TAMPA, Fla. — Florida Surgeon General Joseph Ladapo positioned himself against the American Academy of Pediatrics, the Centers for Disease Control, and the American Dental Association Friday when he came out against community water fluoridation.
“This is something that has been defended for a long time and it is public health malpractice to continue doing it,” Ladapo said.
On Friday, Ladapo announced new guidance recommending cities and municipalities across Florida to stop adding fluoride to the water supply.
"It is clear that more research is necessary to address safety and efficacy concerns regarding community water fluoridation," Ladapo said in a statement. "The previously considered benefit of community water fluoridation does not outweigh the current known risks, especially for special populations like pregnant women and children."
Specifically, Ladapo pointed to what his office called the "neuropsychiatric risk associated with fluoride exposure." Ladapo listed "adverse effects in children, cognitive impairment, increased neurobehavioral problems, skeletal fluorosis," and multiple other potential issues.
For most Americans, the issue of fluoride in the water has only become news in recent weeks. Robert F. Kennedy, Jr. has said he wants fluoride out of water supplies, and Winter Haven, Florida, recently voted to remove fluoride.
Fluoride is a naturally occurring mineral that is present in many foods Americans consume and also in dietary supplements. The National Institutes of Health said fluoride "inhibits or reverses the initiation and progression of dental caries (tooth decay) and stimulates new bone formation."
Since the late 1940s, fluoride has been added to the water supply of most American cities to help prevent dental issues. The National Toxicology Program said it's been "a successful public health initiative for reducing dental cavities and improving general oral health of adults and children."
In the United States, health agencies recommend 0.7 mg/L of fluoride intake as the ideal concentration for maximum oral benefits and minimizing potential harm.
According to his statement, Ladapo agreed with the overall use of fluoride, saying, "Evidence shows fluoride strengthens teeth, making them more decay-resistant." However, Ladapo also said more research is being conducted into the impacts of overall fluoride exposure.
Part of that research comes from the National Toxicology Program, which Ladapo highlighted in his release Friday.
The NTP said there has been concern "that some pregnant women and children may be getting more fluoride than they need now because they now get fluoride from many sources." It initiated a study in 2016 to analyze the research on the topic.
According to the NTP, "higher levels of fluoride, such as drinking water containing more than 1.5 mg/L, are associated with lower IQ in children." However, the NTP said the review analyzed total fluoride exposure and not the health effects of fluoride in drinking water.
"It is important to note, however, that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children's IQ," the NTP said in its report.
Read the full report from the National Toxicology Program, a part of the National Institutes of Health, below:
Fluoride Final 508 by ABC Action News
The NTP review focused on studies in countries including Canada, China, India, Pakistan, and Mexico. In those countries, the NTP said some pregnant women, infants, and children received total fluoride exposure amounts higher than 1.5 mg/L of drinking water or more than twice the limit used in the United States.
For its part,the American Dental Association said that it "remains staunchly in support of community water fluoridation at optimal levels to help prevent tooth decay."
The ADA noted, "Community water fluoridation has also been hailed by the CDC as one of 10 great public health achievements of the 20th century."
The American Academy of Pediatrics said in December 2020, "there have been many unsubstantiated or disproven claims that fluoride leads to kidney disease, bone cancer, and compromised IQ."
"More than 3,000 studies or research articles have been published on the subject of fluoride or fluoridation," the AAP said. "Few topics have been as thoroughly researched as community water fluoridation, and the overwhelming evidence (along with 75 years of experience) supports the safety and effectiveness of this public health practice."
The AAP said it continues to "recommend age-appropriate amounts of fluoride toothpaste and fluoridated water to protect children's teeth." It also said if people live in an area or are served with a water system without fluoridation, "talk to your physician about fluoride supplements."
The National Insitutes of Health's Office of Dietary Supplements did warn of excess levels of fluoride, saying, "chronic, excess intakes of fluoride are also associated with skeletal flurosis." The NIH continued, "However, skeletal fluorosis is extremely rare in the United States and no evidence indicates that it is caused by the recommended level of fluoride in public tap water."
Ladapo's office estimated that more than 70% of Floridians are on community water systems that receive fluoridated water. The office also provides a service to determine whether your water system is included.
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