The ADA has reaffirmed its stance that community water fluoridation is safe and beneficial to oral health, following a federal judge’s ruling that the U.S. Environmental Protection Agency must take action regarding fluoride in drinking water. While the EPA is required to take action, the ruling did not ban or in any way limit the addition of fluoride to public drinking water supplies.

In a Sept. 25 statement, the ADA said it remains “staunchly in support” of community water fluoridation at optimal levels to help prevent tooth decay.

“The district court ruling against the Environmental Protection Agency provides no scientific basis for the ADA to change its endorsement of community water fluoridation as safe and beneficial to oral health,” reads the release.

U.S. District Court Judge Edward Chen specified in his Sept. 24 ruling that although his finding does not “conclude with certainty” that fluoridated water is harmful to public health, there is evidence that fluoride in drinking water poses a potential risk of cognitive decline.

“Given the seriousness of reduced IQ, and the ample support in the record that the United States population is at risk of experiencing IQ decrements of over four IQ points, the severity of the hazard at issue weights in favor of finding the risk at issue unreasonable,” wrote Judge Chen.

Several advocacy groups petitioned to establish a case that fluoride posed an unreasonable risk of harm sufficient to require a response by the EPA under the amended Toxic Substances Control Act, which allows citizens to petition the EPA to consider whether a chemical presents an unreasonable risk of injury to health.

This ruling comes after the Department of Health and Human Service’s National Toxicology Program released “Monograph on the State of Science Concerning Fluoride Exposure and Neurodevelopment and Cognition.” The August report found that drinking water at more than twice the recommended limit is “consistently associated” with lower IQ in children. The report notes that the findings are limited to fluoride exposures that are more than double (≥1.5 mg/L) what the Centers for Disease Control and Prevention currently recommends for the optimal level of community water fluoridation (0.7 mg/L). 

An ADA expert committee examined the report, stating the monograph does not provide any new conclusive evidence that warrants changes in current community water fluoridation practices for public health policy consideration. 

The ADA continues to endorse fluoridation of community water as a necessary way to prevent tooth decay and promote oral health. The Association notes that the CDC named it one of the 10 great public health achievements of the 20th century and that for more than 75 years scientific evidence has pointed to fluoridation as safe and effective.

Judge Chen said the Toxic Substances Control Act requires the EPA to engage with a response since the court found an unreasonable risk of injury. He did not state what exactly the response must be.

“Amended [Toxic Substances Control Act] leaves that decision in the first instance to the EPA. One thing the EPA cannot do, however, in the face of this Court’s finding, is to ignore that risk,” he wrote.

ADA President Linda J. Edgar, D.D.S., said in a statement that oral health is essential and that community water fluoridation has been proven to prevent at least 25% of tooth decay in children and adults.

“The scientific weight of sound evidence around the benefit of community water fluoridation is clear and compelling,” Dr. Edgar said.

Because of the widespread misinformation circulating online and in social media around community water fluoridation, the ADA urged its members to be cautious of “pseudo-scientific information.”

“This information is not always based on research conducted according to impartial and evidence-based scientific methodology; and the conclusions drawn from research are not always scientifically justifiable or without bias,” the release concludes.

For more information on community water fluoridation and ADA advocacy, visit ADA.org/fluoride.