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Pro-tooth decay RFK Jr’s plan to ban fluoride supplements will “hurt rural America,” dentists say In areas without fluoridated water, supplements are the only way to get adequate doses. Beth Mole – May 16, 2025 5:55 pm | 19 Credit: Getty | Flavio Coelho Credit: Getty | Flavio Coelho Story text Size Small Standard Large Width * Standard Wide Links Standard Orange * Subscribers only   Learn more This week, the US health department announced a plan to ban prescription fluoride supplements for children. These ingested fluoride products are dispensed at safe doses by doctors and dentists to prevent tooth decay in children who are unable to get adequate fluoride doses from community water systems—something that may become more common as more states and cities remove or ban fluoride from their water. Both the American Dental Association (ADA) and the American Academy of Pediatrics recommend fluoridating community water and advise prescribing fluoride supplements for children who do not get adequate fluoride dosages through their water. Nevertheless, the Department of Health and Human Services (HHS) under anti-vaccine advocate and conspiracy theorist Robert F. Kennedy Jr states without clear evidence that fluoride supplements harm children's microbiome and pose other health risks. The ADA pushed back strongly, telling Ars Technica in a written statement that the scientific studies the HHS references as evidence of harms "do not in fact demonstrate any harmful effects for the concentrations of fluoride prescribed by physicians and dentists." To support the alleged claim that fluoride harms the gut microbiome, HHS listed two review studies in its announcement. One review, published this year, concludes, "In humans, high doses potentially may be detrimental to the microbiome, whereas ≤ 2 mg/L [sodium fluoride] had positive effects." Community water systems are recommended to have a level of 0.7 mg/L. The other review, published in 2023, said that there wasn't enough human data to make any conclusions. In the announcement, FDA Commissioner Marty Makary was quoted as saying, "The best way to prevent cavities in children is by avoiding excessive sugar intake and good dental hygiene, not by altering a child’s microbiome. For the same reason that fluoride may kill bacteria on teeth, it may also kill intestinal bacteria important for a child’s health." “Harmful” While fluoride can kill bacteria, particularly at high levels, it's used in oral health to inhibit the demineralization of tooth enamel while enhancing the remineralization of tooth surfaces, the ADA clarifies. The best way to get fluoride is through drinking water, the ADA says. But supplements are a safe alternative if a child lives in an area without fluoridated water or if they mostly drink bottled water. Given rampant false and controversial claims about fluoride, more communities are now abandoning it. This week, Florida became the second state after Utah to ban fluoridation state-wide. "Yes, use fluoride for your teeth, that’s fine," Florida Gov. Ron DeSantis said at a news conference after signing the ban into law. "But forcing it in the water supply is basically forced medication on people. They don’t have a choice." ADA President Brett Kessler worries what children in places such as Utah and Florida will do to get adequate fluoride if the ban on supplements goes through. “In non-fluoridated communities, especially rural areas, fluoride supplements are the only chance for individuals to get the appropriate amount of fluoride to prevent tooth decay," Kessler said in the statement. The move will be "particularly harmful to the most vulnerable and those who lack access to care," he added. While Makary said that the FDA will conduct a safety review of  fluoride supplements, the conclusion seems to be foregone, with the HHS writing that it is already "initiating action to remove" the products. The ADA noted that places that have removed fluoride from drinking water, such as Calgary, Canada, and Juneau, Alaska, have seen increases in dental decay, particularly among children and low-income populations. "Proposals like this stand to hurt rural America, not make them healthier," Kessler said. Beth Mole Senior Health Reporter Beth Mole Senior Health Reporter Beth is Ars Technica’s Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes. 19 Comments