Fluoride Removal Cost: $10B for US Water
- public water supplies could cost $9.8 billion over five years to treat increased dental caries and tooth decay in children and adolescents, researchers estimate.
- Simon of Brigham and Women’s Hospital noted the increasing discussions around eliminating water fluoridation in the U.S.,despite its long-standing success as 1945.
- While critics question fluoride's safety, some studies link fluoride exposure to neurobehavioral symptoms and lower IQ scores in children, albeit at higher levels then U.S.
Removing fluoride from U.S. water could trigger a surge in dental care expenses, potentially costing the nation $9.8 billion over five years. This projection, stemming from increased tooth decay adn caries, underscores the financial implications of policies impacting community water fluoridation, as highlighted by experts. The debate rages on as critics question fluoride’s safety, while others cite potential links to neurobehavioral issues, even though several studies’ methodologies have been challenged. News Directory 3 dissects these findings, revealing that without fluoride, tooth decay rates jump substantially, leading to millions more needing dental work. Now, with certain states already banning fluoridation and more legislation proposed, what are the lasting effects of these decisions? Discover what’s next …
Fluoride Removal from Water Could Cost Billions in Dental Care
Updated June 06,2025
Removing fluoride from U.S. public water supplies could cost $9.8 billion over five years to treat increased dental caries and tooth decay in children and adolescents, researchers estimate. The study highlights the potential economic impact of policies affecting community water fluoridation.
Dr. Lisa E. Simon of Brigham and Women’s Hospital noted the increasing discussions around eliminating water fluoridation in the U.S.,despite its long-standing success as 1945. The research underscores the importance of community water fluoridation for dental health.
Data derived from Choi SE, et al. JAMA Health forum. 2025
While critics question fluoride’s safety, some studies link fluoride exposure to neurobehavioral symptoms and lower IQ scores in children, albeit at higher levels then U.S. drinking water recommendations. However, experts have challenged the methodologies and conclusions of these studies.
Earlier this year, Robert F. Kennedy Jr., HHS Secretary, suggested halting CDC recommendations for fluoride in tap water. Florida and Utah have already banned water fluoridation, with similar legislation proposed elsewhere.
Study Design
Simon and Dr. Sung Eun Choi of Harvard School of Dental Medicine simulated dental caries prevalence and treatment costs over 5 and 10 years using a sample of 10,000 youths. The sample was based on data from the 2013-2016 National Health and Nutrition Examination Survey.
The simulation calculated baseline rates of dental caries, abscesses, and tooth loss based on current fluoridation levels. It accounted for varying fluoride exposure levels and the risk of dental fluorosis at excessive levels. The analysis assumed a 25% reduction in dental caries due to fluoridation, as reported by the CDC.
Researchers compared baseline tooth decay rates and costs with a scenario were no participants were exposed to fluoride. The model did not include cognitive outcomes due to a lack of scientific consensus on the impact of fluoridation levels in the U.S.
Cost of Fluoride Removal
Researchers estimated that, at current fluoridation levels, a notable percentage of children and adolescents would still develop dental caries. Removing fluoride would increase the overall prevalence of dental caries by 7.5 percentage points, leading to millions of additional decayed teeth.
this increase in tooth decay would cost an estimated $9.8 billion over five years and $19.4 billion over 10 years. Conversely, increasing fluoridation in areas with low levels could decrease tooth decay and save $9.3 billion over five years.
Even when considering only those who drink tap water in fluoridated communities, fluoride removal would still increase dental decay and cost billions. A sensitivity analysis using lower fluoride effectiveness estimates still projected significant costs associated with fluoride removal.