Utah Becomes the First State to Ban Fluoride in Public Water

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On March 3, 2025, Utah made history by becoming the first state in the U.S. to prohibit fluoride in all public water systems. Governor Spencer Cox signed HB81 into law, ending years of debate about fluoride’s place in drinking water, a discussion that has simmered in the state since the 1970s. The law, which will take effect on May 7, is seen by supporters as a victory for personal choice, while dental and public health experts are sounding alarms about a potential rise in oral health issues. Here’s the story behind Utah’s groundbreaking decision, what it means for the state, and why it’s drawing national attention.

A Long History of Controversy

Utah’s journey with fluoride is not a new one. In 1976, voters narrowly passed a ballot initiative banning fluoride from public water, influenced by claims from groups like the John Birch Society, who argued it was part of a “communist plot.” That ban remained in place until 1998 when state lawmakers reversed course, allowing local communities to decide whether to fluoridate their water. By 2022, approximately 44% of Utah residents had access to fluoridated water. Nationally, about 72% of public water systems include fluoride, a practice the CDC has long supported, citing its effectiveness in reducing tooth decay by around 25%.

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In January 2025, Representative Stephanie Gricius, a Republican from Eagle Mountain, introduced HB81, which quickly gained traction in the GOP-controlled legislature, passing both the House and Senate with substantial support despite opposition from dental professionals and health organizations. Gricius argued that fluoridating water without public consent infringes on individual rights. "The government’s role should be to provide clean, safe water, not to medicate the public," she said after the Senate passed the bill on February 21.

Governor Cox, known for occasionally breaking with his party, signed the bill into law without much fanfare, officially ending decades of fluoridation in Utah’s public water systems.

The Science Behind the Debate

The dental benefits of fluoride are well established. When added to drinking water, fluoride strengthens enamel, helping to prevent cavities, especially in children and low-income families who may not have access to regular dental care. In areas with fluoridated water, tooth decay rates are 25% to 50% lower, according to the Utah Dental Association. Both the CDC and the American Dental Association (ADA) endorse the practice, citing 75 years of research showing that fluoride is safe at the recommended levels of 0.7 milligrams per liter.

However, fluoride opponents have gained momentum, especially since the COVID-19 pandemic fueled skepticism about government health policies. Critics, including Gricius, pointed to a 2024 federal court ruling requiring the EPA to reassess the risks of fluoride after studies suggested a link between high prenatal fluoride exposure and reduced IQ in children. While the National Institutes of Health reviewed several studies on the topic, it noted that many were low-quality, conducted in regions with much higher fluoride concentrations than those found in the U.S. An Australian study, in contrast, found no significant change in IQ from exposure to typical U.S. levels of fluoride in drinking water.

Robert F. Kennedy Jr., the newly appointed U.S. Health Secretary, has been a vocal critic of fluoride, calling it “industrial waste” and linking it to a range of health concerns. His pledge to push for the removal of fluoride from water systems across the country helped bring attention to Utah’s ban, though federal authorities cannot dictate local water policies. Supporters of HB81 also highlighted the cost of fluoridation, arguing that it is wasteful to treat water that ends up being used on lawns or in showers.

What’s Next for Utah?

On May 7, 2025, the 66 water systems in Utah that currently fluoridate their supply, serving nearly 1.5 million people, will stop adding the mineral. Naturally occurring fluoride, often at levels too low to combat tooth decay, will remain in the water, and pharmacists will be allowed to prescribe fluoride pills directly to residents, bypassing the previous requirement to visit a dentist or doctor. Supporters of the ban argue that this gives individuals the freedom to choose whether they want fluoride, but critics point out that the pills can be costly and inconvenient, particularly for low-income or underserved populations who have relied on fluoridated tap water for dental protection.

The Utah Dental Association has strongly opposed the ban. Executive Director Val Radmall, who has seen firsthand the impact of non-fluoridated water on dental health, expressed concern that the decision would lead to more cavities and higher dental costs. The ADA has called for Governor Cox to veto the bill, emphasizing that the decision undermines a longstanding public health initiative. The Utah Oral Health Coalition has estimated that the ban could result in an additional $48 million in dental treatment costs annually, particularly affecting children from lower-income families.

A National Trend?

Utah’s ban is part of a broader trend. Since 2010, over 150 U.S. towns have removed fluoride from their water supplies, and other states such as North Dakota and Tennessee are considering similar measures. While Robert F. Kennedy Jr.'s influence may inspire further action, dental professionals argue that much of the research he references is flawed. Hawaii, where only military bases use fluoridated water, is the closest parallel to Utah’s ban, though Utah’s statewide ban is unprecedented.

As Utah prepares for its new water policy, the state faces an uncertain future. Will tooth decay increase, as many experts predict, or will personal choice triumph as supporters of the ban hope? For now, Utahns will watch closely, with dental professionals across the state bracing for potential fallout. Meanwhile, the rest of the country is closely monitoring Utah’s bold experiment with fluoride, as it could set a precedent for other states and towns considering similar bans. As one Reddit user quipped, “With all the soda we drink here, this could mean a boom for dentists.”