Robert F. Kennedy Jr.’s purpose of eradicating fluoride from the water provide faces challenges no matter what function he performs on well being care within the new Trump administration.
Days earlier than President-elect Trump’s election, Kennedy wrote on the social platform X that “the Trump White House will advise all U.S. water systems to remove fluoride from public water.”
However water fluoridation is a neighborhood authorities determination, and it’s unclear if Kennedy might compel municipalities to eliminate the cavity-fighting chemical.
It is also unclear whether or not Kennedy may have a proper function within the Trump administration, although he has been floated as a possible secretary of Well being and Human Companies (HHS), and Trump has mentioned he’ll let the previous unbiased presidential candidate “go wild” on public well being.
Kennedy wrote that fluoride was “associated” with a bunch of medical points, although many of those claims are linked to publicity to fluoride doses far increased than what most individuals would expertise consuming fluoridated water and brushing their tooth.
Fluoride is a naturally occurring substance that helps to forestall tooth decay by strengthening and rebuilding weakened tooth enamel. Water fluoridation has occurred within the U.S. since 1945.
Whereas Trump has but to say what function Kennedy may have in his second administration, he hasn’t rejected the concept of eradicating fluoride, saying it “sounds OK to me.”
An area determination
The Facilities for Illness Management and Prevention (CDC) says on-line that “state and local governments decide whether to implement water fluoridation.”
The CDC has hailed water fluoridation as one of many high 10 biggest public well being achievements of the twentieth century resulting from its impact in drastically decreasing tooth decay.
There are not any federal legal guidelines that require water fluoridation, although some authorities businesses present limits and suggestions on how a lot fluoride can or must be in consuming water.
“Fluoride is an instance of one thing that could be a hyper native determination. Even inside states, most native authorities resolve whether or not or not fluoride is added to the water. Now, that could be a coverage determination that may occur in any stage of presidency,” Chrissie Juliano, govt director of the Huge Cities Well being Coalition, instructed The Hill.
The U.S. Public Well being Service recommends fluoride ranges — a most of 0.7 milligrams per liter — for max oral and diminished danger of potential hurt, however these requirements will not be enforceable, and any water fluoridation in neighborhood techniques is completed voluntarily.
Potential avenues to a ban
The incoming Trump administration might theoretically use the Poisonous Substances Management Act of 1976 (TSCA) as technique of prohibiting water fluoridation. The TSCA grants the Environmental Safety Company (EPA) the authority to control chemical compounds within the U.S.
“The new administration, with or without RFK’s influence, could seek to ban water fluoridation, or revisit the levels of fluoridation, through several avenues, including TSCA. Whether it will or not remains to be seen as the legal and public health implications of ‘banning’ water fluoridation are significant,” mentioned Lynn L. Bergeson, managing associate of the legislation agency Bergeson & Campbell.
The Trump administration might additionally restrict water fluoridation via the Secure Consuming Water Act of 1974, which grants the EPA authority to control water high quality in all states.
“The federal government presumably could revisit the maximum contaminant level under the Safe Drinking Water Act for fluoride in drinking water and effectively disallow the fluoride. Not quick or easy, but an option,” Bergeson mentioned.
“HHS would need, again presumably, to revisit its recommendation that the current level of fluoride in drinking water … is desirable, as the [American Dental Association] reaffirmed on September 25th in its statement, to prevent tooth decay,” she added.
“Pursuing any such option would be expected to invite significant backlash as well as praise despite the largely uncontroverted support fluoridated drinking water has enjoyed for decades.”
Earlier authorized challenges
The EPA units authorized limits on 90 completely different contaminants in consuming water, together with fluoride.
Per EPA requirements, consuming water might not have greater than 4.0 mg/L of fluoride, with the company citing bone illness and kids probably getting mottled tooth because the potential long-term well being results.
These requirements had been challenged in a 2017 lawsuit filed by a coalition of teams against water fluoridation, claiming of their criticism that the chemical was the reason for unfavourable neurological impacts in people.
The federal choose presiding over the case, Obama appointee U.S. District Choose Edward M. Chen, earlier this yr ordered the EPA to handle the potential impacts of fluoride in consuming water on IQ ranges, writing there was “unreasonable risk” stemming from fluoride in consuming water.
Chen additionally famous, nonetheless, that his unreasonable danger discovering “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.”
The lawsuit was filed after the EPA denied a citizen petition filed by the plaintiffs, which TSCA permits for following a 2016 congressional modification.
Bergeson mentioned she doesn’t interpret the legislation to imply {that a} citizen petition and subsequent judicial attraction can function a substitute for the chance analysis of chemical compounds.
“The implications of getting to a risk management rulemaking via this route leads to a ton of unintended consequences and EPA budgetary and programmatic anomalies,” she mentioned.
The Nationwide Toxicology Program (NTP) beneath the Division of Well being and Human Companies launched the findings of its personal analysis earlier this yr of fluoride’s affect on neurodevelopment and cognition
The NTP concluded that “higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children.”
“It is important to note, however, that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ,” the NTP added.
Ongoing debate
In keeping with Myron Allukian, a dentist of greater than 50 years and former president of the American Public Well being Affiliation, anxieties and conspiracies round water fluoridation have existed for many years.
Allukian, who served as chair of the U.S. surgeon basic’s Work Group on Fluoridation and Dental Well being for the 1990 Prevention Targets for the Nation, was a part of the early efforts to get cities like Boston to undertake water fluoridation.
“When I started out on this, you know, they thought it was a Communist plot. And there was a very active movement that the Communists were for this,” mentioned Allukian, recalling how he later met with a well being official from the Soviet Union who mentioned folks in his nation believed fluoridation was a capitalist scheme.
“People against it have looked for different reasons to be against it,” he mentioned.
Allukian, the previous dental director for the town of Boston, mentioned a fluoride-free atmosphere would end in issues with bones and tooth because the chemical is a pure part of these physique elements. He additionally emphasised that fluoride happens naturally in waterways, so fluoride-free consuming water isn’t a practical purpose.
Jeffrey A. Singer, a surgeon and senior fellow on the Cato Institute libertarian suppose tank, is doubtful in regards to the research linking fluoride to hostile results like decrease IQ.
“These are very poor-quality studies,” Singer mentioned. “Most of them are just observational studies and, you know, correlation is not causation. And in fact, most of them use IQ as their evidence of neurotoxicity and IQ is not a good metric for measuring neurotoxicity.”
Singer opposes placing fluoride within the water provide, although his stance has extra to do along with his perception within the doctrine of knowledgeable consent.
Linda Birnbaum, a former federal scientist with the EPA, additionally opposes water fluoridation as she believes the proof leans strongly in opposition to the observe, particularly early in life and through being pregnant. Birnbaum was additionally the director of the NTP in addition to the Nationwide Institute of Environmental Well being Sciences.
“I think what has happened is, over the last 60 years, you went from where the only source of fluoride that most people got was from their drinking water to now people are getting fluoride every time they brush their teeth or use mouthwash,” mentioned Birnbaum.
“So, the benefit of everybody drinking fluoridated water, as far as prevention of cavities is not clear like it used to be, and I think there’s growing evidence that it, in fact, may not be very helpful anymore.”
