Immediate Past President of the American Academy of Pediatric Dentistry Scott D. Smith, D.D.S., and ADA President Brett Kessler, D.D.S, issued a warning against efforts to eliminate community water fluoridation in a September 5 editorial, stating such decisions could unravel decades of progress in public oral health. 

In the Journal of the American Medical Association Health Forum editorial, “Removing Fluoride From Water? An Oral Health Crisis Will Unfold,” Drs. Smith and Kessler emphasized that fluoride is a cornerstone of preventive dental care, especially for vulnerable populations like children enrolled in Medicaid. 

The editorial asserts that, "Fluoride is not merely a public health success story; it is a structural intervention that helps Medicaid keep up with a high-need pediatric population... If today’s Medicaid funding allows for comprehensive dental care for 1000 children, increased decay from fluoride removal from water systems means that same budget might only cover 700—effectively cutting care for 300 kids.” 

“Community Water Fluoridation silently protects people throughout the lifespan—most importantly, children who cannot regularly visit a dentist or do not have toothpaste or toothbrushes," Drs. Smith and Kessler also wrote.  

They also urge consideration for the potential long-term effects, as the decision to maintain—or remove—fluoride from public water systems is not a scientific one alone. It is a policy choice with generational consequences. If we are serious about protecting children’s health and creating a healthier workforce, then preserving community water fluoridation is not optional but essential. 

The editorial comes amid recent efforts to stop community water fluoridation at the state and federal level. Two states, Utah and Florida, have banned the practice, and others are considering following suit. Additionally, the Centers for Disease Control and Prevention’s oral health division was eliminated in April, with Health and Human Services Secretary Robert F. Kennedy Jr. having long believed fluoride is unhealthy. 

Read the full editorial in JAMA. AAPD Members can find additional tools for these hard conversations online at www.aapd.org/research/policy-center/fluoride-resources/.