Every time we turn on the water tap, we’re doing more than quenching thirst — we’re protecting smiles. For generations, community water fluoridation has quietly and powerfully helped Maryland children and families enjoy better oral health, regardless of income or access to care. It’s one of the greatest public health victories of our time — a simple, safe and effective way to prevent cavities and promote well-being.
Community water fluoridation remains one of the most effective tools we have to proactively protect dental health. Yet recent efforts to revise fluoride guidelines and potentially end water fluoridation threaten to take away that very tool.
As a public health dentist, I see the consequences of untreated cavities in children every day. While good oral hygiene and regular dental visits are key to prevention, community water fluoridation remains the most equitable, cost-effective and proven way to prevent cavities across our communities. There are real barriers to treatment, but fluoridated water is one of the few preventive measures that bypasses them. It doesn’t require an appointment or a co-pay — it just works. However, despite decades of scientific validation and public health success, fluoridation is now under threat.
State bans in Florida and Utah, anti-fluoride legislation introduced in at least 16 other states, including some of Maryland’s neighboring states, along with recent federal directives from Health and Human Services Secretary Robert F. Kennedy Jr. to revise guidelines on fluoride, rely on misinformation and fear — and diminish what the Centers for Disease Control and Prevention (CDC) has previously recognized as one of the top 10 public health accomplishments of the last century. Comprehensive reviews from organizations like the CDC and the American Dental Association continue to affirm the effectiveness and safety of fluoride when used at recommended levels.
Water fluoridation has been endorsed by every major health organization, including the World Health Organization and the CDC. For more than 75 years, community water fluoridation has been studied and proven as a safe and effective public health measure for the prevention of tooth decay. Today, millions of Americans — particularly children — enjoy stronger, healthier teeth because of fluoride in their drinking water.
ADA studies have shown that children who live in communities without fluoridated water are three times more likely to end up in the hospital to undergo dental surgery, and community water fluoridation continues to be effective in reducing tooth decay by nearly 25% in children and adults. Further, the rate of dental cavities among children born after fluoride was added to community water sources was more than 60% lower than that of their older peers.
It’s also worth noting that fluoride levels in public water supplies are not static or unchecked. They are regularly monitored and adjusted based on evolving scientific consensus. Health care professionals, including dental teams, work with families to evaluate all sources of fluoride exposure and ensure the proper balance to prevent cavities without increasing the risk of fluorosis. Community water fluoridation is not a one-size-fits-all policy. It’s an adaptable, science-based strategy guided by decades of research and practice. The consequences of reversal would be devastating.
At the Maryland State Dental Association, we were pleased to recently see our own Sen. Angela Alsobrooks help debunk the myths when she questioned the nominee to be director of the CDC after cuts had recently wiped out the Oral Health Office at the federal agency.
As talks of cuts in Medicaid funding persist at both the state and federal levels, including adult dental Medicaid, water fluoridation is critical to maintaining a baseline of oral health care for underserved communities. Last year, more than 180,000 Marylanders utilized the adult dental Medicaid. Should funding for this important program be cut, along with unfluoridated water, our already stretched hospital emergency departments would likely feel the brunt.
At a time when misinformation spreads faster than facts, we are proud to reaffirm our commitment to science, public health and equity. With trust in science and an unwavering commitment to the communities we serve, the Maryland State Dental Association stands in support of fluoride in community water systems. To preserve the right to clean, safe and protective water — and the health of all Americans — government officials should do the same. Let’s not turn back the clock on a proven public health success.
Dr. Celeste Ziara is a public health dentist and is the president of the Maryland State Dental Association. Dr. Ziara can be reached at advocacy@msda.com.