TAVARES, Fla. – On Inauguration Day, Robert F. Kennedy Jr. has stated he expects President-elect Donald Trump — who nominated Kennedy as the nation’s next health secretary — to advise that fluoride be removed from all U.S. water systems.
Calling fluoride “an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease,” Kennedy’s rhetoric has preempted the actions of some municipalities to make such changes on their own ahead of time, even here in Central Florida.
In Tavares, for example, the city council will soon vote whether to remove fluoride from its drinking water. In Winter Haven, the city commission voted 3-2 last month to remove fluoride its water supply by Jan. 1, 2025.
According to the Florida Department of Health, more than 70% of Floridians live in places where tap water is fluoridated.
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According to the U.S. Department of Health and Human Services (HHS), fluoride is a mineral that strengthens bones and helps protect teeth by likewise strengthening the outer enamel surface.
Though the HHS states most people get enough fluoride each day from using toothpaste and mouthwashes, as well as from food and drink made with fluoridated water, it’s the longstanding act of adding fluoride to public tap water and some bottled waters — a method of preventing tooth decay that was made popular several years before fluoridated dental products were available to the public, regarded as among the greatest public health achievements of the last century — that’s drawn increasing scrutiny from skeptics with the passage of time.
As Florida Surgeon General Dr. Joseph Ladapo announced last month, albeit while advocating squarely against community water fluoridation altogether, the HHS would agree that high exposure levels to fluoride could lead to possible health risks such as “nausea, vomiting, abdominal pain, diarrhea, bone pain and even death in rare cases.” It’s important to note, however, that the HHS states these health risks are only possible by swallowing “extremely large amounts of fluoride from dental products or dietary supplements” and not by consuming standard amounts of fluoride in public tap water.
How much fluoride is too much?
The HHS recommends that 0.7 mg of fluoride are added per liter of drinking water.
Ladapo’s stated guidance against community water fluoridation links to an HHS topic overview regarding neurodevelopment and cognition in relation to fluoride exposure.
Though Ladapo links to the page to support his claim that systemic fluoride exposure has prompted safety concerns related to “adverse effects in children reducing IQ,” the page itself states “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,” adding it’s only been found with “moderate confidence” that lower IQ in children is observed when fluoride levels reach ratios of 1.5 mg/L or more.
The daily recommended amounts and upper limits of fluoride are as follows, according to the HHS:
| Life stage | Recommended amount | Daily upper limit |
|---|---|---|
| Birth to 6 months | 0.01 mg | 0.7 mg |
| Infants 7–12 months | 0.5 mg | 0.9 mg |
| Children 1–3 years | 0.7 mg | 1.3 mg |
| Children 4–8 years | 1 mg | 2.2 mg |
| Children 9–13 years | 2 mg | 10 mg |
| Teens 14–18 years | 3 mg | 10 mg |
| Adult men 19+ years | 4 mg | 10 mg |
| Adult women 19+ years | 3 mg | 10 mg |
| Pregnant teens and women | 3 mg | 10 mg |
| Breastfeeding teens and women | 3 mg | 10 mg |
By the numbers, starting from the age of 9, the average person would have to drink more than 14 liters of water fluoridated at 0.7 mg/L to surpass the daily upper fluoride limit given by the HHS.
Fourteen liters of water comes out to nearly 31 pounds of liquid.
According to the Cleveland Clinic, some people would likely only be able to drink about a third of that volume in an hour or two — something like 3-4 liters of water — before experiencing symptoms of hyponatremia, or water intoxication.
Water intoxication is a condition in which there’s too much water in your body, and it affects your body’s cells. Mild symptoms include nausea, vomiting and bloating. Severe symptoms may include confusion, seizure and coma. It can also be fatal. Treatment may include reducing your water intake. In severe cases, you may need replacement sodium.
Cleveland Clinic, Water Intoxication (excerpt)
A famous case of water intoxication that turned fatal came about in 2007 with the death of 28-year-old Jennifer Strange, who participated in a radio station’s water-drinking contest and died after drinking almost 2 gallons of water.
Two gallons of water fluoridated at 0.7 mg/L would contain about 5.3 mg of fluoride which, while in excess of each daily recommended amount that the federal health officials suggest, remains far below the agency’s stated 10 mg daily upper limit.
In short, while consuming water fluoridated at 0.7 mg/L, hyponatremia would theoretically take effect long before any negative health affects from the fluoride.
Back in Tavares, Dr. Nicholas Potter, a dentist at Tavares Dental, said the complete removal of fluoride from drinking water could have a negative impact.
“Fluoride strengthens the tooth and prevents tooth decay,” Potter said. “It’s reduced cavities in underserved populations for millions and millions of people. I feel that removing it might be detrimental to those who are most vulnerable, like in our lower income communities.”
The Associated Press contributed to this report.
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