FDA meeting reignites debate over fluoride in drinking water Image By HPN Staff Key Points The FDA is reviewing whether ingestible fluoride products like drops and tablets should be regulated as prescription drugs due to safety concerns and lack of formal FDA approval. Although fluoride is endorsed by major health organizations for preventing tooth decay, a rising number of critics — including state lawmakers, parental rights groups, and health figures like Robert F. Kennedy Jr. — argue it poses neurological risks and is outdated. Utah became the first state to ban fluoride in public drinking water, and similar legislation is under consideration in other states, signaling a potential shift in national policy regarding water fluoridation. What has long been known as the “fight over fluoride” has gained new steam, and federal action could be forthcoming to reduce certain products containing it. A recent public meeting hosted by the Reagan-Udall Foundation and the U.S. Food and Drug Administration (FDA) brought renewed national attention to the chemical added to drinking water across much of the United States. The FDA heard conflicting arguments over whether ingestible fluoride products — such as drops and tablets commonly given to children — should be regulated as prescription drugs. Supporters of fluoride, including the American Dental Association, defended its long-standing use. Among the critics were several panelists at the event, who urged the agency to act, arguing that ingestible fluoride products have not received formal FDA approval. The discussion follows the release of the White House’s “Make Our Children Healthy Again: Assessment,” which lists fluoride as a priority area for review. Why it matters More than 200 million Americans drink fluoridated water. Health officials credit the practice with reducing cavities and promoting dental health, particularly among children in low-income communities. But a growing group of skeptics says fluoride use is outdated, poorly regulated and potentially harmful. They cite research that raises questions about neurological risks among children, although other experts, including researchers at the American Academy of Pediatrics, say the evidence does not support those claims. The big picture Water fluoridation began in the 1940s and is endorsed by the Centers for Disease Control and Prevention (CDC), the World Health Organization and major health organizations in the U.S. Nearly 63% of Americans receive fluoridated tap water, according to a report by the CDC. Still, public opposition has gained traction in recent years, fueled by parental rights groups, alternative health advocates and figures like Health and Human Services Secretary Robert F. Kennedy Jr., who has spotlighted fluoride on his “MAHA” Action Tour. Utah became the first U.S. state to ban the addition of fluoride to public drinking water systems, under legislation signed by Gov. Spencer Cox in March that took effect in early May 2025. According to The New York Times, similar bills have been introduced in North Dakota, Tennessee and Montana. Researchers at Johns Hopkins University and other experts say that fluoride remains a key tool in preventing tooth decay, especially in children who face barriers to dental care. What’s next The FDA has initiated steps to remove concentrated ingestible fluoride prescription drug products for children from the market, citing safety concerns and the lack of FDA approval for these products. The agency is reviewing public comments and could issue guidance later this year. Separately, the Environmental Protection Agency has appealed a September 2024 court ruling in which a U.S. district court judge found that the risk of reduced IQ is serious enough to be considered an unreasonable hazard.
