Utah Becomes First State to Ban Fluoride in Public Water

Utah Governor Spencer Cox has signed House Bill 81 (HB81), making Utah the first State in the nation to ban fluoride from public drinking water systems. The decision, announced Thursday, March 27, comes despite strong opposition from leading health organizations, including the American Dental Association (ADA) and the American Medical Association (AMA), both of which urged the governor to veto the measure.  

The bill, sponsored by Representative Stephanie Gricius (R-Eagle Mountain), bars cities and municipalities from adding fluoride to their water supplies, stripping local governments of the ability to decide the matter for themselves. The law takes effect on May 7.  

Governor Cox, who was raised in a community without fluoridated water, compared the practice to being “medicated” by the government.

Supporters of the ban argue that the substance poses significant health risks. Fluoride, while naturally occurring, is often introduced into drinking water through hydrofluorosilicic acid, a byproduct of phosphate mining that contains trace amounts of lead and arsenic. Opponents of fluoridation argue that the process of diluting this chemical is complex and carries risks.  

Concerns over fluoride safety were bolstered by a 2023 ruling from U.S. District Judge Edward Chen in California. He found that the widely accepted fluoridation level of 0.7 milligrams per liter in the U.S. may be too high. “There is substantial and scientifically credible evidence establishing that fluoride poses a risk to human health,” Chen wrote. His ruling prompted the U.S. Environmental Protection Agency (EPA) to re-evaluate its fluoride guidelines.  

Additionally, a University of Florida study, consistent with research conducted in Canada and Mexico, linked higher prenatal fluoride exposure to neurobehavioral issues in young children. “We found that higher exposure to fluoride during pregnancy was associated with more neurobehavioral problems in the children by age three,” said study co-author and assistant professor of epidemiology Ashley Malin.  

Supporters of the ban also pointed to a major public health incident in 2019 in Sandy, Utah. A power surge during a snowstorm caused a fluoride pump to malfunction, releasing highly concentrated fluoride into the city’s drinking water. The chemical, which is 20% denser than water, displaced the water supply, sickening hundreds of residents. Testing revealed fluoride levels had spiked to 40 times the federal limit.  

An independent investigation found failures at multiple levels of government, including the City of Sandy, Salt Lake County Health Department, and Utah Department of Environmental Quality. Officials struggled to assess the risk, and it took over a week for residents to receive proper warnings.  

Fluoride has long been promoted as a key tool in preventing tooth decay. The Centers for Disease Control and Prevention (CDC) calls water fluoridation one of the most significant public health achievements of the 20th century. The ADA maintains that it is “the most cost-effective way to prevent tooth decay on a large scale.”  

“As a father and a dentist, it is disheartening to see that a proven public health policy, which exists for the greater good of an entire community’s oral health, has been dismantled based on distorted pseudoscience,” said ADA President Brett Kessler.  

Rick North, board member of Fluoride Action Network, disagrees. “What’s false is the CDC claiming that fluoridation is one of the 10 greatest health achievements of the 20th century. What’s true is that ending fluoridation will be one of the 10 greatest health achievements of the 21st century,” North has said.

Critics of the ban argue that it will disproportionately harm low-income communities, where fluoridated drinking water is often the primary form of preventive dental care. While fluoride supplements remain available at pharmacies without a prescription, many health professionals fear that access will become more limited, leading to a rise in cavities and other oral health issues.  

Utah’s move could set a precedent for other states. In Florida, the State’s Surgeon General has urged communities to stop fluoridating water. Nebraska lawmakers are considering repealing a mandate requiring fluoride in public water systems, and similar efforts are underway in Ohio, South Carolina, and other states.  

Meanwhile, in Arkansas, a bill proposing restrictions on fluoridation stalled in committee, but its sponsor has vowed to bring it back. In Kentucky, a measure to make fluoridation optional failed to gain traction in the state Senate.  

While Salt Lake and Davis counties voted two decades ago to add fluoride to their water systems, the new law will override those decisions. Some residents argue that banning fluoride ignores the will of the voters, while others feel it restores their right to make personal health choices.  

Water districts have also expressed concerns over the cost and complexity of fluoridation. The Weber Basin Water Conservancy District, for example, had to invest millions to ensure fluoride was delivered only to Davis County residents who approved it, while preventing exposure to those in Weber County who did not.  

The debate over fluoridation remains highly polarized. Robert F. Kennedy Jr., the U.S. Secretary of Health and Human Services, has openly criticized fluoride as an “industrial waste product” and calling it “very, very dangerous.” He has cited studies linking high levels of fluorine to IQ loss and several other serious health conditions. While the EPA is now re-evaluating fluoride regulations, no federal ban has been enacted.  

For now, Utah stands alone as the first state to outlaw fluoride in public drinking water. With other states considering similar measures, the national conversation over fluoride’s safety and necessity is far from over.

At present, there are no similar bills before the Alabama legislature.