Study: Fluoride Removal Could Lead to 25 Million More Cavities in Kids

If you’ve ever wrestled a toothbrush into your toddler’s mouth, you know just how tough it can be to protect those tiny teeth. And while fun toothbrushes and clever brushing hacks can help, a new threat to your child’s dental health may be on the way, with potentially painful and costly consequences.

According to research published in JAMA Health Forum, the elimination of fluoride from US tap water could result in an additional 25.4 million cavities in children over just five years and a $9.8 billion spike in healthcare costs. The long-term picture is even more concerning. After 10 years, these impacts would more than double to nearly 54 million excess decayed teeth and $19.4 billion in costs. The study, which modeled national health outcomes using CDC data, projects an overall 7.5% increase in the prevalence of tooth decay—most severely impacting children from low-income families and those without private dental insurance.

Fluoride is a naturally occurring mineral found in some foods and groundwater. It helps prevent tooth decay by strengthening enamel—the protective outer layer of teeth that’s worn down by acid from bacteria, plaque, and sugars in the mouth. For nearly 80 years, fluoride has been added to public water systems as a simple, cost-effective way to reduce cavities across populations. But now, that public health measure is under growing political and public scrutiny.

In April, US Health and Human Services Secretary Robert F. Kennedy Jr. announced he would direct the US Centers for Disease Control and Prevention (CDC) to stop recommending the addition of fluoride to public drinking water. Kennedy, has publicly called fluoride “industrial waste” and linked it to cancer and other health risks—claims rejected by both the CDC and the American Cancer Society, who cite a lack of credible evidence at current exposure levels. Despite this, two states—Utah and Florida—have already banned the practice this year, raising concerns that more local governments could follow suit.

As of 2022, 72% of the US population received fluoridated water through their community water systems. The CDC, American Academy of Pediatrics and American Dental Association all continue to support fluoridation at regulated levels as safe and effective, especially for young children whose teeth are still developing.

While debates over fluoride continue at the federal level, its removal could leave children more vulnerable to preventable dental disease—especially those who already face barriers to care. Curious to learn more about your child’s dental health? Check out these brushing and dental care tips from the experts.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.