In Florida, a rebellion against fluoride is winning
Florida’s escalating revolt against water fluoridation stretched past midnight in Melbourne City Hall recently as dozens urged their local leaders to abandon the long-standing practice to prevent cavities and tooth decay.
Speaker after speaker insisted they do not consent to be medicated. Several blamed their thyroid problems on the tooth-strengthening mineral. Another who identified herself as a “living woman” accused the city of violating her religious rights, claiming fluoride causes “spiritual suppression.”
The countering pleas from local dentists who said removing fluoride would consign children to poor oral health fell flat as the Melbourne City Council voted 6-1 early Wednesday to end fluoridation after six decades. The decision made the community the largest yet in Florida to ditch a key pillar of public health in recent weeks, affecting nearly 170,000 Space Coast residents who drink Melbourne’s water.
While skepticism of fluoride has historically spanned partisan lines, with the blue states of Oregon, Hawaii and New Jersey having the lowest fluoridation rates, the issue is gaining traction among conservatives as it lands on the Trump administration agenda.
Florida has emerged as the central battleground of the latest fluoride wars as President-elect Trump prepares to take office. Trump’s pick for secretary of Health and Human Services, Robert F. Kennedy Jr., has vowed to pressure localities to end the practice that the Centers for Disease Control and Prevention called one of the 10 greatest public health achievements of the 20th century. But the federal government has limited power to broadly stop fluoridation, leaving the battles to be fought in city halls and local ballot boxes.
In Florida the anti-fluoride activists are winning.
At least six cities decided to stop fluoridating their water since late November when the state’s surgeon general Joseph A. Ladapo, a controversial figure often at odds with mainstream health authorities, became the first statewide public health leader to back the cause, calling fluoridation “public health malpractice.”
“Those communities are making a really good decision,” said Ladapo, who testified in Tavares, population 21,000, in mid-December before the city voted to end fluoridation. “I hope more communities in Florida follow them.”
The once-fringe movement has gained steam as mainstream institutions have legitimized health concerns, including a link between fluoride levels above the acceptable threshold in the United States and lower IQ in children, and cast doubt on the benefits.
While medical associations have dismissed the studies showing neurocognitive harm as irrelevant when examining fluoride concentrations used in drinking water, a federal judge in September concluded the research raised enough concerns to compel the Environmental Protection Agency to issue further regulations.
A recent analysis of research by the Cochrane Library found water fluoridation leads to “slight” reductions in childhood tooth decay and cavities, with the benefits eroding since fluoride became widely available in toothpaste decades ago. Fluoride proponents cite earlier analyses by the same organization that found greater benefits.
Stuart Cooper, who has advocated against water fluoridation for 15 years, said local officials confronting a dizzying array of issues often defer to health authorities when debating the issue. Ladapo’s defection upended that dynamic, portending what could happen nationwide if federal health agencies under Kennedy’s leadership follow his lead.
“Those city councilors, the ones who’ve read research, are going to vote against fluoride regardless,” said Cooper, executive director of the Fluoride Action Network, a national advocacy organization. “Those who maybe were on the fence now have state guidance they can point to.”
Melbourne Mayor Paul Alfrey, who led an unsuccessful charge to remove fluoride in 2019, revived his proposal with a potent new argument: The Florida health agency that persuaded the city to fluoridate water in the 1960s now urges communities to stop doing so, at Ladapo’s direction. Alfrey opened the debate over fluoride by reading from the state surgeon general’s new advisory warning of the dangers of fluoride, noting Ladapo called him earlier that day to support his efforts.
“It was a major shift from 2019 to now,” Alfrey told The Washington Post after the vote. “The medical professionals are doing more research and saying maybe this isn’t a good idea.”
Major medical organizations including the American Dental Association, American Academy of Pediatrics and the CDC stand by fluoridation.
James Antoon, a retired periodontist and Melbourne resident who testified in favor of fluoride, felt his side was being “slaughtered by misinformation” as he heard Ladapo repeatedly invoked.
“It’s very sad that his misinformation and misinterpretation of studies is going to cause this to happen all over the state possibly,” Antoon said. “That’s definitely going to be a problem for children, for adults, for dental health.”
The pro-fluoride dentists told Melbourne councilors thatnhigh doses are what makes substances poisonous and that the current threshold for fluoride in the city’s water was safe, even if the mineral could harm people in other forms and greater concentrations. Alexis Herbeck, a dentist in nearby Merritt Island, began her testimony railing against a substance in the water supply that is fatal if inhaled, a by-product of TNT demolitions and responsible for 236,000 deaths a year.
“This substance is DHMO, also known as dihydrogen monoxide. It’s water,” Herbeck said. “The point that I’m making is anyone, anyone, can dress up anything, even something as inert as water, and make it sound absolutely terrifying.”
A widely cited report from the federal National Toxicology Program finding an association between fluoride and lower IQ in children also emphasized the findings did not apply to the levels of community water fluoridation in the United States.
Ladapo told The Post that it’s a “playing with fire” to assume the health consequences of fluoride would cut off at lower thresholds.
He likened Florida’s handling of fluoride to how the state bucked the medical establishment in its covid response. Gov. Ron DeSantis (R) emerged as one of the nation’s fiercest critics of social distancing measures and mask and vaccine mandates. Ladapo’s stances on vaccines, including spreading debunked claims that mRNA vaccines could contaminate DNA, drew fierce criticism from experts, medical associations and federal health officials.
When it comes to medical issues, Ladapo said Florida offers a model for “putting the health of people above the prior beliefs or the interest of different organizations.”
Jeff Ottley, president of the Florida Dental Association, said Ladapo did not consult his organization before releasing his anti-fluoride guidance.
Ottley does not expect to persuade Ladapo to change his mind when the two finally meet this week. Instead, he wants to impress that children’s oral health will suffer and the poorest may not receive care because of how little the state reimburses dentists, dissuading them from accepting Medicaid patients.
“Fluoride has been in the water for 80 years now,” Ottley said. “If it was unsafe, something would have happened many, many years ago. And if we had IQ problems, wouldn’t we all know it at this point?”
In Florida, 78 percent of residents using community water systems drink fluoridated water, according to the Centers for Disease Control and Prevention, compared with 72 percent of Americans overall.
Ottley is bracing for additional battles over fluoride, including in Gainesville, home of the University of Florida, and in Bartow, east of Tampa Bay. The Florida Keys Aqueduct Authority is soliciting public feedback on fluoridation. Delray Beach, a coastal town of nearly 70,000 north of Boca Raton, is scheduled to reconsider fluoridation in early February.
Delray Beach Mayor Tom Carney believes fluoride has benefits and joked at the council’s first meeting on the topic that he may have a low IQ, but he has great teeth. But he also said the Florida surgeon general’s guidance must be taken seriously, even if it contradicts associations that may be reluctant to reverse their long-standing guidance.
When Carney surveyed attendees at a recent homeowners association meeting about fluoride, they were evenly split. Then again, Carney thinks fluoride supporters can still get the mineral in their toothpaste and the substance is not necessary to make water drinkable.
“The issue really is if half the people don’t want it, then why should I force it upon them?” Carney said.
The city council of Palm Bay, the largest community in Brevard County, voted unanimously to permanently end fluoridation in early January after the body lurched right with the victories of conservative candidates in November. Two of the newly elected councilors said fluoridation was among the most common concerns voters brought up as they knocked on doors during the campaign.
Councilman Chandler Langevin said the skepticism of fluoride is a natural outgrowth of a medical freedom movement in Florida supercharged by opposition to coronavirus vaccine mandates.
“Quite frankly, by now in 2024 the conspiracy theorists have been more accurate than the federal government,” Langevin said. “That’s just the reality since covid has come out.”
Leesburg, a small community of 27,000 in central Florida, stood as an exception when it decided in December to move forward with its plans to fluoridate water despite the concerns raised by the surgeon general. Jimmy Burry, a pharmacist who was mayor at the time of the vote, said he trusted the views of the CDC and American Dental Association over Ladapo. He was unswayed by research showing negative health consequences of fluorides.
“If you put twice the amount of chlorine in the water, it’s probably not going to be good for you either. We are losing sight of what we are trying to do,” Burry said. “I get a sense that there is a feeling in the United States of, ‘Don’t tread on me. You are forcing something on me. You are removing my choice.’”
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