Pediatricians Continue to Recommend Fluoridation

Posted August 26, 2025 & filed under Children's Oral Health and Fluoride, Fluoride and Public Health.

Recent studies and reviews of fluoride have been cited as grounds for this year’s bans on community water fluoridation (CWF) in Florida and Utah. These studies have spurred concern and discussion among health professionals. In a new peer-reviewed article, two pediatricians share their perspectives and how they are talking with parents about fluoride.

In a commentary published in Pediatrics Open Science, Drs. Charlotte Lewis and Susan Fisher-Owens reflect on the many studies that have been released in recent years. They caution readers that some studies should be viewed with caution because of how they were designed and the way in which exposure to fluoride was measured.

The highest profile of these documents was released last year by the National Toxicology Program (NTP). Opponents of fluoridation frequently cite the NTP’s 2024 monograph in reasoning why states or communities should end CWF.

However, Drs. Lewis and Fisher-Owens remind us that the monograph was rejected twice during review by the National Academies of Sciences, Engineering and Medicine. They write, “In addition to inclusion of low-quality studies, [the National Academies’] concern is that NTP ‘failed to make it clear that the monograph cannot be used to draw any conclusions’ “about fluoridated water in the United States. Many studies were conducted in parts of the world where the natural fluoride in water is as much as twice what we use in the US.

“As with other micronutrients,” Drs. Lewis and Fisher-Owens write, “there is a plausible threshold of fluoride exposure above which are adverse neurocognitive effects. Based on the preponderance of high-quality evidence, such a threshold is substantially higher than in CWF. We continue to support CWF as a safe, cost-effective, equitable strategy for cavity prevention and urge our colleagues to do the same.”