SALT LAKE CITY—Utah is set to become the first state in the United States to ban fluoride from its public drinking water, a move that has sparked widespread opposition from dentists and health organizations across the nation. Republican Governor Spencer Cox has announced that he will sign legislation into law that will prevent cities and communities in Utah from deciding whether or not to add fluoride to their water systems.
Fluoride has long been praised for its ability to strengthen teeth and reduce cavities. The mineral helps replace minerals that are lost during normal wear and tear on teeth, according to the U.S. Centers for Disease Control and Prevention (CDC). Adding low levels of fluoride to drinking water has been hailed as one of the greatest public health achievements in the past century, as it is considered an effective way to reduce tooth decay. Government researchers have even found that community water fluoridation can prevent about 25% of tooth decay.
Brad Kessler, the president of the American Dental Association, emphasized the importance of fluoride in preventing dental issues. He said that the scientific evidence supporting the safety and efficacy of this public health measure is clear. He also warned that if Utah stops fluoridating its water, cavities could begin to appear in children within months or even years, which would lead to long-term dental problems for the state’s population.
Governor Cox, however, stated that while he may not feel strongly about the issue, he would still sign the bill. “It’s not a bill I care that much about, but it’s a bill I will sign,” he said. Supporters of the bill, including some Utah lawmakers, argue that fluoridating the water is too expensive.
Republican Representative Stephanie Gricius, who sponsored the bill, acknowledged the benefits of fluoride but said that it is ultimately a matter of “individual choice” for communities to decide whether or not to include fluoride in their water supply.
Governor Cox mentioned that he grew up and raised his own children in a community where fluoride was not added to the water. Despite the lack of fluoride, he pointed out that there has not been any noticeable difference in the oral health of residents in those areas compared to those who receive fluoridated water.
“You would think you would see drastically different outcomes with half the state not getting it,” he said. “We haven’t seen that,” he added. He stressed that the government must have a strong justification for mandating any medication or public health measure for its citizens.
Currently, over 200 million people in the United States, or around 63% of the population, receive fluoridated water through community systems. However, a growing number of cities across the country are beginning to remove fluoride from their water supplies, and other municipalities are considering doing the same. Just a few months ago, a federal judge ordered the U.S. Environmental Protection Agency (EPA) to regulate fluoride in drinking water, as high levels of the mineral could pose risks to children’s intellectual development.
The issue gained added attention when a teenager from Utah testified in favor of the bill, citing a medical emergency that occurred when a fluoride pump in Sandy, Utah malfunctioned in 2019. The malfunction caused an excessive amount of fluoride to be released into the drinking water, which resulted in hundreds of residents falling ill. This incident led many in the state to push for the removal of fluoride from the water supply altogether.
Although high levels of fluoride are rare in public water supplies, the National Institutes of Health (NIH) has stated that it is virtually impossible to consume a toxic dose of fluoride from water containing standard levels of the mineral. Kessler, the president of the American Dental Association, confirmed that the amounts of fluoride added to drinking water are well below the levels that could cause harm.
According to an analysis by the Associated Press, in 2024, 66 of Utah’s 484 water systems reported adding fluoride to their water. Salt Lake City, the state’s largest city, was one of those that fluoridated its water. Rodney Thornell, the president of the Utah Dental Association, recalled that he began practicing dentistry in Salt Lake City before the city added fluoride to its water supply.
He noted that adult patients who grew up in the area before fluoridation continued to experience a high number of cavities, while younger patients who grew up with fluoridated water had fewer dental issues.
“If we’re going to keep eating sugar, we need fluoride,” Thornell said, pointing out that Utah residents tend to consume more candy and sugary drinks than the national average. He also emphasized that the science shows fluoride is highly effective at reducing cavities and carries little to no risk of other health problems.
Many opponents of the fluoride ban argue that the decision will disproportionately affect low-income residents. For many low-income families, public drinking water with fluoride may be the only source of preventative dental care. These families may not be able to afford regular dental visits or fluoride tablets, which are often used as a supplement in areas that do not add fluoride to their water.
Lorna Koci, who chairs the Utah Oral Health Coalition, argued that fluoridation is the most cost-effective way to prevent tooth decay on a large scale. She also pointed out that Utah ranked 44th in the nation for the percentage of residents who receive fluoridated water, with only about two in five Utah residents having access to fluoridated water through community systems in 2022.
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