From the Winter 2025 Journal of the Colorado Dental Association, By Molly Pereira, CDA Executive Director
I’ve been at the CDA for nearly 23 years, so I’ve seen my fair share of fluoride battles in Colorado. In fact, I make a folder on our server for each city/town where this issue comes up, so I have an easy reference to history as needed. Currently, there are 34 folders ordered alphabetically from Arvada to Walsenburg — and some of these folders are more frequently used than others and have multiple folders within them noting each year the issue has come up.
Some of these battles have been easy — like when a city council or water utility responsibly contacts the CDA and asks us to present the benefits of community water fluoridation at a meeting. Some battles are like catching your kids sneaking Halloween candy into their backpacks for school — similar to when we’re notified by our partners at the Colorado Department of Public Health and Environment that a water system has failed to submit regular water testing results or someone in a community hears rumblings of conspiracy theories at public town meetings or when a sneaky water operator/system quietly discontinues fluoridation without public notice. In those cases, we assert ourselves in future meeting agendas, research city council/water utility decision-making protocols, train local spokespeople and continue to be a presence in that area with information catered to the specific concerns of the community. And then there are the battles that cause blood, sweat and tears — like when community water fluoridation is put on a ballot for the public to decide. This one I’ve only had to do three times. It requires launching a full campaign, hiring pollsters, mailing oversized postcards, getting media coverage and staking yard signs (that’s where the blood and sweat often come in).
Most of the people reading this article are dental professionals, so I don’t need to go into the science proving that community water fluoridation is the single most effective public health measure to prevent tooth decay. We all know that fluoride is a mineral that occurs in all water sources (even in the ocean). We all know that more is not always better; there can be too much of a good thing. Community water fluoridation is the process of adjusting the naturally occurring level of fluoride to an optimal level (0.7 mg/L) to benefit oral health.
A recent series of events, detailed below, has awoken the anti-fluoride sleeping dragon in many states, including Colorado. In the past three months, we’ve been working to counter fluoride rumblings, agenda items and actions in Fort Collins, Evergreen, Durango, Canon City, Aspen and now Hayden. I fear 2025 will only wake more dragons.
In 2024, there was a systematic review released by the U.S. Department of Health and Human Services National Toxicology Program (NTP) that garnered national attention. In summary, it stated, “The NTP monograph concluded, with moderate confidence, that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children.” The NTP review was designed to evaluate total fluoride exposure from all sources and was not designed to evaluate the health effects of fluoridated drinking water alone. It is important to note 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 found no evidence that fluoride exposure had adverse effects on adult cognition.
This report was then used in a ruling by a federal judge in a California case (brought by anti-fluoride advocates). U.S. District Judge Edward Chen ruled that adding fluoride to drinking water presented unreasonable risks for children’s developing brains. He ordered the U.S. Environmental Protection Agency to strengthen regulations in drinking water (although he stressed that he was not concluding that fluoridating water endangered public health).
These two events stirred the anti-fluoride movement across the nation, which was amplified when Robert F. Kennedy, Jr., claimed on social media that “on January 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water.”
Studies of drinking water in other countries where fluoride is well above optimal levels do not accurately portray the safety and health effect of community water fluoridation in the U.S. Unfortunately, studies like these mislead and scare the public, giving rise to the dragons.
Fluoride battles are not one size fits all (or one-argument-fits-all). Each community affected has its own unique anti-fluoride angle and we need to understand that angle to get factual information into the community. These angles are rarely science-based (and by that, I mean legitimate peer-reviewed science) and often have a political slant. In recent memory the angles we’ve battled in Colorado have included: mass medication by the government, lower IQ, using offshore products, killing horses, causing cancer and water treatment operator safety. What they do have in common is that they are arguments of passion, but not fact. We have the facts and the evidence to dispute every one of these arguments and the CDA is always willing and able to come to your community if or when these fluoride rumblings start.
What can you do as a trusted healthcare provider?
- Be aware of where your water comes from and watch for upcoming agendas for city/town council meetings or meetings of your water utility board. If the topic of community water fluoridation comes up, let the CDA know, and we can look into it for you.
- Visit “My Water’s Fluoride” on the Centers for Disease Control and Prevention’s website (https://nccd.cdc.gov/doh_mwf) to get general information on your water source.
- Incorporate water fluoridation in your chairside education (if you don’t already). Dentists are continually rated as the most trusted messenger of fluoride information. Help your patients establish the core knowledge that community water fluoridation is safe and effective in preventing tooth decay.
- Contact the CDA if we can help!
I have a feeling that 2025 will pack a punch. We’re ready to battle dragons wherever they are awoken!
