How Utah dentists are preparing patients for the first statewide
fluoride ban
[May 07, 2025]
By HANNAH SCHOENBAUM
SALT LAKE CITY (AP) — With Utah's first-in-the-nation ban on fluoride in
public drinking water set to take effect Wednesday, dentists who treat
children and low-income patients say they're bracing for an increase in
tooth decay among the state's most vulnerable people.
Republican Gov. Spencer Cox signed the law against the recommendation of
many dentists and national health experts who warn removing fluoride
will harm tooth development, especially in young patients without
regular access to dental care.
Florida is poised to become the second state to ban fluoride under a
bill that Republican Gov. Ron DeSantis announced Tuesday he would sign
soon. The Ohio and South Carolina legislatures are considering similar
measures.
Supporters of states’ efforts to ban fluoride said they did not dispute
that it could have some benefits but thought people should not be given
it by the government without their informed consent.
“It really shouldn’t be forced on people,” DeSantis said.
U.S. Health Secretary Robert F. Kennedy Jr. has applauded Utah for being
the first state to enact a ban and said he plans to direct the Centers
for Disease Control and Prevention to stop recommending fluoridation
nationwide.
Many patients not in the know
A majority of Utah water systems already did not add fluoride. The state
ranked 44th in the nation for the percentage of residents receiving
fluoridated water, with about 2 in 5 receiving it in 2022, according to
CDC data. The law will impact about 1.6 million people in Salt Lake City
and elsewhere in northern Utah who are losing fluoridation, state
officials say.
Dentists in Salt Lake City over the past week said many patients were
unaware of the upcoming ban, and most did not realize the city had been
adding fluoride to their drinking water for nearly two decades.
“I did not know about a ban,” said Noe Figueroa, a patient at Salt Lake
Donated Dental Services, a clinic that provides free or heavily
discounted dental treatment to low-income residents. “Well, that’s not
good. I don’t think that’s good at all.”
At Donated Dental, providers expect their monthslong waitlist for
children's procedures to grow significantly and their need for volunteer
dentists to skyrocket. The effects of the ban in children’s teeth will
likely be visible within the next year, said Sasha Harvey, the clinic’s
executive director.
“Fluoridated water is the great equalizer,” Harvey said. “It really
benefits everybody, regardless of your age, gender, your ethnicity, your
education level, your income level — it helps everyone.”
A public health achievement under scrutiny
The fluoridation process involves supplementing the low levels of
fluoride that occur naturally in most water to reach the 0.7 milligrams
per liter recommended by the CDC for cavity prevention. Water treatment
plants dump fluoride into the water in liquid or powder form and often
use dosing pumps to adjust the levels.
Nearly two-thirds of the U.S. population receives fluoridated drinking
water, according to health officials. It was long considered among the
greatest public health achievements of the last century.
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Sasha Harvey, executive director of Salt Lake Donated Dental
Services, stands in her clinic that provides free or heavily
discounted dental treatment to low-income patients, Monday, May 5,
2025, in Salt Lake City, Utah. (AP Photo/Hannah Schoenbaum)
 Fluoride fortifies teeth and reduces
cavities by replacing minerals lost during normal wear and tear,
according to the CDC. It’s especially important to children whose
teeth are still developing. For some low-income families, public
drinking water containing fluoride may be their only source of
preventative dental care.
Some supporters of the Utah law pointed to studies linking high
levels of fluoride exposure to illness and low IQ in kids. The
National Institutes of Health says it’s “virtually impossible” to
get a toxic dose from fluoride added to water or toothpaste at
standard levels.
Elaine Oaks, a Bountiful resident and trustee of her local water
district, said it's not the role of government to decide that the
entire population should receive fluoride in their drinking water.
Individuals and parents should be able to make that decision for
themselves, she said.
Before signing the bill, Cox said there is no difference in health
outcomes between communities with and without fluoride — a statement
Utah dentists say is false.
“Any dentist can look in someone’s mouth in Utah and tell exactly
where they grew up. Did you grow up in a fluoridated area or a
non-fluoridated area? We can tell by the level of decay,” said Dr.
James Bekker, a pediatric dentist at the University of Utah in Salt
Lake City.
Barriers to fluoride supplements
The law shifts responsibility to individuals, meaning all Utah
residents will need to be proactive about their oral health, Harvey
said. Most patients at her clinic only come in when a toothache
becomes unbearable, and many cannot spare the few dollars a month
needed to buy fluoride supplements to add to their drinking water at
home.
Figueroa, the free dental clinic patient, said other expenses take
priority.
Fluoride toothpaste alone is insufficient for children because it
doesn't penetrate the tooth's outer layer, Bekker said. When a
person regularly ingests fluoridated water, their saliva bathes the
teeth in fluoride throughout the day and makes them stronger.
Bekker said he recommends Utah parents add fluoride supplements to
their children’s drinking water. But for families who don’t visit
doctors regularly, that may prove difficult.
Fluoride tablets require a prescription from a doctor or dentist.
Utah providers are working to make the supplement accessible over
the counter, but Bekker said that change may be months or years
away.
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