A new study published in JAMA Health Forum warns that eliminating fluoride from US public water supplies, a proposal supported by Donald Trump’s health secretary, Robert F. Kennedy Jr, could lead to a sharp rise in children’s cavities.
Researchers estimate that within just five years, the absence of fluoride would cause an additional 25.4 million cavities in American children, along with $9.8 billion in health care costs. In about 10 years, it would lead to about 54 million excess decayed teeth in children and adolescents and $19.4 billion in costs.
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The study estimates that removing fluoride from US water supplies would result in “one newly decayed tooth for every third child in America,” according to lead researcher and dentist Dr Lisa Simon.
Fluoride is a naturally occurring mineral that has been artificially added to water in the United States for decades to prevent tooth decay. Kennedy argues that adding fluoride to public water supplies poses potential health risks. Water fluoridation was also part of his ‘Make America Healthy Again’ report. Utah and Florida have banned adding fluoride to water.
Simon and her co-author, Harvard assistant professor of oral health and epidemiology Sung Choi, analysed data from the National Health and Nutrition Examination Survey (NHANES) to model the potential cost and prevalence of tooth decay among kids.
Using data collected from 2013 to 2016, the researchers ran their statistical analysis between November 2024 and February 2025, projecting outcomes over five- and ten-year periods.
They found that around one in five children aged 2 to 5 already had dental issues. More than half of children aged 6 to 12 experienced dental issues, with the figure rising to over 57% among teenagers. The researchers found that removing fluoride from water supplies would push these rates even higher — by more than 7 percentage points across all groups.
“This is a huge cost for our country, and it’s all avoidable. There is no better replacement for the time-tested, doctor-trusted use of fluoride in community water programs,” Dr Brett Kessler, president of the American Dental Association, said in a statement, reported CNN. “No amount of political rhetoric or misinformation will change that good oral health depends on proper nutrition, oral hygiene and optimally fluoridated water, or fluoride supplements if community water programs lack fluoride.”
