President-elect Donald Trump has announced plans to appoint Robert F. Kennedy Jr. as head of the U.S. Department of Health and Human Services.
If confirmed, Kennedy would oversee major health agencies like the CDC, FDA, and NIH, leading a department with around 80,000 employees and a multi-trillion-dollar budget.
Kennedy, a long-time critic of fluoride, recently vowed to remove it from public water, a practice affecting two-thirds of Americans.
In a post on X, Kennedy stated that on January 20, the Trump administration would advise all U.S. water systems to eliminate fluoride.
"On January 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water. Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease,” Kennedy wrote in a social media post.
The U.S. has started adding fluoride to public water since the 1960s to prevent tooth decay, and health agencies continue to support it.
However, many European countries, including Germany and Sweden, do not fluoridate water, relying on toothpaste and other products instead. Other countries such as Australia heavily fluoridate public water.
Critics argue that with fluoridated toothpaste widely available, water fluoridation may be less necessary today. They also raise concerns about potential long-term risks from fluoride exposure, such as dental and skeletal fluorosis.
Environmentalists worry about fluoride’s impact on ecosystems. High levels, especially accumulation over time can be harmful to humans, aquatic life, affecting fish health, plant growth, and biodiversity.
Fluoride is challenging to remove from water due to its solubility. Unlike chlorine which can evaporate, fluoride ions are non-volatile, meaning they don’t evaporate with water when heated and create a binding that require more energy intensive and advanced processes to seperate.
Kennedy’s views align with his calls to scrutinise food and water additives, which he says should be a matter of individual choice.
While Trump’s choice has drawn praise from some, it has raised concern among public health officials. If appointed, Kennedy’s stance on fluoride could lead to major shifts in U.S. health policy.
Why Countries Fluoridate Public Water?
The primary reason countries fluoridate public water supplies is to reduce tooth decay at the population level, especially for communities that may lack access to adequate dental care.
Water fluoridation began in the U.S. in the 1940s and 1950s, with other countries following suit.
Although there has been evidence of fluoride reducing tooth decay, most studies have only focused on its positive effects neglecting its broader negative impact.
Is Industrial Waste As ‘An Industrial Waste’?
Sort of. Fluoride added to public water supplies is industrially produced fluoride compounds - by-products of the phosphate fertilizer industry. Here’s how it’s made and added:
- Source of Fluoride Compounds: The fluoride used in water fluoridation usually comes from industrial processes, primarily the production of phosphate fertilizers. During this process, fluoride gas is captured and processed into compounds that are safe for water treatment. The most common compounds used in water fluoridation are:
- Sodium Fluoride (NaF)
- Fluorosilicic Acid (H₂SiF₆)
- Sodium Fluorosilicate (Na₂SiF₆)
- Industrial Production: These fluoride compounds are by-products of the phosphate fertilizer industry. Phosphate rock naturally contains fluoride, and when it’s processed to make fertilizers, fluoride gases are released. Instead of letting these gases escape (which would be harmful to the environment), industries capture and convert them into stable fluoride compounds suitable for water treatment.
- Purification and Quality Control: The captured fluoride is purified and standardized to meet strict quality and safety standards. Regulatory agencies like the American Water Works Association (AWWA) and the National Sanitation Foundation (NSF) set specific criteria for the purity and quality of fluoride additives used in drinking water.
- Distribution to Water Treatment Facilities: These fluoride compounds are then packaged and distributed to municipal water treatment facilities. Water treatment plants add fluoride in carefully controlled amounts, usually at concentrations around 0.7 mg/L (parts per million), which is generally considered below the toxic level.
- Automated Dosing Systems: At the water treatment facility, automated systems monitor and control the dosing of fluoride to ensure that the correct, safe amount is added to the water supply.
Which Countries Produce Fluoride? Fluoride production is tied to the phosphate fertilizer industry, as fluoride is a byproduct of phosphate rock processing. The top producers of fluoride compounds for industrial use and water fluoridation include:
- China: China is the world’s largest producer of fluoride products, including sodium fluoride and fluorosilicic acid. Much of this fluoride comes from the phosphate fertilizer industry and is exported for various uses, including water fluoridation.
- Mexico: Mexico has substantial reserves of fluorite (calcium fluoride, or fluorspar), which is the main mineral used to produce fluoride compounds. Mexico exports significant quantities of fluoride, primarily to the U.S. and other nearby markets.
- South Africa: South Africa is a significant producer of fluorite and exports fluoride compounds for industrial uses, although not specifically tied to phosphate fertilizers.
- Mongolia: Mongolia also produces fluorite for export, supplying fluoride for industrial applications worldwide.
- Russia: Russia produces fluoride from fluorspar mining and from phosphate fertilizer byproducts, supplying both domestic and international markets.
What Are Arguments Against fluoridation?
Fluoridated toothpaste, mouth rinses, and other dental products are now widely accessible and affordable. Many argue that these products allow individuals to get sufficient fluoride without contaminating the water supply.
While there exist the benefits of fluoride in preventing tooth decay are well-documented, some recent studies question the extent of its effectiveness given the availability of fluoride in other products. Some researchers argue that the benefit might not be as significant as it was in the past, particularly for communities with widespread use of fluoride toothpaste.
There are concerns about the potential risks of long-term fluoride exposure, such as dental fluorosis (mottling of teeth) and, in rare cases, skeletal fluorosis (bone issues due to high fluoride intake). Additionally, there is a growing awareness of fluoride’s environmental impact, especially when it accumulates in natural water systems.
Some people believe that water fluoridation removes individual choice, as people are automatically exposed to fluoride whether they want it or not. They argue that people who want fluoride protection can choose to use fluoridated toothpaste or other products.
Australia and the U.S. have one of the highest levels of water fluoridation in the world, while much of Western Europe has opted out. Some countries, like Sweden, Germany, the UK, and the Netherlands, do not fluoridate water.
An excess of fluoride in drinking water causes dental fluorosis and skeletal fluorosis. The World Health Organization has recommended a guideline value of 1.5 mg/L as the concentration above which dental fluorosis is likely. Fluorosis is endemic in more than 20 developed and developing nations.
Can People Remove Fluoride From Water?
Fluoride is hard to remove from water once mixed because it exists as a dissolved ion (fluoride ion, F⁻), which integrates well into the water and does not easily separate without specialized filtration. Here’s why fluoride is challenging to remove:
- Small Ionic Size and High Solubility: Fluoride ions are very small and highly soluble in water. Once dissolved, they blend seamlessly with water molecules and don’t precipitate or separate easily, making them difficult to filter out with basic methods like standard carbon filters.
- Strong Chemical Bonds: Fluoride has a strong affinity for forming chemical bonds with other elements, which makes it resistant to simple removal methods. For example, while chlorine can be removed by standard carbon filters due to its volatility, fluoride requires more complex filtration due to its stability and ionic nature.
- Lack of Volatility: Fluoride ions are non-volatile, meaning they don’t evaporate with water when heated. This makes it impossible to remove through simple distillation without additional specialized steps, as fluoride remains in the boiling chamber.
- Specialized Removal Methods Needed: To effectively remove fluoride, more advanced and costly methods are necessary, including:
- Reverse Osmosis (RO), which forces water through a membrane that blocks fluoride and other dissolved ions.
- Activated Alumina filters, which use a material specifically designed to adsorb fluoride ions.
- Ion Exchange Resins, which swap fluoride ions with other harmless ions.
- Cost and Accessibility: These specialized methods can be costly and require maintenance, making them less accessible for individual use or in areas without advanced water treatment facilities.
Due to these factors, fluoride removal requires more complex filtration technology, which is why it’s difficult to eliminate fluoride from water once it’s been added.
