Robert F. Kennedy Jr., a former environmental and civil rights advocate and expected pick for Health Secretary in the incoming Trump administration, has announced in a tweet that 'on January 20th [2025] the Trump White House will advise all U.S. water systems to remove fluoride from public water.' Kennedy goes on to claim that 'fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.' Fluoridation of drinking water is widespread in the US, and fluoride is added to about 10% of tapwater in the UK. Let's review Kennedy's claims.
Is fluoride an industrial waste?
Yes. According to a paper published by the Scientific World Journal, '[fluoride] is a generally unwanted byproduct of aluminium, fertilizer, and iron ore manufacture.' The same paper claims that while water fluoridation was associated with a reduction in dental caries, 'by up to 60% among almost 30,000 schoolchildren in Grand Rapids, [Michigan],' simultaneously 'these findings have been criticised for major methodological flaws, including data cherry-picking and selection bias... Notwithstanding this and before the final results of these studies were known, the US Public Health Service adopted the 1 ppm dose and supported the widespread introduction of community water fluoridation schemes in 1950.'
Is fluoride associated with arthritis?
Yes. A paper published by the Malaysian Orthopaedic Journal, available to read on the US National Library of Medicine website, states that 'fluorosis has been associated with an increased risk of degenerative changes in the knee. Multiple studies have found an association between arthritis and elevated fluoride levels.' The paper concludes that there is 'an increased risk of knee arthritis in patients with elevated blood fluoride levels and patients with increased fluoride levels are associated with more severe symptoms and radiographic disease.'
Is fluoride associated with bone fractures?
To some extent. This is a little more complex. Studies published by the US National Library of Medicine, and Nature magazine conclude that there is no association between fluoridation and bone fractures. However, a study published in the European Journal of Public Health concludes that the 'risk of bone fractures appears to non-linearly increase along with exposure to fluoride in drinking water, regardless of bone site and sex, at levels of exposure above the WHO standard and similar to those that have associated to altered thyroid and cognitive function. Under a public health perspective, fluoride in drinking water should be kept below 1.5 mg/L to prevent bone fractures.'
Is fluoride associated with bone cancer?
Yes. While Google's AI-generated response to this question answers in the negative, citing a number of studies, a quick scroll down reveals plenty of good evidence of association. A study published by the South Asian Journal of Medicine found that 'both, the serum and drinking water fluoride levels, were significantly higher in patients with osteosarcoma as compared to controls (P > 0.05, P > 0.001, respectively).' The study concludes that 'these results suggest a link between fluoride exposure and osteosarcoma.' Furthermore, a Guardian article from 2005 states that 'fluoride water causes cancer', citing research made available by the Environmental Working Group, a Washington-based nonprofit, who requested at the time the research was published 'that fluoride in tap water be added to the US government's classified list of substances known or anticipated to cause cancer in humans.' Concerns around fluoride and cancer generally focused on osteosarcoma, a rare cancer that affects children, particularly young boys, with a 50% mortality rate and with almost all survivors losing limbs to amputation.
Is fluoride associated with IQ loss?
Yes. An unpublished assessment by the US federal government's National Toxicology Program reports 'moderate confidence' that drinking water containing fluoride at levels at least twice as high as those recommended by the federal government is associated with lower IQ in children. The Fluoride Action Network (FAN) and other groups argue that such data indicate EPA should be regulating fluoride under the Toxic Substances Control Act (TSCA). This issue was the subject of a federal courtcase brought by Food and Water Watch against the US Environmental Protection Agency. The Court found that 'adding fluoride to drinking water poses such a sufficient risk of lowering children’s IQ that the EPA must respond in some regulatory way.' IQ is by no means a perfect measure of an individual's intelligence. However the correlation between high levels of fluoride in water and a measured decrease in IQ should be enough put citizens on guard about possible damage caused by fluoride to the human nervous system.
Is fluoride associated with neurodevelopmental disorders?
Yes, to some extent, with further research required. A study published in the journal Medicina concludes that 'current epidemiological evidence indicates that fluoride exposure may have neurotoxic effects on neurodevelopment, including behavioral alterations, cognitive impairment and psychosomatic issues,' while stating that more studies were needed 'to provide conclusive evidence of an etiologic association between pre- or post-natal fluoride exposure and ADHD.'
Is fluoride associated with thyroid disease?
Yes. Even Google's AI-generated response to this question admits that 'some studies have found an association between fluoride exposure and thyroid disease.' A review of studies published in the journal Environmental Research tells us that 'for thyroid disease, the few available studies suggested a positive association with goiter and with hypothyroidism in both children and adults.'
Conclusion
Water fluoridation was rolled out on a grand scale in the US in 1950, before the final results of the study in Grand Rapids Michigan, cited above, were fully known. The Centre for Disease Control has listed water fluoridation as one of the 10 greatest US public health achievements of the 20th century. In the light of the issues raised by Robert F. Kennedy, Jr., all of which are grounded in good science and reasonable concern, it seems fair to conclude that, even if the new Trump administration makes a great number of mistakes over the next four years, 'advising US water systems to remove fluoride from public water' will not be one of them. Why Google's AI-generated answers to questions about fluoride appear to ignore data about the substance's potential harmfulness is anybody's guess.
by, Sam Davidson, Writer and Author
