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The Benefits of Fluoride: Addressing Public Concern and Supporting Topical Use
1Associate Professor and Director, Division of Biomaterials, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama.
Compendium of Continuing Education in Dentistry (Jamesburg, N.J. : 1995)
|March 2, 2026
Summary
Fluoride in drinking water, once a public health triumph for preventing cavities, faces new scrutiny. Recent studies link it to reduced IQ in children, prompting policy changes and a review of its use and alternatives.
Area of Science:
- Public Health
- Toxicology
- Environmental Science
Background:
- Community water fluoridation has historically reduced dental caries.
- Recent findings from the National Toxicology Program (NTP) raise concerns about fluoride's safety.
- Policy shifts and legal actions are questioning the established use of fluoride.
Purpose of the Study:
- To review the historical context of fluoride in public health.
- To examine the evidence for and against fluoride in water and oral health products.
- To assess current criticisms and explore alternatives to fluoride for caries prevention.
Main Methods:
- Literature review of historical data on fluoride and dental health.
- Analysis of recent toxicological studies and policy documents.
- Evaluation of scientific evidence on fluoride alternatives.
Main Results:
- NTP monograph (August 2024) reported fluoride above 1.5 mg/L linked to lower child IQ.
- US district judge mandated EPA action on "unreasonable risk" of water fluoridation (September 2024).
- FDA initiated removal of ingestible fluoride products (May 2025); Utah and Florida banned water fluoridation (May/July 2025).
Conclusions:
- The long-standing public health benefits of water fluoridation are under significant challenge.
- Emerging evidence necessitates a re-evaluation of fluoride's safety and efficacy.
- Further research into fluoride alternatives for oral health is warranted.
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