.

“I just hope it doesn’t get caught up in some liberal-conservative narrative and that people just concentrate on the science,” said North, who recently advised activists who defeated a ballot measure to fluoridate water in Hillsboro, Oregon.

Ladapo, Florida’s surgeon general since 2021, has repeatedly defied public health practices — such as failing to urge parents to vaccinate their children or keep unvaccinated students home from school during a recent measles outbreak — drawing scorn from public health experts who say his decisions imperil Floridians.

Kennedy has praised Ladapo, recently telling reporters that the Florida surgeon general had been on a list of potential candidates to be selected as HHS secretary before Kennedy was picked. Ladapo remains under consideration for a senior government role and has been discussed as a top deputy under Kennedy, director of the CDC or U.S. surgeon general, according to two people who spoke on the condition of anonymity to discuss private conversations.

Some recent studies have cast doubt on the benefits of fluoride while raising concerns about health consequences.

A review of research by the Cochrane Library, considered the gold standard for evaluating medical literature, determined the benefits of water fluoridation have shrunk in recent decades as fluoridated toothpaste has become widely available. As a result, the review found, fluoridated water offers slight reductions in cavities and tooth decay.

The side effect garnering the most attention from reputable authorities is a possible drop in children’s IQ after the federal National Toxicology Program concluded with “moderate confidence” that higher levels of fluoride are associated with lower IQ in children based on research. The report cautioned that there was insufficient data to determine if that association occurs in levels used in the United States. It also did not go as far as Ladapo’s recommendation about other potential risks to Americans.

Fluoride proponents have argued these studies should not be used to justify ending fluoridation because many occurred in communities outside the United States with fluoride levels considered excessive by public health authorities.

U.S. health officials in 2015 lowered the recommended amount of fluoride in drinking water, saying it was less necessary given other available sources of fluoride. A federal judge in September ordered the Environmental Protection Agency to further regulate fluoride in drinking water, saying there was potential risk to children’s developing brains. The judge noted that his finding “does not conclude with certainty that fluoridated water is injurious to public health.”

“The more people know about fluoridation, the more they are opposed to it,” said North, the anti-fluoride activist. “Fluoridation is a house of cards, and it is going to fall.”

By Fenit Nirappil

Fenit Nirappil is a reporter for the Health & Science team who covers public health, infectious diseases and LGBTQ issues. He previously covered local politics. follow on X @FenitN

By Dan Diamond

Dan Diamond is a national health reporter for The Washington Post. He joined The Post in 2021 after five years at Politico, where he won a George Polk award for investigating the Trump administration's response to the coronavirus pandemic.follow on X @ddiamond

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