For over 80 years, adding fluoride to water has been one of the most effective ways to protect dental health. It reduces the number of cavities by 25% and strengthens teeth. This practice protects millions of people, especially those who do not have access to regular dental visits. However, some U.S. states have begun removing fluoride from water, which could halt decades of progress. New research suggests that this decision could lead to more than 25 million additional cavities and an extra $10 billion in costs over the next five years.
Dental caries is one of the most common chronic diseases globally. Fluoride protects teeth by strengthening their enamel and helping to repair damage caused by acids produced by bacteria. Without it, the number of cavities increases sharply, especially in low-income families whose children need this free protection the most.
Despite a strong scientific consensus and the support of major healthcare organizations such as the American Dental Association and the World Health Organization, water fluoridation has been stopped in some states. These organizations confirm that fluoride in water at recommended levels is safe, effective, and economical. Unfortunately, the spread of misinformation and conspiracy theories that link fluoridation to neurodevelopmental problems in children have led to its restriction. However, these claims are based on research where fluoride levels are much higher and do not meet U.S. standards, as well as on large-scale misinformation campaigns.
New research published in the journal JAMA Health Forum predicted that stopping water fluoridation would lead to a sharp increase in cavities and dental treatment costs. Medicaid, which is already struggling to provide services to vulnerable children due to a lack of resources, will face a serious challenge. In regions where fluoridation has been halted, dental treatment costs have increased by almost 50%.
In addition to costs, removing fluoride exacerbates social inequality. It offers a rare preventive benefit that is accessible to everyone regardless of socioeconomic status. The loss of this protective factor will increase the gap between high-income families, who have the opportunity to visit a private dentist, and low-income families, where dental services are less accessible.
