SALT LAKE CITY, Utah – In a groundbreaking move, Utah has officially become the first state in the United States to ban the addition of fluoride to its public drinking water systems. Governor Spencer Cox signed House Bill 81 (HB81) into law on March 27, 2025, with the legislation set to take effect on May 7, 2025. The decision has sparked intense debate, pitting public health advocates against those who argue for personal choice and question the safety of fluoride.
“Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.” Health and Human Services Secretary RFK, Jr. posted on X.com.
The bill, introduced by Republican State Representative Stephanie Gricius and supported by Senator Kirk Cullimore, prohibits municipalities and public water authorities from adding fluoride to drinking water, effectively reversing a practice that has been in place in parts of the U.S. since 1945. Utah’s move comes amid growing skepticism about water fluoridation, fueled in part by concerns raised by U.S. Health and Human Services Secretary Robert F. Kennedy Jr., who has long advocated for its removal, citing potential health risks.
Fluoride has been added to public water supplies for decades to strengthen teeth and reduce cavities, a practice hailed by the Centers for Disease Control and Prevention (CDC) as one of the top public health achievements of the 20th century. In Utah, however, only about 44 percent of residents served by community water systems received fluoridated water prior to the ban, one of the lowest rates in the nation according to CDC data from 2022. The state’s largest fluoridated system was in Salt Lake City, serving nearly 1.5 million people across Salt Lake and Davis counties.
Supporters of the ban, including Governor Cox, argue that it restores personal freedom, allowing individuals to decide whether to use fluoride through alternatives like toothpaste or supplements. “This isn’t about banning fluoride entirely,” Cox said at a press conference following the signing. “It’s about giving Utahns the choice rather than mandating it through their water.” The law also includes provisions for pharmacists to prescribe fluoride supplements, shifting responsibility from public systems to individual healthcare providers.
Critics, including the American Dental Association (ADA) and the Utah Dental Association, have sharply condemned the decision. The ADA called it a “wanton disregard for the oral health and well-being of [Utah’s] constituents,” warning that the ban could lead to increased dental issues, particularly among low-income communities who rely on fluoridated water as a cost-effective preventative measure. Studies cited by the CDC suggest water fluoridation reduces dental decay by at least 25% in children and adults, even with widespread access to fluoride toothpaste.
Opposition voices, like that of Lorna Koci, chair of the Utah Oral Health Coalition, emphasize the economic impact. “Fluoridation saves an average of $32 per person annually in dental costs,” Koci noted. “Removing it could cost Utahns millions and disproportionately harm those without access to regular dental care.”
The push to ban fluoride gained momentum following claims of potential health risks, including a 2024 U.S. government report that linked higher fluoride exposure—above levels typically found in U.S. water systems—to lower IQ in children. However, public health experts argue that the fluoride levels in American drinking water (0.7 milligrams per liter, as recommended by the U.S. Public Health Service) are well below thresholds associated with adverse effects. A federal judge’s recent order for the Environmental Protection Agency to reassess fluoride regulations has further fueled the debate, though no conclusive evidence has overturned the scientific consensus on its safety at current levels.
Utah’s water districts are now preparing for the transition, with the Utah Department of Environmental Quality issuing guidance on safely phasing out fluoride by May 7. Some districts, which invested millions in fluoridation infrastructure, face logistical challenges in disposing of remaining fluoride stocks. Meanwhile, other states like Florida, Ohio, and South Carolina are watching closely, with similar anti-fluoride legislation under consideration.
As Utah charts this untested path, public health officials plan to monitor dental health outcomes, particularly among vulnerable populations. The ban marks a significant shift in the national conversation about fluoride, balancing individual liberty against decades of public health policy. Whether it sets a precedent for other states remains to be seen, but for now, Utah stands alone as the first to turn off the fluoride tap.
