Utah’s Proposed Ban on Fluoride in Public Water Systems: A New Precedent in the U.S.
Utah is on the brink of making history as the first state to implement a complete ban on fluoride in public water systems. A recently passed bill, which prohibits cities and communities from deciding whether to add the cavity-preventing mineral to their water supplies, has sparked intense debate. If signed into law by Governor Spencer Cox, this legislation would set a significant precedent in the United States, particularly at a time when federal health secretary Robert F. Kennedy Jr. has expressed skepticism about water fluoridation—a practice widely regarded as one of the greatest public health achievements of the 20th century. The bill cleared its final legislative hurdle on Friday and now awaits the governor’s approval. A spokesperson for Cox has not yet indicated whether he will sign the bill into law.
The Cost Debate: Lawmakers Weigh the Expense of Water Fluoridation
Proponents of the bill, including state Republican Representative Stephanie Gricius and Senator Kirk Cullimore, argue that the cost of fluoridating public water is too high. Gricius emphasized that the legislation is not an outright rejection of fluoride’s benefits but rather a push for “informed consent and individual choice.” She noted that the bill also deregulates access to fluoride pills, allowing residents to choose whether to use fluoride in a different form. However, dental health advocates, such as Lorna Koci of the Utah Oral Health Coalition, counter that water fluoridation is the most cost-effective way to prevent tooth decay on a large scale. They warn that ending the practice could disproportionately harm low-income residents who may not have access to other forms of preventive dental care.
Fluoride’s Impact on Public Health: A Divisive Issue
Fluoride has long been recognized for its ability to strengthen teeth and reduce cavities by replacing minerals lost during normal wear and tear. According to the U.S. Centers for Disease Control and Prevention (CDC), nearly two-thirds of the U.S. population drinks fluoridated water. However, opponents of fluoridation point to concerns about its potential health risks, particularly at high levels, which some studies suggest could pose a risk to children’s intellectual development. A federal judge recently ordered the U.S. Environmental Protection Agency (EPA) to regulate fluoride in drinking water due to these concerns. Despite these worries, the CDC and other health organizations continue to endorse water fluoridation as a safe and effective public health measure.
Utah’s Current State of Water Fluoridation: A Patchwork System
Currently, Utah ranks 44th in the nation for the percentage of residents receiving fluoridated water, according to 2022 data from the CDC. Only about two in five Utah residents served by community water systems have access to fluoridated water. Out of 484 Utah water systems that reported data to the CDC in 2024, just 66 fluoridated their water. The largest of these is Salt Lake City, the state’s biggest city. In smaller communities, such as Brigham City, voters have shown strong support for keeping fluoride in their water. In 2023, a measure to remove fluoride from Brigham City’s public water supplies was defeated by a more than two-to-one margin.
The Dental Community’s Response: A Call to Reconsider
Dental health professionals in Utah are urging lawmakers to rethink the ban on water fluoridation. Val Radmall, executive director of the Utah Dental Association, shared his experience working in a non-fluoridated community for three decades. He recalled that patients from areas without fluoridated water often had significantly more cavities than those from areas with fluoridated water. “I’d have a patient come in without cavities or anything else like that, and I’d say, ’You didn’t grow up here. Where did you grow up?’ … because everybody here has lots of cavities!” Radmall said. He and others met with Gricius to discuss their concerns, but so far, their efforts have not led to a reversal of the bill.
The Future of Water Fluoridation: A Shifting Landscape
As Utah’s bill moves closer to becoming law, the broader debate over water fluoridation continues to evolve. While some cities across the country have already removed fluoride from their water, others are considering following suit. The federal government’s growing scrutiny of fluoride, coupled with high-profile figures like Robert F. Kennedy Jr. expressing skepticism, has emboldened anti-fluoridation advocates. However, dental health experts remain adamant that water fluoridation is a critical tool for improving public health, particularly for low-income communities with limited access to dental care. Whatever the outcome in Utah, the conversation about fluoride’s role in public health is unlikely to fade anytime soon.
