Utah and Florida became the first two states to ban community water fluoridation in 2025, and HHS Secretary Robert F. Kennedy Jr. has publicly directed the CDC to stop recommending the practice. The pivot follows an August 2024 National Toxicology Program monograph that found, with moderate confidence, that fluoride exposure above 1.5 mg/L is associated with lower IQ in children — a finding reinforced by a JAMA Pediatrics meta-analysis published January 6, 2025. For the roughly 209 million Americans whose water is fluoridated, the political and scientific ground is shifting faster than federal rulemaking can keep up with.
What’s Happening in 2026
Utah moved first. Governor Spencer Cox signed HB 81 on March 27, 2025, making community water fluoridation (CWF) illegal statewide effective May 7, 2025. The law bars any person or political subdivision from adding fluoride to a public water system and, as a partial concession to dentistry, authorizes pharmacists to prescribe fluoride supplements without a dental or medical referral.
Florida followed. Governor Ron DeSantis signed SB 700 — the “Florida Farm Bill” — on May 15, 2025. Its fluoride provisions took effect July 1, 2025, barring the use of “certain additives” in public water systems. DeSantis characterized fluoridation as “forced medication” that violates informed consent.
Other states have moved less cleanly. In Louisiana, a fluoride bill advanced in both the 2025 and 2026 legislative sessions; the 2026 version (SB 4) would let individual water systems with more than 5,000 service connections hold customer votes on whether to keep fluoridating. Nebraska’s LB 147 would convert that state’s existing fluoridation mandate into a local option. Tennessee’s 2025 bill to require utilities to stop fluoridating by May 1, 2025 died in the state Senate. Montana’s bill missed the general-bill transmittal deadline and stalled. Ohio and several other states have considered proposals that have not passed.
Federal activity has been rhetorical rather than regulatory. On April 7, 2025, Kennedy told the Associated Press he would direct the CDC to stop recommending CWF; the same day, EPA Administrator Lee Zeldin announced in Salt Lake City that the agency would “expeditiously review new scientific information” on fluoride’s health risks. EPA followed up on January 22, 2026, by releasing a preliminary assessment plan and literature survey for public comment, accelerating a review that under normal Safe Drinking Water Act timelines would not have been due until 2030.
Worth keeping straight: the current CDC-recommended optimal level for fluoridation is 0.7 mg/L, set in 2015 (down from the previous 0.7–1.2 mg/L range). The EPA’s enforceable Maximum Contaminant Level (MCL) for fluoride is 4.0 mg/L, with a non-enforceable secondary standard of 2.0 mg/L to prevent dental fluorosis. The optimal level and the MCL are different numbers for different purposes.
The Science at the Center of the Debate
The NTP monograph published August 21, 2024 is the document driving most of the current policy debate. After evaluating studies through October 2023, the National Toxicology Program concluded with “moderate confidence” that fluoride exposure above 1.5 mg/L in drinking water is consistently associated with lower IQ in children — on the order of 2 to 5 IQ points across the underlying literature. The studies were overwhelmingly conducted outside the United States, in countries such as China, India, Iran, Pakistan, Canada, and Mexico, where some populations experience total fluoride exposures well above US levels.
The nuance most coverage misses: the NTP explicitly stated there was insufficient data to draw conclusions about exposures below 1.5 mg/L. US community water fluoridation targets 0.7 mg/L — less than half that threshold.
The JAMA Pediatrics meta-analysis by Taylor et al., published online January 6, 2025, analyzed 74 epidemiological studies and reported an inverse dose-response: each 1 mg/L increase in urinary fluoride was associated with a decrease of roughly 1.63 IQ points. Inverse associations persisted in subgroup analyses restricted to urinary fluoride below 4, 2, and 1.5 mg/L. The authors noted that most included studies had high risk of bias, and stated that their analysis was not designed to speak directly to the US CWF policy question. No included study was conducted in the United States.
A 2024 Cochrane update on fluoridation’s cavity-prevention benefit complicated the other side of the ledger. It found that more recent studies — conducted in an era when fluoride toothpaste is universally available — show a smaller cavity-reduction effect than the landmark studies that established the practice in the mid-20th century.
Major dental and public health bodies have not changed their position. Through 2024 the American Dental Association, American Academy of Pediatrics, and CDC continued to endorse CWF as a safe, effective, and cost-effective caries-prevention measure at the recommended 0.7 mg/L level.
What This Means for Your Tap Water
As of the most recent CDC reporting (2022), about 72.3% of Americans on community water systems — roughly 209 million people — received fluoridated water, which works out to around 63% of the total US population. That share is now dropping as state bans take effect.
A key point about the state bans: they prevent utilities from adding fluoride. They do not remove naturally occurring fluoride, which can be significant. Groundwater across parts of the Southwest and western Great Plains — Texas, Oklahoma, Colorado, New Mexico, Arizona — contains natural fluoride levels that routinely exceed 2 mg/L, and wells in some areas exceed the EPA MCL of 4 mg/L. In these regions, the political debate about CWF is essentially irrelevant; the relevant question is whether your water exceeds the enforceable federal limit.
If you live in a state that has banned fluoridation and your utility uses surface water, your tap water’s fluoride level will typically drift down to a natural background of roughly 0.1 to 0.3 mg/L over weeks to months as the system flushes. If you are on a private well in a high-fluoride aquifer, nothing about the CWF debate protects you — private wells are not regulated under the Safe Drinking Water Act at all, and the only way to know your exposure is to test. See our well water testing guide for how to go about it.
Who’s Affected Right Now
Utah: Before HB 81, about 44% of Utah residents received fluoridated water — already one of the lowest rates in the country, concentrated in Salt Lake and Davis counties and Brigham City. Roughly 1.6 million people saw their supply shift to natural background levels beginning May 7, 2025.
Florida: Roughly 70 to 78% of Floridians were on fluoridated systems before SB 700, depending on the source. All counties that fluoridated had to stop by July 1, 2025, affecting tens of millions of residents.
Private well users in high-fluoride regions: Unaffected by the political debate, but potentially facing the most real exposure risk. Natural fluoride above 2 mg/L causes dental fluorosis; above 4 mg/L it violates the federal MCL.
States where legislation is pending or recently failed: Louisiana (advanced in 2025 and 2026), Nebraska (LB 147), Ohio, and several others. Bills in Tennessee and Montana failed in 2025.
Cities that opted out voluntarily: A growing list, including Buhl, Idaho and water districts in Union County, Oregon, predates the state-level wave.
What You Can Do
- Check your current fluoridation status. The CDC’s My Water’s Fluoride tool at nccd.cdc.gov/DOH_MWF/ lists the fluoridation status of participating public water systems by state and utility.
- If you are on a private well or in a naturally high-fluoride area, test. A certified laboratory test for fluoride runs $20 to $50. See how to test your tap water for the process.
- If you want to remove fluoride, know what works. Standard activated-carbon filters and most pitcher filters do not remove fluoride. The three effective removal methods are reverse osmosis (typically 85–95% reduction), distillation, and activated alumina filtration. Our guide to the best reverse osmosis systems covers certified options.
- Read your CCR. Your utility’s annual Consumer Confidence Report reports fluoride levels whether or not your state still allows fluoridation.
- For full contaminant context, see the fluoride contaminant profile with health effects, regulatory history, and detection data.
How WaterVerge Tracks This
WaterVerge pulls fluoride monitoring results from the EPA’s Safe Drinking Water Information System (SDWIS), which covers fluoride as a regulated contaminant under the 4.0 mg/L MCL. City pages display detected fluoride levels where a utility has reported them, along with any MCL violations on record. As state fluoridation bans take effect, reported fluoride concentrations in affected utilities will fall toward natural background — a shift that will show up in future SDWIS updates. Search your city to see current fluoride data for your water provider.