Patient Resources
Get Healthy!
Study Warns Fluoride Bans May Raise Tooth Decay in Children
- March 24, 2026
- HealthDay Staff HealthDay Reporter
Removing fluoride from drinking water could lead to more cavities in kids and higher health care costs, a new analysis suggests.
Researchers estimate that if five states stop adding fluoride to public water, more than 132,000 additional kids could need dental treatment within three years.
That includes procedures like fillings or tooth extractions.
Those added costs to Medicaid could reach nearly $40 million, according to the analysis, which was led by the CareQuest Institute for Oral Health. The institute is a nonprofit that promotes fluoridation.
The report focused on Florida, Kentucky, Louisiana, Missouri and Oklahoma. Florida has already banned fluoride in public water systems. The other states are considering similar bans.
In Florida alone, the study estimates 52,131 more kids than would otherwise be expected will need dental care post-ban.
Tooth decay can start early, even before a child’s first tooth appears.
Fluoride helps protect teeth by strengthening enamel, making it harder for bacteria to cause damage.
“Water fluoridation is the most broad-based, evidence-based, available-to-everyone tool that children can benefit from,” Melissa Burroughs, senior director of public policy at CareQuest, told NBC News.
The U.S. Centers for Disease Control and Prevention (CDC) says adding fluoride to community water has reduced tooth decay by 25% over time.
Fluoride has been used in public water systems for decades, but it has become somewhat of a hot topic in recent years.
At least 21 states have introduced bills to ban fluoride, according to the National Conference of State Legislatures. Utah and Florida were the first to pass bans, both taking effect last year.
Many people have raised concerns about possible health risks of fluoride use.
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has called fluoride “industrial waste,” though that messaging has recently changed.
"Fluoride is essential for oral health," Dr. Jay Bhattacharya, acting CDC director, said. "The key thing is making sure the right dose is delivered in the right way."
He added that very high levels of fluoride "can have neurological and developmental impacts."
A 2025 study from the National Institute of Environmental Health Studies found a link between higher fluoride exposure and lower IQ scores in kids.
But researchers did not recommend removing fluoride from drinking water.
Experts note that many of those studies looked at places with much higher fluoride levels than those in the U.S.
The CDC recommends 0.7 milligrams per liter of fluoride in drinking water, which equates to about three drops in a 55-gallon barrel.
The CareQuest analysis focused on Medicaid, which covers about 37 million kids in the U.S. who are disabled or whose families have limited income.
But experts say the real cost could go beyond that number.
Many kids on Medicaid do not receive regular dental care. When problems get worse, families may turn to ERs instead.
That's “about the most expensive, least effective place to go,” Dr. Scott Tomar, head of the Department of Population Oral Health at the University of Illinois in Chicago, told NBC News. He was not involved in the study.
What's more, Tomar said dentists in states that ban fluoride may start seeing more problems in young kids very soon.
“Fluoride is incorporated into the enamel, and it makes that tooth structure more resistant to acid attack, essentially making it less likely to be affected by the bacteria that causes tooth decay,” he explained. “Once they start getting their teeth, you will start to see the lack of prevention show up.”
More information
The Nutrition Source has more on fluoride.
SOURCE: NBC News, March 19, 2026
