Should Manatee County take fluoride out of drinking water? Official calls for removal

A Manatee County official is calling for the removal of fluoride from the county’s drinking water following a renewed national debate about whether it poses health risks.

In a controversial ruling in September, a federal judge said that current fluoride levels used around the U.S. could pose a risk to developing children’s brains and ordered the Environmental Protection Agency to take action. That ruling was followed by guidance from Florida’s surgeon general in November that municipalities should stop fluoridating water altogether.

Citing both developments, Commissioner Amanda Ballard added the discussion of fluoride removal as an agenda item for the board’s next meeting on Tuesday.

Reached for comment, Ballard said she is in favor of removing fluoride and will seek support from her fellow commissioners next week to make the policy change.

“I think there are many other sources people can now choose to get their fluoride, whether dietary fluoride or through their toothpaste,” Ballard said. “I believe in people having the choice.”

But health agencies and organizations stand by the decades-long practice, which is proven to dramatically reduce tooth decay and oral disease, especially in underserved communities. Several of those organizations are pushing back on efforts to remove fluoride and say that levels used in drinking water are safe.

Court ruling clashes with federal fluoride guidance

The U.S. Public Health Service recommends that municipalities add a very low concentration of fluoride to prevent tooth decay and protect oral health. The health service says community fluoridation of water has been “a major factor” in the country’s reduction of tooth decay. The Centers for Disease Control and Prevention estimates it has helped reduce tooth decay by 25% and calls fluoride “a safe intervention.”

The CDC said the U.S. and international scientists have not found any “convincing scientific evidence” linking fluoride in drinking water to health issues, including low intelligence.

But in September, a federal judge in California sided with advocacy groups who claimed the current levels of fluoride used around much of the U.S. could pose a risk to children.

“Specifically, the Court finds that fluoridation of water at 0.7 milligrams per liter – the level presently considered “optimal” in the United States – poses an unreasonable risk of reduced IQ in children,” U.S. District Judge Edward Chen wrote. “It should be noted that this finding does not conclude with certainty that fluoridated water is injurious to public health; rather ... the Court finds there is an unreasonable risk of such injury, a risk sufficient to require the EPA to engage with a regulatory response.”

Chen’s decision leaned heavily on a recent science review by the National Toxicology Program, part of the U.S. Department of Health and Human Services. The report underscored a link between high levels of fluoride exposure and reduced IQ in children.

However, the report’s conclusion was based on fluoride levels of over 1.5 milligrams of fluoride per liter — more than double the amount used in Manatee County’s water supply.

The report also said that it was not meant to be used as guidance on whether fluoride should be added to water supplies. It did not provide an estimate of how much fluoride must be present to cause loss of IQ points in children, and it said there was no significant evidence of cognitive impairment in adults.

Florida’s top doctor says stop all fluoride in water

In November, State Surgeon General Joseph A. Ladapo cited the same report when he issued guidance recommending that local municipalities stop fluoridating water altogether.

Ladapo also cited several studies that found associations between high fluoride exposure and developmental issues in children, including lower IQ, attention deficit hyperactivity disorder and neurobehavioral problems.

“It is clear more research is necessary to address safety and efficacy concerns regarding community water fluoridation,” Ladapo said in a statement. “The previously considered benefit of community water fluoridation does not outweigh the current known risks, especially for special populations like pregnant women and children.”

Dentists, health organizations support fluoridation

The American Dental Association (ADA) called Ladapo’s guidance “misinformed and dangerous.”

“While some recent studies have shown that sustained exposure to high levels of fluoride above 1.5 parts per million could negatively impact health, that amount is more than twice the 0.7 ppm recommended for community water fluoridation,” the association said in a news release responding to Ladapo’s recommendation.

“The ADA believes in the use of proven, evidence-based science when making public policy decisions,” ADA President Brett Kessler said in the release. “For Dr. Ladapo to call community water fluoridation ‘medical malpractice’ and call on all municipalities to end its practice is a dangerous statement that stands to harm the oral and overall health of all Floridians.”

Other health organizations that support the fluoridation of water include the Florida Dental Association, the American Academy of Pediatrics (AAP), the CDC and the World Health Organization.

The ADA and the AAP also criticized Judge Chen’s ruling against water fluoridation. They said water fluoridation can help prevent lifelong consequences from tooth decay.

“It disproportionately impacts children who are racial minorities, come from low-income families or have special needs. Decades of research support the safety and effectiveness of fluoride to prevent (tooth decay),” the organizations said in a joint statement in September.

The organizations also questioned the validity of the NTP report.

“Other studies have found no link between fluoride and IQ, and the National Academies of Sciences, Engineering and Medicine twice rejected previous drafts of the NTP report.”

Manatee County official seeks removal of fluoride from drinking water

Manatee County fluoridates its water to around the 0.7 milligrams per liter recommended by the U.S. Department of Health and Human Services.

But Ballard argued that the oral health benefits of fluoride are not worth the potential risk of overexposure and cognitive health issues. Ballard backed Ladapo’s guidance and said there are many alternatives for people who want the benefits of fluoride.

“I do think it’s an important balance and obviously we have seen positive effects with community health with the fluoridation of our water. But at the point we decided to start adding fluoride, we didn’t have the info we have now,” Ballard said.

“We’ve gotten a lot of info through some recent lawsuits as well as some recent scientific studies that show pretty decisively that there is increased risk of neuropsychiatric disorders as well as decreased IQ from fluoridation of our water source,” Ballard said.

Manatee County leaders to discuss fluoride removal

Despite the protests of doctors and dentists, several Florida municipalities are choosing to follow Ladapo’s guidance.

Municipalities that have since voted to remove fluoride from their drinking water include Melbourne and Tavares, and Port St. Lucie leaders passed a temporary ban.

Collier County and Winter Haven voted to remove fluoride last year, before Ladapo’s guidance.

Manatee County commissioners are scheduled to discuss the issue during a board meeting scheduled for 9 a.m. Tuesday, Jan. 28, at 1112 Manatee Ave. W., Bradenton.

This story was originally published January 22, 2025 at 5:50 AM.