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Fluoride has been in most American tap water for decades. It's there to help prevent tooth decay, especially in children. Scientists and health officials say it's one of the biggest public health wins of the 20th century. But lately, fluoride has found itself at the centre of a heated debate. Some claim it's linked to lower IQ, thyroid disease, even bone cancer.
Others say these fears are overblown or unsubstantiated, fueled by misinformation and conspiracy theories. Now the new U.S. Health Secretary, Robert F. Kennedy Jr., also known as RFK, has been vocal about his strong anti-fluoride views. I think fluoride is on the way up. I think the faster that it goes out, the better. So what does the science really say about fluoride? Why has it got people baring their teeth? And will RFK Jr. remove it from American tap water?
That's what we're going to be talking about today on What in the World from the BBC World Service with me, Hannah Gelbart. Here to break all of this down for us is BBC reporter Phoebe Hobson. Hello. Hi. So why are people so upset about fluoride in the US? Fluoride has always been a controversial issue in the US. It was initially put into tap water around about 80 years ago and it's meant to help people's teeth and stop them having cavities.
There's sort of concern around the health implications of this that have been growing and it's been really fuelled by the appointment of Robert F. Kennedy Jr. as the new health secretary under Trump. He's a big fluoride opponent, so he's really sort of stoked the flames of the anti-fluoride movement who say that the natural mineral could have negative health implications on children's IQ and also other unsubstantiated claims to do with cancer and bone density.
And there were some major reports that were released quite recently that have definitely added fuel to this. Yeah, there have been. There was a big review done in August last year that essentially said, yes, there are some substantiated claims that fluoride can be linked to neurotoxicity. I think one thing we have to be very careful of is fluoride
that the levels of fluoride in these studies were a lot higher than what is found in US drinking water. So the kind of the science and the practicalities of what's really going on in the US and drinking water are actually quite different. What do you mean by neurotoxicity? So neurotoxicity is essentially something that's bad for your brain. You're going to eat it or drink it and it's going to have a harmful impact. The studies imply that fluoride, if you drink it at a certain level, it could reoccur.
reduce the IQ of children. This was the main issue that really caused alarm. Robert FK Jr., he sort of jumped on this bandwagon. He's made claims, which I want to stress are unfounded, that it could also be linked to the increase of autism in the US. It's a very emotive issue because it makes people very worried about what they could be doing to their children. And there's this whole argument, of course, about whether you should have free choice as to whether you want to consume fluoride if it's in the drinking water. That takes away your choice.
Completely. And that's sort of like a bigger picture, isn't it? It's like, do you believe in the foundations of public health? And that's also a bit of the sticking point that people feel like they should have a choice in the US, particularly as now we see fluoride added into toothpastes and mouth rinses. It's also...
Worth noting that fluoride is in other things, you know, it's in tea, it's in food. So the idea that you could sort of completely remove fluoride from your diet is kind of impossible. Talk to me a bit more about this anti-fluoride movement. What are they doing? Where are they gathering and speaking out about fluoride?
Right at the start, the movement was linked to conspiracy theories. And that's what the anti-fluoride movement was for a long time. It was a conspiracy movement. But now it's gone into the mainstream under Robert F. Kennedy Jr. And you'll see, I saw it when I was living in the US. It's all over TikTok and social media about avoid fluoride. You could damage your kid's IQ. Is there a pro-fluoride movement?
Yes, very much. There's a very pro-fluoride health movement. In fact, the American Centre for Disease Control is a big supporter of fluoride in tap water. They consider it, you know, one of the biggest achievements in the 20th century in terms of public health. You know, they say it reduced cavities by about 25%. I should also mention another group that largely supports fluoride is our dentists.
Dentists want to see healthy teeth. And when I was in the US, I spoke to people from the American Dental Society. I also went to the NYU Dental School and I spoke to dentists there. And they say, you know, we want people to have fluoride. We would be overrun in our facilities if people stopped having fluoride in their tap water. One of the reasons...
Improving dental health became so important was that you miss school. If you've got cavities, you're in pain. Bad dental health also further down the line is linked to other health complications. Worst case scenario, the teeth can die and fall out and then you can't actually chew food. So this is potentially has potentially very serious health consequences.
Now, as you say, we've got Robert F.K. Jr. as the US Health Secretary. He's been very outspoken against water fluoridation. Do you think that he could change the amount of fluoride in American tap water? So Robert F. Kennedy Jr. is completely against fluoride in tap water. He has put out on X lots of unsubstantiated claims about how it's really, really bad for you. But he can't actually...
change things on a state level. You know, the way the US public health system works is it's done at a local level. And that is happening in some places. For example, Utah recently banned fluoride in water. I will say that they still encourage it in toothpaste. So he can't really currently do anything massively drastic about it. ♪
We wanted to find out a little bit more about fluoride and how it actually works in your body and on your teeth. So we asked Michelle Roberts, a BBC health reporter. ♪
Fluoride is a natural mineral found in soil and water, but the amount varies and depends on where you live in the world. Some places add fluoride to drinking water because it's good for teeth by strengthening enamel, which helps prevent dental decay and fillings. That's why it's included in many brands of toothpaste and mouthwash too. But some people can get too much with negative health effects. If
If young children are exposed to excessive fluoride which bonds with enamel, over time they can develop a condition called dental fluorosis, with white flecks or lines and in some cases even brown or grey discolouration of the teeth. Similarly, an abundance of fluoride can weaken and damage the bones and joints too. Some worry it could also affect the brain and children's IQ, after some researchers reported a possible link.
There's no strong evidence though. Organisations like the WHO have already recommended safe limits. It says excessive fluoride intake can sometimes happen if, for example, people consume groundwater that's naturally rich in fluoride, particularly in warm climates where water consumption is greater or where high fluoride water is used in food preparation or to water crops.
As Michelle mentioned, the WHO, that's the World Health Organization, has recommended safe limits for fluoride in drinking water. We spoke to Dr. Yuka Makino from the WHO, who told us that the global guideline for fluoride in water is between 0.5 and 1.5 milligrams per liter. But if there's a greater intake from other sources like food, it could be on the lower end.
She said the WHO is aware of all the studies and is reviewing them and all relevant information to make sure their advice is up to date and accurate.
So Phoebe, let's zoom out now. Where else in the world is fluoride added to drinking water? Fluoride is added to drinking water in parts of Brazil, in Malaysia, Australia, parts of Canada, also England. And the US is a place that fluoridates the most, but it is generally like a very popular health policy for places that want to improve dental health. Are there countries that have added fluoride in and then changed their mind and taken it out again?
Yeah, so there are places that have had fluoride in the water. So Israel is one of these places. They had it in the water. They took it out, noticed an increase in cavities. You also have some places in Canada. There's Calgary. Calgary took it out, but then decided, actually, we want it back in. So this year they're putting it back in the water. So really, you see this sort of like tussle at local level about people putting it in and taking it out. Is the anti-fluoride movement gaining traction in other parts of the world? Yeah.
I would say it definitely is. I think the anti-fluoride movement comes under this sort of broad brush sort of scepticism of institutions, right, and how we've seen in recent years people being less trusting of governments, less trusting of scientists. So while you have scientists saying it's good for dental health, it's not going to harm your children's IQ, you have people saying, you know, well, how do you know? It's a hard one to sort of
sometimes convince people now because there is this sort of anti-fluoride movement kind of globally. There are some claims that I've been reading online about fluoride. Some of them we've mentioned already, but I just want to kind of go through them and fact check them with you, Phoebe. So first of all, right, does fluoride in drinking water lead to lower IQ levels in children? That's the one that causes the most amount of alarm,
There have been studies that have linked it to lower IQ levels in children when it is at levels far higher than what is in tap water. And sort of the basis of toxicology is that anything in a high dose is poisonous. Many people criticise the studies that have been looking at the neurotoxicity of fluoride to be looking at it in contexts that are completely different from drinking water. For example, in China where there's high levels of fluoride in some areas in groundwater where they want to take it out because it's far too high the amount that's present.
But currently, the levels in drinking water, there is actually no correlation between fluoride having a neurotoxicity impact. Does fluoride cause cancer? That has been found to be unsubstantiated, but RFK Jr. has sort of peddled that as one of his sort of theories, but the scientific community in general is completely against that. Does fluoride cause brittle bones? Again, the key issue with this is to think about the dose. In a high, high dose...
It has been linked to issues with bone density. However, that's a dose far higher that is in tap water. Can fluoride change the colour of your teeth? Yes, it definitely can change the colour of your teeth, again, at a very high dose. And what is fascinating about this, it's actually a process called fluorosis, where you can see on people's teeth, initially it's sort of white specks and then it becomes sort of darker.
In the US, they realised that fluoride could improve dental health because in areas where you could see fluorosis on people's teeth, they didn't have as many cavities. So that's what kind of sparked this sort of idea in public health is why don't we add it to tap water to improve the dental health of people? Phoebe, thank you so much for coming into the studio. Thank you for having me. Thank you.
If you like this episode, we have covered similar topics like what you need to know about tetanus vaccines. That one was an idea from our listener Henry, who sent us a voice note asking us to investigate whether health claims about the jab are true. And if you've got an idea for something you'd like us to look into, you can always get in touch with us. We're on Instagram, on YouTube, on WhatsApp. All of our details are in the show notes.
Thank you for joining us for this episode of What in the World from the BBC World Service. I'm Hannah Gelbart and we'll be back with another episode soon. See you then.
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