Birmingham Sues Water Authority Over Fluoride Removal | Ars Technica

Residents of Birmingham, Alabama, received conflicting information regarding the status of fluoride in their municipal water supply during March 2026. On March 20, 2026, Central Alabama Water (CAW) announced it had discontinued water fluoridation, citing aging equipment and increasing maintenance costs. However, subsequent reporting revealed that the utility had ceased adding fluoride to the water supply years prior to the public announcement.

The discrepancy highlights a significant failure in public notification systems and infrastructure management. On March 24, 2026, a CAW spokesperson informed local WBRC news that three of the utility’s water treatment plants had abandoned fluoride addition in January 2023, August 2023, and March 2024, respectively. This means the removal occurred before a 2025 law that restructured the water board, yet there was no public notification of the change at the time.

It’s important to realize that pretty much no one in Birmingham has had any fluoride in their water for two years.

CAW spokesperson to WBRC news

The lack of timely communication prevented residents from consulting with dental care providers regarding alternative fluoride sources. CAW’s initial statement on March 20, 2026, emphasized unsubstantiated health concerns alongside the equipment issues. The utility noted that customers could purchase toothpaste and mouthwash containing fluoride to protect their teeth. In a statement, CAW said ending drinking water fluoridation allows customers and their health care providers to make more individualized decisions about fluoride use.

Legal and Municipal Response

Birmingham Mayor Randall Woodfin publicly criticized the water utility’s leadership following the revelation. In a series of Facebook posts, Woodfin addressed the board’s commitment to transparency and adherence to notification statutes. The city administration argued that stripping a public health measure from hundreds of thousands of people’s drinking water without proper notice violated basic regulatory expectations.

This is the same board that promised transparency. The same leadership that said they would run this utility the right way. And now they can’t even follow a basic notification statute before stripping a public health measure from hundreds of thousands of people’s drinking water.

Birmingham Mayor Randall Woodfin

In late March 2026, the City of Birmingham filed a lawsuit against CAW. According to local WVTM13 news, the filing claims that CAW failed to provide notice of the change. The city requested an emergency court order for fluoridation to resume. The lawsuit asserts that removing fluoride from the water threatened residents’ dental health, specifically impacting low-income residents and children who lack access to dental care. When reached for comment regarding the lawsuit, the City of Birmingham declined to comment, and CAW stated it does not comment on pending litigation.

Public Health Implications

The American Dental Association (ADA) and the American Academy of Pediatrics recommend fluoridating community water to prevent tooth decay, particularly in children. Water fluoridation is considered one of the top 10 public health achievements by the Centers for Disease Control, and Prevention. Despite this consensus, unfounded fears and conspiracy theories regarding the practice have persisted since its introduction in the US in 1945.

Health experts have pushed back against the assertion that topical fluoride products alone are sufficient substitutes for water fluoridation. Scott Tomar, head of the department of population oral health at the University of Illinois Chicago, addressed the efficacy of toothpaste compared to water treatment.

It certainly is true that fluoride-containing toothpaste is effective at preventing decay, but it’s not true that that alone justifies removing fluoride from our drinking water.

Scott Tomar, University of Illinois Chicago

Tomar indicated that CAW’s move to remove fluoride would put residents at risk of more cavities. He noted that the cessation of fluoridation usually shows up first in the youngest children, placing them at the greatest risk.

Broader Policy Context

The situation in Birmingham occurs amidst broader national discussions regarding water fluoridation policy. Anti-vaccine Health Secretary Robert F. Kennedy Jr. Has made strong, unsubstantiated claims that fluoridated water is unsafe, despite having no background in medicine, public health, or science. As health secretary, Kennedy has pledged to remove fluoride from US water.

A modeling study conducted by Harvard University researchers in 2025 analyzed the potential impact of such a policy shift. The study found that if the pledge to remove fluoride from water systems is followed through, it would lead to 25 million more decayed teeth in children and teens in the first five years. The Birmingham case illustrates the logistical and health consequences that can arise when infrastructure changes are implemented without aligning with public health recommendations or notification protocols.