Louisiana moves to ban fluoride in drinking water | Health care/Hospitals

The efforts underway by Louisiana lawmakers to ban fluoride from public drinking water are bringing warnings from dentists and health experts, who said Thursday that the mineral has improved dental health and that removing it from water supplies is likely to lead to more cavities and tooth decay. 

Senate Bill 2, which passed the Louisiana Senate and is now headed to the House, would repeal the state’s fluoridation program and prohibit any public water system from adding the mineral. 

Fluoride, a naturally occurring mineral in water, soil and food, strengthens tooth enamel. Since the 1940s, many U.S. communities have added fluoride to their water supplies for that purpose, and it is largely celebrated as a win for public health. Research suggests that drinking water with added fluoride can reduce cavities by up to 25 percent.

Dr. Felicia Rabito, an epidemiologist at Tulane University, said its benefits for oral health are well-established.

“There is a robust body of evidence that shows these programs work,” she said, pointing to studies that showed how cavities rose in other cities and states that ended fluoridation programs.

The Canadian city of Calgary stopped fluoridating its water in 2011, and by 2019, elementary students saw a rise in cavities in baby teeth to 64.8%, compared to 55.1% in Edmonton, which kept fluoridation. Decay in permanent teeth more than doubled.

In Wisconsin, cavity rates increased by 200% in second graders within five years of stopping fluoridation in 1960.

Both cities ultimately voted to resume fluoridation in response to the rise in tooth decay.

“This has been a low-cost, very successful program for communities throughout the country,” Rabito said. “The children that are at greatest risk are those who don’t have access to good oral care.”

Fluoridated water, like vaccines and processed foods, has been a longstanding focus of skepticism for U.S. Health and Human Services Secretary Robert F. Kennedy, Jr., and the position has been taken up by some conservative Republicans.

Kennedy has claimed it is linked to various health issues, including reduced IQ in children. And while some studies have shown an association of fluoride levels with lower IQ in children, it is only at much higher levels than what is allowed in the U.S. water supply, said Rabito. 

“It absolutely had no evidence at all of these associations at the levels that we have in community fluoridation programs,” Rabito said.

Louisiana’s fluoridation policies

In Louisiana, only 38% of the population is served by systems that fluoridate water, well below the national average of 72%, according to the federal Centers for Disease Control and Prevention. 

In 2008, Louisiana lawmakers passed the Community Water Fluoridation Act, which required public water systems with more than 5,000 service connections to fluoridate their water, but only if the state could find funding for it. Only a handful of water systems in Baton Rouge, Lafayette and Shreveport fluoridate the water beyond what is naturally occurring.

New Orleans water fluoridation began in June of 1974, according to the Sewerage and Water Board. 

Dentists sound the alarm

Some dentists are sharply critical of the state’s move to eliminate fluoridation entirely.

“If this passes, we’re going to see a huge increase in childhood cavities, especially in areas with low access to care,” said Dr. Jacob Dent, a Lake Charles-based dentist who also has a practice in Baton Rouge.

He said that while some parents may consider relying on fluoride varnishes or other treatments, those measures don’t replace systemic fluoride intake.

“If you take the fluoride out of the water, what are you going to do to supplement it so we don’t have a downturn in oral health?” he said. “I haven’t seen anything proposed to fill that gap.”

Dr. Gregory Guerra, president of the New Orleans Dental Association, said he sees children with tooth decay regularly.

“There’s so much disease out there, and it’s totally preventable,” he said. “Fluoridation is a major contributor to the prevention of childhood tooth decay.”

Tooth decay causes kids to miss school and parents to miss work for dentist appointments. Untreated decay can lead to infection, systemic illness and problems with the alignment of permanent teeth.

He also warned that switching to a fluoride toothpaste or in-office fluoride treatments alone isn’t a sufficient replacement. 

“The fluoride is incorporated into the teeth while they’re forming in utero and early in life,” Guerra said. “That’s a window of opportunity you’ll miss if kids don’t get it.”

The American Dental Association criticized Louisiana Surgeon General Dr. Ralph Abraham for supporting the bill. The Louisiana Dental Association and the New Orleans Department of Health also oppose the fluoride ban.

What happens next

If passed by the House and signed into law by Gov. Jeff Landry, Louisiana’s fluoride ban would take effect January 1, 2026.

Under the bill, public water systems would only be allowed to add fluoride back if at least 15% of registered voters in the affected area sign a petition requesting fluoridation, and a majority votes to approve the measure in an election.

No similar election can have occurred in the previous four years.

Residents can check their water system’s fluoridation levels at the CDC’s My Water’s Fluoride Website.