EPA’s fluoride review fast-tracked: What does it mean for your water?

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The Environmental Protection Agency is expediting a health assessment on fluoride in drinking water that would normally have taken place in 2030, the agency announced on Jan. 22.

A federal judge ordered the EPA to conduct the review in 2024, following a report from the National Toxicology Program linking high levels of fluoride in drinking water to lower IQs in children.

Many experts have questioned the quality of the studies used for this report. The report summarized studies conducted in Canada, China, India, Iran, Pakistan and Mexico, and looked at fluoride levels over 1.5 milligrams per liter, more than twice the Centers for Disease Control and Prevention’s recommended level for drinking water of 0.7 mg/L.

David Allnutt, a former EPA division director who worked on Safe Drinking Water Act implementation, told Planet Detroit that the EPA’s only role is to set the maximum contaminant level for fluoride, currently 4 mg/L. The decision over whether to fluoridate drinking water is otherwise left to states and municipalities.

If the maximum allowable level were lowered, it could affect areas such as West Texas, where Undark reports that the source water contains high levels of naturally occurring fluoride.

Allnutt doubted the maximum allowable fluoride level would be lowered enough to impact municipalities fluoridating their water at the CDC’s recommended level.

Yet, the EPA’s review comes amid widespread public skepticism about water fluoridation, with cities such as Wyandotte and Grayling discontinuing the practice. Dental experts have told Planet Detroit that water fluoridation is a crucial intervention for preventing cavities, especially for children, older adults, and those with limited access to dental care.

U.S. Health Secretary Robert F. Kennedy Jr. has a history of opposing drinking water fluoridation, previously calling fluoride a “dangerous neurotoxin” and saying he would advise the CDC to stop recommending the practice.

EPA Administrator Lee Zeldin said in the fluoride review announcement that the agency is “working in lockstep with Secretary Kennedy.” Kennedy was also quoted in the press release, saying growing evidence shows ingesting fluoride can cause neurological harm, while most of its benefits come “almost entirely from topical contact.”

Jess Kramer, EPA assistant administrator for the Office of Water, said in a webinar hosted by the group MAHA Action that the fluoride review will “only focus on potential harmful effects and will not consider beneficial effects,” Reuters reported. 

An EPA spokesperson told Planet Detroit the agency is “committed to ensuring that all Americans can rely on safe drinking water while supporting water affordability, and the Trump EPA is supporting drinking water systems like never before.”

Dr Judith Jones, an adjunct professor of dentistry and public health at the University of Detroit Mercy, said efforts to undermine fluoridation are an assault on one of the most well-documented health measures of the last century.

“Water fluoridation is an equal-opportunity preventive procedure that reaches all levels of society, from kids to old people,” Jones said, adding that studies show fluoridation reduces cavities by roughly 25%.

Jones challenged Kennedy’s statements on the safety of ingesting fluoride. She notes that while teeth are developing, ingested fluoride helps strengthen tooth structure, reducing grooves and fissures and making teeth more impermeable.

More broadly, fluoride helps strengthen teeth and prevent cavities by replacing minerals lost during normal wear and tear, according to the CDC.

U.S. medical groups overwhelmingly support community water fluoridation.

Research supports drinking water fluoridation, experts say

Joseph Cotruvo, former director of the EPA’s Drinking Water Standards Division, is among the health experts challenging the National Toxicology Program’s report linking fluoride to lower IQs in children.

He said the report lacks studies from the United States and looked at many countries with diverse socioeconomic environments. Some studies failed to account for other sources of fluoride in the diet and relied on unreliable IQ measurements in children, Cortuvo said.

“They didn’t see much of anything in adults in the same communities,” he said, questioning why there would be an improvement in IQ as children grow up.

Margherita Fontana, a professor at the University of Michigan School of Dentistry, previously told Planet Detroit that higher-quality studies from Sweden and Australia have not found an association between fluoride and reduced cognitive function.

Research has also shown the impacts of ceasing fluoridation.

Calgary removed fluoride from its water in 2011 and observed an increase in dental caries among children. A subsequent study found that 64.8% of Calgary second-grade children had one or more cavities in their baby teeth, compared with 55.1% in Edmonton, where the municipal water supply is fluoridated.

In 2021, 62% of Calgary voters supported the reintroduction of fluoride, and the city began adding it to drinking water again last year.

Allnutt said there was considerable irony in the EPA’s decision to expedite its fluoride review, wondering if there will be adequate personnel to conduct the review at an agency that lost over 25% of its staff in the last year.

“The agency is simultaneously rolling back standards for PFAS, which are fluorinated forever-chemicals, a different form of fluorine,” he said. “Those demonstrably cause cancer, liver damage, and environmental harm.”

An EPA spokesperson said the agency had rescinded the regulatory determinations for several types of PFAS chemicals “due to an error in the regulatory process carried out by the prior administration.”       

Alnutt said that if the agency were truly concerned about children’s health, it would make sense to start by reviewing these industrial pollutants, not fluoride.

“To me, it’s a bit of ‘show the sparkly object to hide the bigger ball’.”

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