The Florida Department of Health has issued new guidance advising against community water fluoridation, citing concerns about potential health risks. The recommendation comes from State Surgeon General Dr. Joseph A. Ladapo, who highlighted the availability of alternative fluoride sources and ongoing research into the effects of systemic fluoride exposure.
Fluoride is found naturally in groundwater, rainwater, soil, plants, and foods. Community water fluoridation involves adjusting fluoride levels in drinking water to help prevent tooth decay. While this practice was once widely used to deliver fluoride systemically across populations, many municipalities in the United States and several European countries have stopped adding fluoride to public water supplies.
According to the department, topical sources such as toothpaste and mouthwashes are now common ways people receive fluoride. Research indicates that fluoride can strengthen teeth and make them more resistant to decay. However, further studies are underway to assess the overall impact of fluoride exposure on public health.
The department’s statement lists several safety concerns related to systemic fluoride exposure: “Adverse effects in children reducing IQ, cognitive impairment, and attention deficit hyperactivity disorder. Increased neurobehavioral problems in children whose mothers ingested fluoride during pregnancy. Accumulation of fluoride in the pineal gland, causing sleep cycle disturbance. Skeletal fluorosis, which could increase the risk of bone fracture. Potential risk of premature menarche in adolescent girls. Potential suppression of the thyroid gland by inhibiting iodine absorption.”
Given these risks—especially for pregnant women and children—and considering that alternative dental health products are widely available, Dr. Ladapo recommends against community water fluoridation.
“It is clear more research is necessary to address safety and efficacy concerns regarding community water fluoridation,” said State Surgeon General Dr. Joseph A. Ladapo. “The previously considered benefit of community water fluoridation does not outweigh the current known risks, especially for special populations like pregnant women and children.”
The Florida Department of Health continues its efforts to support oral health through school-based preventive dental services; county health department clinics; screening and referral programs; provider education; promoting healthy habits with an emphasis on reducing sugar consumption; distributing oral health care supplies; and offering tobacco cessation resources.
More than 70% of Floridians using community water systems currently receive fluoridated water based on self-reported data from 2023. Residents can check if their local system adds fluoride by visiting the Florida Department of Health’s Public Water Systems Actively Fluoridating webpage: https://www.floridahealth.gov/environmental-health/drinking-water/fluoridation/_documents/active-fl-communities.pdf
The Florida Department of Health is accredited by the Public Health Accreditation Board and works statewide to protect public health through integrated state, county, and community initiatives.
