CHICAGO, March 28, 2025 — The American Dental Association (ADA) is disappointed in Governor Cox and the Utah Legislature’s wanton disregard for the oral health and well-being of their constituents. Eighty years of community water fluoridation at optimal levels has proven safe and effective at reducing tooth decay and maximizing citizens’ oral health.
House Bill 81 ends one of the most equitable, trusted and tested public health strategies in the arsenal of preventive medicine.
“As a father and a dentist, it is disheartening to see that a proven, public health policy, which exists for the greater good of an entire community’s oral health, has been dismantled based on distorted pseudo-science,” said Brett Kessler D.D.S., ADA President. “The most common chronic childhood disease is cavities. We know that when community water fluoridation stops, it’s the children and the most vulnerable of our communities who suffer. We urge legislators and voters across the country not to make Utah’s significant mistake, and, instead, to trust credible data and science which shows that optimally fluoridating community water is safe, effective and helps prevent dental disease.”
There is substantial evidence to show that when fluoridation ceases, dental disease increases. Windsor, Canada voted fluoridation out in 2013. A 2018 report of the Windsor-Essex County Health Unit showed the percentage of children with "decay and/or requiring urgent care" in 2016/2017 increased by 51 percent compared to 2011/2012. The result of that study was Windsor voted to restart its community water fluoridation program in 2018. The trend toward greater dental disease also presented in Calgary where fluoride was stopped. The magnitude of increased decayed teeth was greater in Calgary where fluoridation was stopped than in Edmonton where it was continued in 2011.
While the decision in Utah marks the first statewide ban in the country, there is stark evidence in the U.S. of what’s to come, based on the experience in Juneau, Alaska where misinformation resulted in a fluoride cessation in 2007. Juneau’s location made for a unique situation to witness the actual impact of ending fluoridation since it is situated where no nearby fluoridated water sources could provide some level of protection. Results show significant negative impact that cannot be ignored:
- Dental caries-related procedures and treatment costs for children from low-income families increased.1
- The mean cavities-related treatment costs per patient were also significantly higher for all age groups, ranging from a 28% to 111% increase among the suboptimal community water fluoridation groups after adjusting for inflation.2
According to Centers for Disease Control and Prevention (CDC) estimates, providing optimally fluoridated water to US communities for one year saves $6.5 billion in dental treatment costs and offers a return on investment of $20 for every $1 spent on water fluoridation. On average, communities with water fluoridation experience 25% fewer cavities, saving $32 per person annually by avoiding dental treatment costs and leading to fewer missed work and school days.
“Community water fluoridation programs save states money, save the federal government money, and save people money,” said Dr. Kessler. “I urge every dentist and community member to make their voices heard if there are proposals in your area that threaten the oral health of our communities. Together, we have made a difference this year in New Hampshire, North Dakota, South Dakota and Arkansas to support the dental health of our communities and ensure that the most vulnerable, at-risk populations continue to benefit from one of the greatest public health achievements of our time.”
A similar bill in New Hampshire, which was voted down, came with a predicted cost increase for the state between $1,000,000 to $3,000,000 if community water fluoridation ended in the same fashion as proposed in Utah. The budgetary impact included the cost of treating increased dental disease along with shifting costs to prescribing supplements, an inefficient method of preventive care.
Fluoridation of community water supplies is the adjustment of the existing, low level of naturally occurring fluoride in drinking water to an optimal level for the prevention of tooth decay. It is recommended that community water systems adjust the amount of fluoride to 0.7 milligrams per liter of water, which is equivalent to one inch in 23 miles. The average lifetime cost per person to fluoridate a water supply is less than the cost of one dental filling.
For more information on community water fluoridation and ADA advocacy, visit ADA.org/fluoride.