Fluoridation rates can vary widely within states, depending on local preferences and public health policies.
While there’s a strong push for community water fluoridation in the U.S. due to its benefits in preventing dental decay, opposition to it often centers around health concerns and the belief in individual choice, leading to variability in adoption across states and municipalities.
As of recent data, most U.S. states allow fluoride to be added to public drinking water, but there are a few exceptions where fluoridation is either banned or not mandatory. These states typically have local control, meaning individual communities can choose whether or not to fluoridate their water.
Alaska: While some cities in Alaska fluoridate their water, the state does not mandate it.
California: No statewide ban, but there are several cities in California that do not fluoridate their water.
Hawaii: Hawaii does not mandate fluoridation statewide, but it does allow it at the local level.
Missouri: Missouri does not mandate fluoridation, and local jurisdictions can decide.
North Carolina: The state has local control, and some areas opt out of fluoridation.
Oklahoma: Similar to other states, municipalities in Oklahoma may choose whether to fluoridate their water.
Montana and Wyoming also have smaller communities that do not fluoridate their water.
New Jersey, while not banning fluoridation outright, has certain municipalities that opt out of the practice, reflecting local decision-making.
Overall, the risks mainly arise from excessive fluoride exposure, which is uncommon with regulated public water systems. The main risks of fluoride are:
Dental fluorosis: Overexposure in children during tooth development can lead to cosmetic changes like white spots or streaks on teeth.
Skeletal fluorosis: Long-term excessive fluoride intake can cause joint pain and stiffness, affecting bones, though this is rare in areas with regulated fluoride levels.
Thyroid issues: High fluoride levels may impact thyroid function by lowering iodine levels, but evidence is limited and typically associated with very high exposures.
Potential neurotoxicity: Some studies suggest a possible link between fluoride and reduced IQ in children, but these findings are controversial and not conclusive at normal exposure levels.
