Researchers in the United States have found that banning fluoride from public water supplies would lead to a significant rise in tooth decay and dental expenses, especially among children who are publicly insured or uninsured.
The study, conducted by a team at Mass General Brigham in Boston, Massachusetts, focused on children because fluoride helps strengthen teeth as they develop. There is strong evidence linking fluoridated water to better oral health in young people.
The researchers analyzed data from 8,484 children aged 0 to 19, about half of whom were girls. This data came from the National Health and Nutrition Examination Survey (NHANES), which represents the US population. Using this information, they created a microsimulation model to predict how removing fluoride from drinking water would affect children’s oral health, quality of life, and dental care costs.
They tested two scenarios over five and ten years, which match typical policy planning periods: one with current fluoride levels maintained, and another with fluoride removed from public water.
The results showed that without fluoride, the number of decayed teeth would rise by 7.5 percentage points. This means 25.4 million more teeth would develop decay over five years — roughly one affected tooth for every three American children. At the same time, cases of fluorosis — a condition causing tooth enamel discoloration due to too much fluoride — would decrease slightly by 0.2 million.
The researchers also estimated that dental care costs would increase by $9.8 billion over five years and nearly double to $19.4 billion after ten years.
“We know fluoride works,” said Dr. Lisa Simon, a lead researcher. “Our study shows how much communities benefit from it and what they stand to lose if it is removed.”
