U.S. Regulators Begin Removing Fluoride Supplements for Children Amidst Controversy
The landscape of preventative dental care in the United States is undergoing a significant shift as federal health regulators initiate the process of removing ingestible fluoride supplements for children from the market. This move, spearheaded by Health Secretary Robert F. Kennedy Jr., marks the latest development in his ongoing campaign against the use of fluoride, a mineral traditionally hailed for its tooth-strengthening properties.
The U.S. Department of Health and Human Services, in a news release issued on May 13, announced that the Food and Drug Administration (FDA) is commencing a phase-out of concentrated ingestible fluoride prescription drug products. These supplements, typically administered orally via tablets or drops, are often prescribed to children considered to be at high risk of developing dental cavities and tooth decay, particularly those residing in areas where the public water supply lacks fluoridation.
The FDA’s decision to remove these supplements from the market stems from the agency’s assertion that they have not received formal approval. Further fueling the decision, FDA Commissioner Marty Makary suggested that these supplements might negatively impact a child’s gut microbiome. Makary cited studies indicating a potential correlation between the ingestion of fluoride and various health concerns, including thyroid disorders, weight gain, and even a possible decrease in IQ.
Health Secretary Kennedy Jr. has been a vocal critic of fluoride, stating that "Ending the use of ingestible fluoride is long overdue." He framed this decision as a step towards fulfilling President Trump’s promise to “Make America Healthy Again,” positioning his opposition to fluoride as part of his broader “Make America Healthy Again” movement, which seeks to address what he describes as a “chronic disease epidemic.”
However, Kennedy’s stance on fluoride has drawn significant criticism from scientists, dental health organizations, and public health experts. These groups have cautioned that his recommendations against fluoride are detrimental to public health.
Erin Haley-Hitz, President of the American Dental Hygienists Association, responded to the FDA’s announcement by emphasizing that "Rationales for limiting use should be based on evidence, and there is no scientific evidence that fluoride at low levels affects gut microbiota." She further warned that "Removing fluoride resources will create unprecedented challenges for oral disease prevention in underserved areas."
The American Dental Association (ADA) has also reaffirmed its commitment to community water fluoridation as a crucial measure for preventing tooth decay, as reported by Reuters. The ADA and numerous other health organizations cite extensive research demonstrating the safety and effectiveness of fluoride in preventing dental caries.
The FDA has established a target date of October 31 for concluding a safety review and public comment period regarding the measure. This period will allow stakeholders to voice their opinions and provide additional evidence to support or challenge the agency’s decision.
The debate surrounding fluoride use extends beyond supplements and also encompasses the fluoridation of public water supplies. The article referenced a broader trend in the United States, noting that "As bans spread, fluoride in drinking water divides communities across the US."
Fluoride’s primary mechanism of action involves strengthening the tooth’s enamel, the hard outer layer, making it more resistant to the acids produced by bacteria in the mouth, which are the primary cause of tooth decay. Additionally, fluoride can reverse early stages of tooth decay by replenishing and preventing the loss of essential minerals.
Historically, before the widespread adoption of community water fluoridation, dental decay and cavities were a prevalent health issue affecting a significant portion of the United States population, according to Johns Hopkins Bloomberg School of Public Health. Public health officials subsequently recommended water fluoridation after research conclusively demonstrated its effectiveness in reducing tooth decay rates.
The Centers for Disease Control and Prevention (CDC) has recognized the fluoridation of drinking water as one of the "10 greatest public health achievements" of the 20th century, attributing it, in part, to the significant increase in Americans’ life expectancies during that period.
Over 100 health organizations, including the CDC, American Medical Association, World Health Organization (WHO), American Academy of Pediatrics, and the ADA, consistently maintain that water fluoridation is both safe and effective. Studies have shown that community water fluoridation can reduce tooth decay by more than 25% in both children and adults, even in an era where fluoride is readily available in various dental products.
Secretary Kennedy’s views on fluoride extend to broader claims about its potential negative impacts on health. He has endorsed claims that fluoride is linked to a range of health conditions, including ADHD, hypothyroidism, and reduced IQ. These claims have been strongly refuted by dentists and epidemiologists, who argue that they lack scientific validation and warn that removing fluoride from water systems could have serious consequences for public health.
In April, Kennedy indicated his intention to advise the CDC to cease recommending that cities and states add fluoride to public water systems. However, it is important to note that adding fluoride to water is not mandated by law.
Several states have already taken steps to limit or ban fluoride in public water systems. Utah became the first state in the U.S. to ban fluoride in public water systems after Governor Spencer Cox signed legislation in March, with the law taking effect on May 7. Florida is poised to become the second state to ban fluoride from public water supplies, as Governor Ron DeSantis announced his plan to sign a similar bill into law, expected to take effect on July 1.
The move to remove ingestible fluoride supplements for children and the broader debate over water fluoridation highlight a significant divide in perspectives regarding public health interventions. While proponents emphasize the proven benefits of fluoride in preventing tooth decay, opponents raise concerns about potential risks and advocate for individual choice. The FDA’s ongoing safety review and public comment period will play a crucial role in shaping the future of fluoride use in the United States. The outcome will undoubtedly have significant implications for oral health, particularly for vulnerable populations who rely on these preventative measures.
