By Abbas Nazil
Utah has made history as the first U.S. state to ban the fluoridation of its public drinking water, a move that reflects growing skepticism about the long-standing public health practice.
Governor Spencer Cox signed the law on Thursday, setting the ban to take effect on May 7.
The decision places Utah at the forefront of a movement challenging fluoride’s role in water treatment, with other Republican-led states, including North Dakota, Tennessee, and Montana, considering similar bans.
The prohibition comes amid renewed scientific debate over fluoride’s potential risks. Fluoridation, introduced into U.S. water systems in 1945, is widely credited with reducing childhood cavities and adult tooth decay.
The Center for Disease Control and Prevention has recognized it as one of the most significant public health achievements of the 20th century.
However, concerns over fluoride’s possible neurotoxic effects have led some policymakers and communities to reconsider its benefits.
The controversy intensified last year when the U.S. Department of Health and Human Services, under former President Joe Biden, published a report concluding with “moderate confidence” that higher fluoride levels were associated with lower IQ scores in children.
The debate gained further traction in January when researchers published a study in *JAMA Pediatrics* that identified a statistically significant link between fluoride exposure and reduced IQ levels.
However, the study did not establish a definitive threshold at which fluoride becomes harmful, leaving key questions unanswered.
While many health organizations, including the World Health Organization, set fluoride safety limits at 1.5 milligrams per liter—double the U.S. guideline of 0.7 mg/L—there is still ongoing discussion about whether these standards should be updated.
Critics argue that the recent studies do not adequately account for other environmental and genetic factors that may contribute to cognitive development, and that the benefits of fluoridation outweigh potential risks.
The pushback against fluoridation is not limited to conservative states. Liberal-leaning cities such as Portland, Oregon, and Honolulu, Hawaii, have also chosen to ban fluoride from their public water supplies.
Internationally, several countries, including Germany and France, have long rejected fluoridation, favoring alternative dental health strategies.
Supporters of fluoridation argue that it plays a crucial role in reducing dental health disparities, particularly among lower-income populations with limited access to dental care.
However, with fluoride toothpaste widely available since the 1960s, some studies suggest that the benefits of water fluoridation have diminished over time.
A Canadian study found that discontinuing fluoridation led to increased dental caries, while an Irish study reported a reduction in severe cavities in both fluoridated and non-fluoridated areas.
As Utah’s ban sets a precedent, the nationwide debate over fluoridation’s role in public health is likely to continue.