States Are Removing Fluoride From the Water. Here’s What You Need To Know

When you pour yourself a cup of tap water, you might not think about how it’s impacting your dental health. But the nearly three-quarters of Americans who live in jurisdictions that fluoridate their drinking water, each sip can serve as a stopgap against cavities.

But for residents of certain states, that safeguard might be coming to a swift end. In a swelling anti-fluoridation movement, several states are progressing in efforts to ban the mineral from drinking water sources. In March, Utah governor Spencer Cox signed a bill prohibiting anyone from adding fluoride to public water systems. In the last week of April, Florida legislators passed a similar bill. All it needs now is governor Ron DeSantis’s signature.

Is fluoride safe?

Fluoride is the ionic form of fluorine. If you were a chemistry nerd in high school, you might recognize fluorine as the first element of the halogen group, nestled toward the end of the second row between oxygen and neon.

Fluoride is naturally occurring in almost everything we eat, with particularly high concentrations in seafood, spinach, gelatin and tea. Organizations ranging from the American Academy of Pediatrics to the Centers for Disease Control and Prevention (CDC) maintain it is both safe and effective for passively maintaining oral health. The American Dental Association calls fluoridated water "the most efficient way to prevent cavities."

Still, opponents say that fluoridating water is at best a waste of money, and at worst, a potentially harmful violation of bodily autonomy. And Robert F. Kennedy Jr., recently appointed secretary of health and human services, has called fluoride an "industrial waste."

Where fluoride’s being banned — and what to do about it

Along with Utah and Florida, states like Kentucky, Massachusetts, Nebraska, Wisconsin and North Carolina have all introduced legislation to ban fluoride from drinking water.

And since water fluoridation is under the purview of state and local governments, even if you live in a state where fluoride is legal, you may or may not be getting it in your drinking water. (Portland, Ore., for example, banned fluoride in the water all the way back in 1956, though many other Oregon cities do add the mineral to their water system.)

The result in population-level dental trends can be telling. According to a U.S. News analysis of data from the CDC and the 2022-2023 National Survey of Children's Health, for example, in Idaho, where only 31% of people on a government water source receive fluoridated water, 67% of third-graders were found to have tooth decay. Meanwhile, in Illinois — where 98% of city residents are on a fluoridated water source — only 42% of third-graders had cavities.

Fortunately for those who want to maintain their access to fluoride, both professional dental fluoride treatments and fluoride supplements are available. Fluoride can also be found in over-the-counter toothpastes and mouthwashes, though for higher-concentration versions, you may need a prescription.

Unfortunately, most dental insurance policies don’t cover fluoride treatments for adults. (For children up to age 12 — and sometimes even up to age 18 — coverage may be offered.)

Either way, a dental insurance plan can help you afford regular care — and potentially avoid bigger problems by taking care of them early. The average dental insurance plan is only $22 per month.

Medicaid is required by law to cover dental care for children and young adults under age 21. But again, adult coverage is less guaranteed — though all but three states provide some level of dental care for adult Medicaid enrollees. Seniors, too, should take care to ensure they have dental coverage, which is only available through Medicare Advantage (not Medicare Part A or Part B).

Even if you don’t have dental insurance, getting regular cleanings is imperative for both your comfort and your health — especially if you live in a place where the water isn’t fluoridated. Although out-of-pocket dental costs can soar, there are ways to find more affordable dental services, such as going to a dental school or discount clinic.

Brace yourself on getting to know your options, but your teeth will thank you — as will your bank account.