The state of Utah has made history as the first in the United States to prohibit the addition of fluoride in public water supplies, despite facing resistance from both dentists and national health organizations. These groups caution that eliminating fluoride could lead to health issues, particularly affecting low-income neighborhoods disproportionately.
Republican Governor Spencer Cox has officially approved legislation that prevents cities and communities from making individual decisions on whether to include fluoride in their water systems.
Similar measures are being contemplated in Florida, Ohio, and South Carolina, although lawmakers in New Hampshire, North Dakota, and Tennessee have already dismissed such proposals. In Kentucky, a bill to allow optional fluoridation did not progress in the state Senate.
However, communities sometimes exceed the recommended levels because fluoride occurs naturally at higher levels in certain water sources. In 2011, officials reported that 2 in 5 U.S. adolescents had at least mild tooth streaking or spottiness because of too much fluoride.
Since 2015, federal health officials have recommended a fluoridation level of 0.7 milligrams per litre of water. For five decades before that, the recommended upper range was 1.2 milligrams per litre. The World Health Organisation has set a safe limit for fluoride in drinking water of 1.5 milligrams per litre.
Fluoride is considered one of the greatest health achievements in 100 years
The addition of low levels of fluoride to drinking water has long been considered one of the greatest public health achievements of the past century: one of the most cost-effective ways to prevent tooth decay on a large scale.
Fluoride in drinking water can reduce cavities by at least 25 per cent for all age groups, according to the Utah Dental Association. Opponents of the Utah legislation to limit fluoridation warn it will have a disproportionately negative effect on low-income residents who may rely on fluoridated water as their only source of preventative dental care.
It’s a matter of personal choice, Utah’s bill sponsor says
The sponsor of the Utah legislation, Republican Rep. Stephanie Gricius, acknowledged fluoride has benefits, but said it was an issue of “individual choice” to not have it in the water.
Out of the 484 Utah water systems that reported data in 2024, only 66 fluoridated their water, an Associated Press analysis showed. The largest was that in the state’s biggest municipality, Salt Lake City.
Utah in 2022 ranked 44th in the nation for the percentage of residents that receive fluoridated water, according to the CDC data.
