Florida Surgeon General Ladapo urges communities to stop fluoridating their water

ORLANDO, Fla. — Florida Surgeon General Dr. Joseph Ladapo, a health care skeptic who has been mentioned for possible jobs in the Trump administration, issued an advisory Friday calling on Florida communities to stop fluoridating their water supplies.

Ladapo, citing controversial studies about the potential negative health consequences of fluoridation, made the announcement at a news conference at Winter Haven, where officials announced last week they would halt water fluoridation in that city by the end of 2024.

“It is clear more research is necessary to address safety and efficacy concerns regarding community water fluoridation,” Ladapo said in a statement. “The previously considered benefit of community water fluoridation does not outweigh the current known risks, especially for special populations like pregnant women and children.”

The advisory comes after U.S. President-elect Donald Trump announced he intends to appoint Robert F. Kennedy Jr., who has been openly critical of community water fluoridation, as Secretary of the U.S. Department of Health and Human Services. Before Trump’s victory in the election, Kennedy had promised Trump will call to halt fluoridation on his first day in office as president.

U.S. communities began fluoridating water in 1945, and the resulting reduction in tooth decay has been hailed as one of the great public health victories of the 20th century. But the practice has long generated some amount of controversy, and recently the controversy has grown.

Ladapo’s advisory — like Kennedy’s remarks — mentions studies that show negative effects to health linked to fluoridation, including reduction of IQ for unborn children, increased risk for ADHD and skeletal fluorosis and negative effects to the thyroid gland. The studies, however, are far from conclusive.

The advisory also mentions the practice has been ended in municipalities across the U.S. and in several European countries like France and Germany, and that fluoride is still widely available through other sources like toothpastes and mouthwashes, as well as being directly provided and applied by dental providers.

“Due to the neuropsychiatric risk associated with fluoride exposure, particularly in pregnant women and children, and the wide availability of alternative sources of fluoride for dental health, the State Surgeon General recommends against community water fluoridation,” the advisory reads.

Ashley Malin, an assistant professor in the University of Florida’s Epidemiology Department who has studied fluoride’s effects in pregnant women, told KFF Health News there is evidence that fluoride exposure has been associated with the diseases and disorders that RFK listed, but with caveats.

She said some studies show that higher fluoride exposure, particularly during pregnancy, is associated with reduced child IQ, and that prenatal exposure also is linked to decreased intellectual functioning. However, many of these studies took place in countries outside the U.S., some of which put fluoride in their drinking water at twice the United States’ recommended level.

In a statement sent to The Orlando Sentinel after the release of Ladapo’s advisory, the Florida Dental Association said it strongly supports community water fluoridation at optimal levels.

“Fluoride is naturally present in the water in many parts of the country, including Florida, and has been researched for more than 80 years,” the statement said. “The overwhelming, credible scientific evidence consistently indicates that fluoridation of community water supplies is safe and effective at preventing and repairing tooth decay.

“As a result, fluoride has been added to community water supplies nationwide for over 75 years and the CDC considers community water fluoridation one of the greatest public health achievements of the 20th century.”

The advisory states that an estimated 70% of Florida communities practice water fluoridation.

Ladapo has drawn widespread criticism for other positions he has taken on matters of public health, most prominently his vigorous opposition to mRNA-based vaccines against COVID-19, which he claims are unsafe. A wide range of experts have said Ladapo has thoroughly misrepresented the facts and studies about that vaccine technology, which comprise most of the approved COVID-19 vaccines.

He also drew criticism for failing to urge parents to vaccinate their children or keep unvaccinated students home from school during an alert advising the Fort Lauderdale community of a February measles outbreak.