Fluoride on Trial: Update

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THE TOPLINE

• A federal court has ruled that the current levels of fluoride in drinking water pose an unreasonable risk of injury to public health, particularly to children’s cognitive development.
• Fluoride exposure, even at levels considered “optimal” for dental health in the U.S., has been linked to lower IQ and other neurological effects.
• The EPA must respond, as the court’s finding mandates regulatory action to address this risk.

In a pivotal ruling, a federal court has determined that fluoride levels in U.S. drinking water present an unreasonable risk to public health. This decision comes after a lengthy legal battle in which a coalition of consumer groups argued that the EPA failed to protect the public from fluoride’s neurotoxic effects. The court’s opinion highlights research, including data from the National Toxicology Program (NTP) and EPA’s own experts, which link fluoride exposure, particularly in children, to reduced IQ—an issue we’ve been calling out for several years.

The court ruled that the current fluoridation level of 0.7 mg/L—deemed “optimal” by health authorities—poses an unreasonable risk to children. The court found compelling evidence from human studies, including a review of over 70 epidemiological studies, which confirm that even lower levels of fluoride can have detrimental effects on children’s cognitive development.

The term “unreasonable risk” is from the Toxic Substances Control Act (TSCA); if, at the end of a risk evaluation, the EPA determines a chemical poses an unreasonable risk to public health or the environment, the agency must act immediately to eliminate the risk. The TSCA also allows courts to determine that a chemical poses an unreasonable risk even if the EPA has found otherwise. Courts can then order the EPA to engage in rulemaking regarding the chemical.

The court criticized the EPA’s attempts to downplay compelling evidence, noting that the agency relied on technicalities to avoid taking action. The ruling emphasized that the EPA must engage in regulatory changes to reduce this risk.

It’s a sad situation when the agency charged with protecting the public from dangerous chemicals needs to be forced to do its job by a court.

This decision challenges the decades-long practice of adding fluoride to municipal water supplies, originally implemented in the 1940s to combat dental decay. Today, about 66% of Americans receive fluoridated water, but the court’s ruling casts serious doubt on whether the benefits outweigh the potential risks to public health.

What does the science say?

For years, fluoride has been heralded for its role in reducing cavities, but there’s a growing body of evidence suggesting that its risks—particularly to the brain—outweigh the benefits. A landmark 2006 National Research Council report found that EPA’s fluoride standards were inadequate, linking exposure to various health problems, including effects on the brain, bones, endocrine system, and the pineal gland.

A Lancet Neurology study added fluoride to its list of chemicals associated with developmental neurotoxicity in 2014, a list that includes just 12 other substances. Since the NRC report, nearly 50 human studies have reinforced the connection between fluoride and cognitive harm, especially in children.

What’s next?

This court ruling is a significant victory for those advocating against water fluoridation. The ruling does not require immediate cessation of fluoridation but forces the EPA to take the findings seriously and respond with appropriate regulatory measures. This may signal the beginning of the end for widespread water fluoridation as it currently exists in the U.S.

We’ll continue to monitor the EPA’s next steps and keep you informed of further developments. With this court decision, the momentum is clearly shifting towards a reassessment of fluoride’s role in public health.