- Federal agencies are reexamining water fluoridation safety following a 2024 report linking high fluoride levels to lower IQ in children.
- The EPA released a new protocol to study fluoride's effects on children's brain development and dental fluorosis.
- A federal court ruled that current fluoridation levels pose an unreasonable risk of reduced IQ in children.
- The chemicals used for fluoridation are industrial byproducts containing trace amounts of arsenic, lead, and aluminum.
- Fewer than an eighth of the world's countries fluoridate water, with most of Western Europe banning the practice.
The U.S. Environmental Protection Agency has taken a major step toward determining whether the fluoride added to most Americans' tap water poses a danger to children's developing brains, announcing a new scientific protocol that will examine links between fluoride exposure and reduced IQ. The move comes as mounting research—including studies funded by the National Institutes of Health and a landmark federal court ruling—has forced regulators to accelerate a review originally not due until 2030.
EPA Administrator Lee Zeldin announced the release of the Protocol for Developing the Fluoride Human Health Toxicity Assessment on August 3, calling it a milestone in the agency's expedited review under the Safe Drinking Water Act.
"Every American should be able to count on safe and healthy drinking water, plain and simple," Zeldin said. "In light of new science and real concerns from the public, the Trump EPA is working in lockstep with HHS to expedite our review of fluoride under the Safe Drinking Water Act."
What the protocol covers
The new protocol lays out how the agency will conduct a dose-response analysis to pin down what levels of fluoride exposure cause harm. The review will look specifically at children's brain development, including effects on IQ, along with dental fluorosis — the staining and pitting of tooth enamel linked to fluoride overexposure.
Health and Human Services Secretary Robert F. Kennedy Jr. framed the review as a matter of parental rights and scientific transparency.
"Parents deserve the truth about fluoride in drinking water—not assumptions, not politics, but rigorous science," Kennedy said. "That is why HHS is working side by side with EPA to ensure this assessment focuses on the health risks that matter most for children, including neurodevelopmental effects and dental fluorosis. By conducting a rigorous dose-response analysis and making every step of the process transparent, we will give states, communities, and families the scientific foundation they need to make informed decisions about fluoride in drinking water."
Years of research fuel the push
The EPA's accelerated review follows years of accumulating research suggesting fluoride may cause harm at levels currently deemed safe. Advocacy groups such as the Fluoride Action Network also point to the fact that the FDA has never approved fluoride as safe and effective for ingestion, and note that fluoride toothpaste must carry a poison warning for children under six. The National Toxicology Program, after an eight-year review, concluded with moderate confidence that higher fluoride exposure is tied to lower IQ in children, citing dozens of human studies showing the same pattern.
In September 2024, a federal court ruled that fluoridation of water at 0.7 milligrams per liter—the level considered "optimal" in the United States—"poses an unreasonable risk of reduced IQ in children." The court ordered the EPA to take regulatory action, noting that approximately 200 million Americans have fluoride intentionally added to their drinking water.
The chemicals used for fluoridation—primarily hydrofluorosilicic acid, an industrial byproduct from phosphate fertilizer and aluminum production—are not pharmaceutical or food-grade and can carry trace arsenic, lead, and aluminum.
America stands apart globally
Water fluoridation remains rare worldwide. Fewer than an eighth of the world's roughly 196 countries fluoridate their water at all, meaning well over 90% of the global population drinks water without added fluoride — including most of Western Europe, where several nations have banned the practice outright. Health researchers have also found no clear link between fluoridation and lower rates of tooth decay compared with non-fluoridating countries over the past half-century.
For decades, Americans were told fluoridation was settled science and simply a matter of trust in federal health agencies. That the EPA is only now, under court order, rigorously studying its effects on children's brains suggests families were owed this scrutiny — and this data — long before fluoride became a fixture in the nation's water supply.
Sources for this article include:
Please contact us for more information.