A study warns that removing fluoride from public water could lead to millions of additional cavities in children and billions in healthcare costs, disproportionately affecting low-income families.

A new study published in JAMA Health Forum estimates that removing fluoride from public drinking water in the US would lead to 25.4 million excess decayed teeth in children and adolescents within five years, along with $9.8 billion in health care costs. After 10 years, these impacts would more than double to nearly 54 million excess decayed teeth and $19.4 billion in costs.
Fluoride, a mineral that strengthens tooth enamel, has been added to public water systems in the US since 1945. The CDC considers it one of the 10 greatest public health achievements of the 20th century. However, recent bans in Utah and Florida, along with political rhetoric, threaten this practice.
The study highlights that low-income families and children on Medicaid would be disproportionately affected by the removal of fluoride, as they rely more on public water systems for dental health benefits.