Kentucky came the closest it ever has to reversing its statewide water fluoridation requirements for most public utilities last session, with legislation passing the House but failing to make ground in the Senate.
On Tuesday, two lawmakers appeared before the Interim Joint Committee on State Government to present the issue again — and they made clear they intended to revive the legislation again next year.
“The legislation simply undoes the unfunded mandate in the state of Kentucky that requires water producers to add fluoride to the water,” said Rep. Mark Hart, a Republican from Falmouth.
Hart said his goal isn’t to outright ban fluoride in the public water supply — as Utah and Florida did earlier this year — but to give localities the option to not fluoridate their water, a decision that would be made by the local water board.
“When it comes to, in this case, dental treatment, we're not promoting fluoride one way or the other, good or bad,” Hart said. “We're trying to steer away from that conversation, because that's not what the legislation does.”
At the table with Hart were outspoken opponents of water fluoridation who questioned the oral health benefits and expounded the potential risks to brain development. The American Dental Association credits water fluoridation with reducing tooth decay by more than 25% in children and adults.
A 2024 Kentucky Public Radio review found that the cost of water fluoridation varied across localities. The Louisville Water Company spends about $284,000 each year out of a $112 million operating budget. Kentucky American Water, which serves residents in Lexington and parts of several surrounding counties, estimates that the company will spend over $120,000 in bulk fluoride costs over a 12-month period.
Water fluoridation in Kentucky began in Maysville and Louisville in 1951, according to the state Cabinet for Health and Family Services, and in the 1960s, the legislature changed the law to require public water systems to be fluoridated.
While Hart insisted his proposed law was not meant to be a debate over the health benefits or risks of fluoride, water fluoridation has increasingly become a political football, as prominent skeptics like U.S. Health and Human Services Secretary Robert F. Kennedy Jr. argue it is more harmful than beneficial.
Stephen Robertson, the president of the Kentucky Dental Association and practicing dentist in Bowling Green, said Kentucky has been a leader in water fluoridation and urged the legislator not to go backwards.
“We feel that we have 79 years of quality science showing that this is effective,” Robertson said. “It's no different than the iodine in the salt — when was the last time you saw somebody with a goiter — or the vitamin D in the milk.”
In response to a question about Kentucky’s poor rankings in national studies on oral health, questioning the usefulness of fluoride thus far, Robertson asked, “How much further do you want to go down?”
Before the committee, Jack Kall, the executive chair of the International Academy of Oral Medicine and Toxicology and Louisville dentist, used language similar to Secretary Kennedy, calling fluoride a neurotoxin. He spoke directly before the bill’s supporters.
“Fluoride will interfere with brain development, it does a lot of other nasty things too, but that's the big focus here, and so we need to keep that in mind,” Kall said.
At least one lawmaker, GOP Sen. Steve Rawlings of Burlington, said he would also support a total ban.
The science behind fluoride
Drinking water is one of the main ways that Americans get fluoride, with almost two-thirds of Americans receiving fluoridated drinking water, according to the U.S. Centers for Disease Control and Prevention. The public health agency has declared water fluoridation to be one of the greatest public health achievements of the 20th century.
The naturally occurring mineral, which is also sometimes artificially added to toothpastes and mouthwashes, strengthens teeth and reduces cavities, according to the CDC.
Studies have found that high levels of fluoride may be linked with streaking or spotting on teeth and, in a report from the National Toxicology Program, lower IQs in children. The study looked at drinking water with over 1.5 milligrams of fluoride per liter, more than twice the levels recommended by the CDC. In part based on that study, a federal judge ordered the EPA to further regulate fluoride in drinking water last year.
