RFK Jr. says Trump will remove fluoride from drinking water. Here's what you should know

Now it's being called out by Robert F. Kennedy Jr. — who may be on his way to becoming the head of the incoming presidential administration's health initiatives — as a practice that should be stopped. He recently claimed that Donald Trump would push to remove fluoride from drinking water on his first day in office.

Over the weekend, Trump told NBC News he had not discussed the issue with Kennedy, saying, “But it sounds OK to me. You know it's possible.”

Speaking to NPR on Wednesday morning, Kennedy noted on Morning Edition: “We don't need fluoride in our water. It’s a very bad way to get it into our systems.”

Below is an introduction to the topic of fluoride in drinking water, its history of controversy, and what the science says about it.

What is Fluoride?

Fluoride is the chemical ion of the mineral fluorine. According to the CDC, it occurs naturally in trace amounts in soil, water, plants and some food sources, including plants and animals. It can also be released from volcanic emissions or as a byproduct in the production of aluminum, fertilizers and iron ore.

Once in the body, according to the National Institutes of Health Office of Dietary Supplements, about 80% of the food consumed is absorbed in the gastrointestinal tract, with about 50% remaining in the body of adults – all but 1% is absorbed in Bones and bones are stored in teeth – and the other 50% is excreted in the urine. In young children, up to 80% of the ingested fluoride is retained because more is absorbed into the bones and teeth than in adults.

Why is fluoride in drinking water?

According to the NIH, fluoride is used to prevent or reverse tooth decay and stimulate new bone formation.

In 1945, Grand Rapids, Michigan became the first city in the world to fluoridate its drinking water. This followed a doctor's research into fluoride and fluorosis – the discoloration of tooth enamel caused by an excess of fluoride – and his suggestion that safe levels could help prevent tooth decay.

According to the National Institute of Dental and Craniofacial Research, fluoridation in Grand Rapids became a 15-year project in which researchers monitored tooth decay rates in 30,000 schoolchildren; After 11 years, tooth decay rates in Grand Rapids children born after adding fluoride to the water supply were found to decrease by more than 60%. It was considered a scientific breakthrough that could revolutionize dental care.

According to NIH, the U.S. Public Health Service has recommended adding fluoride to tap water since 1962 to reduce the risk and severity of tooth decay. Currently, the CDC states that the recommended concentration – which is not enforceable and is a decision at the local, not federal, level – is 0.7 mg/L. The CDC says drinking fluoridated water keeps teeth strong and reduces tooth decay by about 25% in children and adults. (Another common source of fluoride is toothpaste, which, according to the CDC, adheres fluoride to the tooth surface when brushing and increases the amount of fluoride in saliva, which helps rebuild the outer layer of tooth enamel.)

Today, fluoridated municipal drinking water – including tap water and foods and beverages prepared with municipal drinking water – accounts for approximately 60% of fluoride intake in the United States. In 2022, according to the CDC, more than 209 million people, or 72.3% of the U.S. population served by public water supplies, will have had access to water with fluoride levels that prevent tooth decay.

The chemicals used to fluoridate drinking water in the United States are fluorosilicic acid, sodium fluorosilicate and sodium fluoride, which are byproducts of the production of phosphate fertilizer, according to the NSF.

The CDC has a website that lists fluoride levels in tap water by county.

Is fluoride safe in drinking water?

Yes, says the CDC, which released a statement on the safety and effectiveness of fluoridated water earlier this year.

It states: “The safety and benefits of fluoride are well documented and have been extensively reviewed by multiple scientific and public health organizations.” The US Public Health Service; the UK National Institute for Health Research, Center for Reviews and Dissemination, at the University of York; and the National Health and Medical Research Council, Australia, have all conducted scientific research by expert panels and concluded that fluoridation of community water is a safe and effective way to promote good oral health and prevent tooth decay. The U.S. Community Preventive Services Task Force made a strong recommendation for community water fluoridation to prevent and control tooth decay based on systematic reviews of the scientific literature in 2001 and again in 2013.”

Why is fluoride in tap water controversial?

In his comment posted on

While he may be correct about the source, the CDC's recent statement disputes the health risks raised by Kennedy and suggests that the only potential risk is fluorosis from excess fluoride over a long period of time.

“Expert panels composed of scientists from the United States and other countries with expertise in various health and scientific disciplines,” it said, “reviewed the available evidence in the peer-reviewed literature and found no convincing scientific evidence supporting fluoridation of community water Water is associated with all possible adverse health effects or systemic disorders such as increased risk of cancer, Down syndrome, heart disease, osteoporosis and bone fractures, immune disorders, low intelligence, kidney disease, Alzheimer's disease or allergic reactions.

That's not to say that adding fluoride to water has been controversial for all these years, starting in the late 1940s, when activists on the far right of American politics claimed that fluoridation was part of a broader conspiracy to impose a socialist or communist regime.

Recently, in 2016, an article from Harvard Public Health questioned the safety of fluoridated drinking water and highlighted the possibility of brain toxicity based on studies in laboratory animals and other studies linking it to learning, memory and cognitive deficits brought.

That story sparked a flood of letters, some supportive, including from the dentist, researcher and former head of preventive dentistry at the University of Toronto, who worked for years on a comprehensive scientific study of fluoride toxicity. He noted, “I was trained in traditional dentistry and for many years accepted the prevailing opinion of the Canadian and US dental/medical establishment that water fluoridation was 'safe and effective'…I was wrong.”

But many more responses expressed sharp criticism of the article, such as one from a group of dentists, including the dean of the Harvard School of Dental Medicine, who called for the article to be repealed and provided pages of evidence of where the article went wrong.

According to the NIH, high doses of fluoride – typically in rare accidents involving excessively high fluoride water content or accidental ingestion of topical dental products containing fluoride – can cause nausea, vomiting, abdominal pain, diarrhea, periostitis and even, rarely, death. But such an acute dose, the NIH notes, “would be virtually impossible to achieve with water or toothpaste containing standard amounts of added fluoride.”

Another possible consequence of chronic, excessive fluoride intake is skeletal fluorosis, which can lead to symptoms such as joint pain, osteoporosis and muscle wasting. However, according to the NIH, it is “extremely rare” in the United States and there is no evidence that it is caused by recommended levels of fluoride in tap water.

In addition, the NIH adds, one study found a link between higher levels of fluoride in the mother's urine during pregnancy and a higher rate of neurobehavioral problems in a child at age 3, while another similar study found no such link have.

Regarding the claim that higher fluoride intake during early development is linked to lower IQ and other cognitive impairments, the NIH adds that researchers, including those behind a review by the National Academies of Sciences, Engineering, and Medicine, consider the evidence to be weak and methodologically flawed.

Finally, regarding claims about fluoride and bone cancer, the American Cancer Society (ACS) notes that many systematic reviews of the association have found “insufficient” conclusions and “no clear association.” It is noted that some of the controversy over the possible link stems from an old study (1990) in laboratory animals that found higher than expected rates of osteosarcoma – a rare bone cancer – in male laboratory rats who drank fluoridated water became.

Meanwhile, many population-based studies have examined the possible link between water fluoride levels and cancer and have “found no strong association with cancer,” the ACS reports.

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