The U.S. Food and Drug Administration (FDA) is facing mounting pressure from dentists, doctors, and public health experts after signaling plans to ban ingestible fluoride supplements used to prevent tooth decay in children without access to fluoridated water.
The move follows a divisive public hearing held Tuesday at the FDA’s headquarters, where medical professionals and advocacy groups debated the safety and necessity of fluoride tablets prescribed to children in non-fluoridated communities. The supplements have long been a fallback for low-income families or those living in areas without access to fluoridated drinking water.
Dr. James H. Bekker, a professor at the University of Utah School of Dentistry and former president of the American Dental Association, warned the FDA against moving forward with a ban. “When we don’t have fluoride, we see an increase in tooth decay and greater reliance on emergency dental services,” he said.
The FDA’s proposed ban stems from concerns raised in a controversial study published in JAMA Pediatrics in January 2025, which linked high fluoride exposure to lower IQ scores in children. However, experts argue that the fluoride levels associated with those findings far exceed the doses found in either water fluoridation or prescription supplements.
FDA Commissioner Dr. Marty Makary defended the agency’s approach, saying, “When it comes to children, we should err on the side of safety.” The FDA has stated that fluoride supplements were never subjected to comprehensive drug evaluations and believes further scrutiny is warranted.
Dr. George Tidmarsh, newly appointed head of the FDA’s Center for Drug Evaluation and Research, voiced support for reassessing fluoride’s risks, citing the JAMA study and praising presentations from anti-fluoride campaigners, including the Fluoride Action Network.
The hearing was part of an ongoing public comment period that runs until October 31, when the FDA will complete its safety review and potentially decide on whether to remove fluoride supplements from the market.
Medical professionals and public health advocates warned that banning these products would disproportionately impact low-income children and families in rural or underserved areas. Dr. Jennifer Webster-Cyriaque, acting director of the National Institute of Dental and Craniofacial Research, said fluoride remains essential: “Just brushing and using toothpaste alone is not enough.”
The controversy follows wider efforts to roll back water fluoridation in several states. Both Utah and Florida banned fluoride in public water systems this year, after Health and Human Services Secretary Robert F. Kennedy Jr. labeled it “industrial waste” and called for its removal nationwide.
Dr. Scott Tomar of the University of Illinois Chicago said the U.S. is alone in questioning the safety of fluoride at current exposure levels: “We are the only country questioning this.”
While the official FDA panels were split, the majority of public commenters at the hearing reiterated the long-standing dental consensus that fluoride is a safe and effective public health measure.
“There is no serious or robust data showing these products harm public health,” said Peter Pitts, president of the Center for Medicine in the Public Interest. “Removing them risks undoing decades of progress in dental care for the most vulnerable Americans.”
