It’s been considered one of the greatest public health achievements of the 20th century: by putting a small amount of fluoride in the water supply, public health officials have prevented millions of cavities, saved tens of billions of dollars in dental costs, and made children healthier.
But in a post on X on Saturday, former presidential candidate Robert F. Kennedy Jr. said one of his first acts as an official in a new Trump administration would be to “advise all U.S. water systems to remove fluoride from public water.” He went on to list several false statements about the effects of fluoride and then linked to a video on a website founded by prominent anti-vaccine advocate and conspiracy theorist Del Bigtree.
Former President Donald Trump appeared receptive to the idea of nixing fluoride from the water supply. “Well, I haven’t talked to him about it yet, but it sounds OK to me,” Trump said Sunday in a telephone interview with NBC. “You know, it’s possible.”
Experts were swift to condemn the promise to remove fluoride from the water. “Fluoride has been well tested. It clearly and definitively decreases cavities, and is not associated with any clear evidence of the chronic diseases mentioned in that tweet,” says Dr. Paul Offit, a researcher and physician at Children’s Hospital of Philadelphia.
“Robert F. Kennedy Jr. is a science denialist. He makes up his own scientific truths and ignores the actual truths,” Offit says.
Fluoride has clear benefits
The science is unambiguous – adding fluoride to the water supply has been effective in lowering the number of cavities in both children and adults. Fluoride works to restore minerals to teeth that are lost when bacteria grow rapidly inside the mouth, particularly after consuming sugary snacks.
More than a dozen recent studies from governments and academic institutions around the world have found that fluoride reduces tooth decay in children and adults by around 25%, according to the American Dental Association. It is particularly beneficial for those in lower-income families who may not have access to fluoride products, such as toothpastes and mouth rinses. A study by the Colorado School of Public Health found that adding fluoride to the water saved roughly $6.8 billion dollars in dental expenses in one year alone.
In recent years, some studies have suggested that high levels of fluoride might cause lower IQ in children. A recent government review found moderate evidence for the effect, but not at the levels currently used in U.S. drinking water. The ADA says that the benefits of fluoridation continue to outweigh any possible risks.
Stark contrasts
Dr. Amanda Stroud is a dentist who sees the effects of fluoride – and its absence – every day in her job working as dental director at a health nonprofit in western North Carolina. AppHealth serves kids who have fluoridated city water and others who have well water that has no fluoride. The differences are stark, she says.
The children who are drinking water that has fluoride, she says, often have a good, solid set of teeth without cavities. They can take smiling and eating without pain for granted, “which is a joyful thing at that age,” Stroud says.
When children are drinking well water, it’s a different story. “They could possibly have decay on every tooth,” she says. “When they smile, they could possibly have teeth broken down to the gum line. Their teeth are appearing brown or mottled.”
And that is a painful condition that makes brushing and eating healthy foods like fruits and vegetables more difficult. “It's heartbreaking,” she says.
The original public health conspiracy theory
Despite the clear benefits, conspiracy theories around fluoride have existed for almost as long as the water has been fluorinated, according to Matthew Dallek, a political historian at the George Washington University.
“In a way the conspiracy theory about fluoride in the drinking water is one of the original public health conspiracy theories,” he says.
Fluoride was first introduced in 1945 in Grand Rapids, Michigan, which also happens to be the Trump campaign's last rally site before election day.
Putting fluoride in water quickly spread around the country once the benefits were clear in Grand Rapids.
But right from the start, wild theories about the chemical were circulating. “It served as an almost perfect conspiracy theory,” he explains. Fluoride was unseen, mandated by the government, and present in tap water, a substance that pretty much everyone was ingesting.
Dallek says that the theories were particularly pushed in the 1960s by the John Birch Society, a far right group that alleged communists had infiltrated much of the government. The group believed that “any step towards government interventions was essentially a step on the road to a communist country,” he says. As a result, they “latched on to fluoride as part of a communist plot.”
The claims around fluoride were diffuse, but included the ideas that it would somehow be used for mind control, or that it was a chemical weapon designed to poison people. Initially, at least, the ideas seemed to find some traction with the public.
“There were movements that sprouted up all over the country to stop fluoridation in the drinking water,” Dallek says.
In 1966, Honolulu’s government vetoed a measure to include fluoride in the water. Fluoride still isn’t used in Hawaii and a 2015 report found that the state had the highest rate of tooth-decay among children in the nation, and it continues to have some of the worst oral health of any state.
Mocked in movies
But the movement never caught on more broadly. The fluoride conspiracies were openly mocked in movies such as Stanley Kubrick’s “Dr. Strangelove,” in which General Jack Ripper starts a nuclear war in part over a belief that fluoride was a communist plot. By the 1980s, the issue largely died away. “Occasionally there were anti-fluoride campaigns that would pop up around the country,” Dallek says.
But in the wake of the COVID-19 pandemic, fluoride conspiracy theories have resurfaced, often pushed by individuals such as Kennedy who also believe that childhood vaccines cause autism and other diseases. Today, anti-vaccine advocates push the harms of fluoride along with those of vaccines and chemtrails, supposed trails of chemicals left by commercial airliners to harm people and the environment.
Kennedy on Monday posted a video urging his supporters to vote for Trump so he’s elected with a strong mandate. “Then, no one will be able to stop us when he empowers me to clean up corruption in the federal agencies, and especially our health agencies,” he said.
But Offit says that Kennedy’s potential role in leading the nation’s public health could prove disastrous, particularly for young people who benefit from both fluoride and vaccines. “It’s only the children who will suffer his ignorance,” Offit says.
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