--- title: As Fluoride Bans Spread, Who Will Be Hit the Hardest? description: Cavities are at risk of skyrocketing as more states consider banning water fluoridation—and some children are more vulnerable than others. canonical: https://time.com/7291761/fluoride-bans-cavities-dental-health-costs/ author: Chantelle Lee article:opinion: false article:content_tier: free article:published_time: 2025-06-06T18:46:36.000Z article:modified_time: 2025-06-09T20:56:36.000Z article:section: Health og:title: As Fluoride Bans Spread, Who Will Be Hit the Hardest? og:description: Cavities are at risk of skyrocketing as a growing number of states consider banning the use of fluoride in public water. og:url: https://time.com/7291761/fluoride-bans-cavities-dental-health-costs/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt1f2af0627ef24d4c/6998c73407a30d083077d0fb/Fluoride-Bans-Children-Impact.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2121 og:image:height: 1193 og:image:alt: Dentist office og:type: article twitter:card: summary_large_image twitter:title: As Fluoride Bans Spread, Who Will Be Hit the Hardest? twitter:description: Cavities are at risk of skyrocketing as a growing number of states consider banning the use of fluoride in public water. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt1f2af0627ef24d4c/6998c73407a30d083077d0fb/Fluoride-Bans-Children-Impact.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # As Fluoride Bans Spread, Who Will Be Hit the Hardest? > Sponsored content. 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Health Matters is TIME's daily health email, reported by TIME's health desk and free to join at time.com/newsletters. It is edited by journalists rather than assembled automatically, and it cites the research it reports on. #### Is Health Matters free? Yes. Health Matters is a free daily newsletter from TIME, available at time.com/newsletters. #### Who reads TIME's Health Matters newsletter? Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. by [Chantelle Lee](https://time.com/author/chantelle-lee/) ## Chantelle Lee Reporter Updated: Jun 9, 2025 8:56 PM UTCPublished: Jun 6, 2025 6:46 PM UTC  A recent study projected that if the entire country were to stop adding fluoride to the water supply, tooth decay would increase by about 7.5%, representing about 25 million more cavities. A recent study projected that if the entire country were to stop adding fluoride to the water supply, tooth decay would increase by about 7.5%, representing about 25 million more cavities. Linda Raymond—Getty Images by [Chantelle Lee](https://time.com/author/chantelle-lee/) ## Chantelle Lee Reporter Updated: Jun 9, 2025 8:56 PM UTCPublished: Jun 6, 2025 6:46 PM UTC Cavities and dental costs are at risk of skyrocketing as a growing number of states consider [banning the use of fluoride in public water](https://time.com/7285568/what-to-do-fluoride-removed-from-water/)—and children from low-income households are likely most vulnerable. In March, Utah became the first state to prohibit adding fluoride to drinking water. A couple months later, Florida followed suit. Several other states are now considering similar bills. In a recent [study](https://jamanetwork.com/journals/jama-health-forum/fullarticle/2834515) published in _JAMA Health Forum_, researchersprojected what would happen if the entire country were to stop adding fluoride to the water supply. The potential impact on both people’s oral health and their dental bills was substantial: Tooth decay, the study found, would increase by about 7.5%—representing about 25 million more cavities—and the U.S. would face about $9.8 billion in additional costs over five years, including both what families would have to pay out-of-pocket for dental care and what the government would need to pay for public health insurance. And those impacts would disproportionately affect children on public insurance plans or without insurance, the researchers found. Fluoridated water is “an amazing public health intervention that comes straight from the tap,” says the senior author of the study, Dr. Lisa Simon, an internal medicine physician at Brigham and Women’s Hospital, who is also a general dentist. **Read More:** [_The Science Behind Fluoride in Drinking Water_](https://time.com/7172655/is-fluoride-in-drinking-water-safe/) “Fluoride works for everyone—it benefits adults, it benefits children,” Simon says. “But the people who derive the most benefit from it are people who have a harder time accessing routine dental care.” “Unfortunately, in our country, that is more likely to be children and families who are low-income, who rely on public insurance, or who otherwise face challenges in getting to a dentist,” she says. States’ moves to ban the use of fluoride in public drinking water come as the Trump Administration—due in large part to the influence of Robert F. Kennedy Jr., Secretary of the U.S. Department of Health and Human Services (HHS)—has pushed back against the practice. Kennedy has long blasted water fluoridation, [claiming](https://x.com/RobertKennedyJr/status/1852812012478398923) it is linked to arthritis, bone cancer, IQ loss, and more, and signaled that HHS will stop recommending it. The Environmental Protection Agency has [said](https://www.epa.gov/newsreleases/epa-will-expeditiously-review-new-science-fluoride-drinking-water) that it is studying the potential health risks of fluoride, and the Food and Drug Administration [said](https://www.fda.gov/news-events/press-announcements/fda-begins-action-remove-ingestible-fluoride-prescription-drug-products-children-market) it is taking steps to remove prescription ingestible fluoride supplements for children from the market. Some research [suggests](https://jamanetwork.com/journals/jamapediatrics/fullarticle/2828425) that fluoride could be associated with lower IQ scores, but only at significantly high levels of exposure—the amount of fluoride that is added to public water, based on federal guidelines, is far lower. That study has also generated [controversy](https://www.statnews.com/2025/01/06/fluoride-iq-jama-pediatrics-critiques-meta-analysis/) and [criticism](https://jamanetwork.com/journals/jamapediatrics/article-abstract/2828430) from many health experts. And the majority of public health experts, [pediatricians](https://pubmed.ncbi.nlm.nih.gov/33257404/), and [dentists](https://www.ada.org/about/press-releases/american-dental-association-reaffirms-support-for-community-water-fluoridation) insist that water fluoridation is a long-standing practice that is both safe and effective at protecting oral health and fighting cavities and tooth decay. **Read More:** [_America’s Dental Health Is in Trouble_](https://time.com/7291226/america-dental-oral-health/) “It’s been touted to be one of the most successful or greatest public health initiatives, right up there with vaccinations,” says Dr. Tomitra Latimer, a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago. U.S. localities started adding fluoride to public water in 1945, and the Centers for Disease Control and Prevention (CDC) has [credited](https://www.cdc.gov/fluoridation/about/index.html) the public health initiative for the “dramatic decline in cavities” in the country in the years since. According to the CDC, drinking fluoridated water reduces cavities by roughly 25% in both children and adults. Tooth decay, though preventable, is [one of the most common childhood diseases](https://medicine.iu.edu/blogs/pediatrics/lend---the-most-common-chronic-disease-of-childhood-in-the-us). And children of color, children who come from low-income households, children on public insurance plans that limit which providers they can see, and children who live in rural areas and have to travel long distances to access care—all of them are at greater risk of developing cavities, according to Latimer. Children with autism also tend to have a [heightened risk of developing cavities](https://childrensdentalhealth.com/dental-visits-for-children-with-autism/) because they may struggle with brushing their teeth regularly, she says. While there are alternative sources of fluoride that people can purchase, the cost may be out of reach for many families, Latimer says. That’s why, she says, fluoridated water is so critical: It’s an easily accessible tool that can help protect the oral health of children who are most vulnerable to cavities. 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