A national fluoride fight comes to Miami-Dade, spurred by Florida's surgeon general

MIAMI — Will a new conservative tide in Miami-Dade County wash fluoride out of the drinking water, too?

Florida’s top health official under Gov. Ron DeSantis last week recommended local governments stop adding fluoride to water supplies, claiming alleged risks for mental development in children outweigh the help the chemical provides in strengthening children’s teeth.

The advisory by state Surgeon General Dr. Joseph Ladapo followed a similar fluoride warning by Robert F. Kennedy Jr., President-elect Donald Trump’s pick as health secretary.

Now, a Miami-Dade commissioner is praising calls to rid drinking water of fluoride and reverse what the Centers for Disease Control and Prevention calls a milestone achievement for public health by reducing tooth decay across the country.

“You’re absolutely right @FLSurgeonGen,” Commissioner Roberto Gonzalez, a Republican representing the West Kendall area, said in a recent social media post responding to Lapado’s fluoride declaration. “The science has been ignored on this for a long time, we need to act quickly and help save our residents from unnecessary toxins.”

The post by Gonzalez, a lawyer, could add Miami-Dade to the list of battlegrounds for a fluoride fight that many medical experts say is unfounded and driven by misguided conclusions.

“We’re going to be busier than ever if they take fluoride out of the water,” said Dr. Jeff Ottley, president of the Florida Dental Association. “We’re going to take probably the greatest single public health achievement in the 20th century — and we’re going to remove that? So that kids who need help are going to have cavities and bigger cavities?”

Gonzalez didn’t respond to an interview request, so for now it’s not known if he’ll sponsor legislation to end Miami-Dade’s practice of adding tiny amounts of fluoride to drinking water. But with both the DeSantis administration and the incoming Trump administration advocating for removing fluoride from drinking water, the controversy could be on its way to Miami-Dade — a county that the two Republicans won by double digits in their most recent elections.

Roy Coley, who oversees Miami-Dade’s Water and Sewer Department, said that, so far, he hasn’t received any requests from Gonzalez related to a potential change in the county’s fluoride policy.

“Of course, at the Water and Sewer Department, we don’t claim to be the experts of the science of fluoride,” he said. “We just follow the advice of the experts, until we are told otherwise.”

While new to Miami-Dade, the fluoride debate has been gaining steam in recent years. Two recent developments helped energize the push against fluoride in drinking water.

One was a federal study released in August by the National Toxicology Program, part of the Department of Health and Human Services, that linked lower IQs in children with high levels of fluoride exposure — at rates about double the fluoride that’s found in Miami-Dade and other municipal water systems.

The other development was a September ruling by federal Judge Edward Chen, appointed during Barack Obama’s presidency, ordering the Environmental Protection Agency to take action over what the judge concluded were reasonable concerns about harm caused by fluoride in drinking supplies. That conclusion was based in part on the National Toxicology Program’s study.

“In all, there is substantial and scientifically credible evidence establishing that fluoride poses a risk to human health,” Chen wrote in a Sept. 24 ruling for an advocacy group demanding EPA action on fluoride. “It is associated with a reduction in the IQ of children and is hazardous at dosages that are far too close to fluoride levels in the drinking water of the United States.”

The ruling left it to the EPA to decide what regulatory action is required, which could include warnings about potential harm from fluoride.

Medical groups, including the American Academy of Pediatrics, pushed back against letting the ruling dilute support for fluoride in drinking water.

They noted Chen stopped short of saying there was proof that typical fluoride levels in drinking water pose any health risks, especially with the federal study linking harm to levels beyond what’s found in municipal water systems.

“Fluoride is an effective way to prevent (cavities) with decades of research supporting its safety and effectiveness,” the pediatrics group posted on its website after the ruling. “Communities that have stopped fluoridating water have seen dental (cavities) increase.”

While the federal study flagged harm for concentrations of 1.5 milligrams per liter of water, Miami-Dade and other water systems typically target a mix of 0.7 milligrams or less per liter. For scale, a teaspoon holds about 5,000 milligrams of liquid.

Ashley Malin, an assistant professor in the epidemiology department at the University of Florida’s medical school, recently co-wrote a paper that went further than the federal study did by linking low IQ in children with fluoride levels found in water supplies.

Malin’s research matched fluoride levels in pregnant women’s urine with their children’s mental abilities and found links between higher levels of fluoride and neurodevelopment issues, such as frequent temper tantrums and anxiety.

“It’s concerning,” she said. Malin called Lapado’s guidance on fluoride “a logical one given the current state of the science.”

Coley, the Miami-Dade administrator over Water and Sewer, said he’s seen flare-ups over fluoride before.

“In the 30 years I’ve been doing this, this controversy has come and gone multiple times,” he said.

Each time, Coley said, the consensus of public health experts kept in place the long-standing conclusion that fluoride in drinking water makes children healthier. Removing fluoride, he said, could leave a disparity between rich and poor when it comes to dental health — with affluent parents replacing the lost fluoride with dental rinses and other supplements available for purchase.

“It’s the poorest children in the county that will get none of that,” said Coley, who was recently promoted from Water and Sewer director to chief utilities and regulatory services officer by Mayor Daniella Levine Cava.

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