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A Pennsylvania lawmaker has introduced a bill to ban fluoride in public water, one of a growing number across the country.
The bill, dubbed the Fluoride Choice Act, would prevent fluoridation of any public drinking water across the state, a move that has sparked criticism from dentists and Democratic leaders.
Constituents brought the issue to Sen. Dawn Keefer (R-31), representing parts of Cumberland and York counties, who introduced the bill alongside co-sponsor Sen. Wayne Langerholc (R-35), representing parts of Cambria, Centre and Clearfield counties.
“The Fluoride Choice Act empowers families and individuals to make informed decisions about their fluoride consumption, upholding their personal freedom to choose what’s best for their health,” Keefer said in a statement provided to Next Generation Newsroom.
The Centers for Disease Control and Prevention praise fluoridation and its ability to prevent cavities as one of the great public health interventions of the 20th century, but the CDC does not mandate its addition to water.
“Study after study have shown that the effects of fluoride are positive,” said Dr. James Mancini, clinical director of Meadville Dental Center and president-elect of the Pennsylvania Dental Association. “My profession, we believe in fluoride. We believe in public health fluoridation. We believe that it works, and we've seen the results of it.”
However, critics have cited research showing high levels of fluoridation — typically beyond what is in drinking water — could have negative effects on children’s health.
Recent criticisms from Robert F. Kennedy Jr., secretary for the U.S. Department of Health and Human Services, have fanned the flames of debates over its use.
Keefer modeled her bill after Utah’s bill banning fluoride, making it the first state in the country to ban fluoridation earlier this year.
Florida followed suit, passing a law to ban fluoride last month. Other states, including Ohio, have considered or are considering bans this year.
While the Republican party controls both the state houses in Florida and Utah, that’s not the case in Pennsylvania. A slight Democratic edge in the commonwealth’s House of Representatives could pose a challenge to Republican efforts to ban the mineral.
Typically, the decision to fluoridate is made at the local level by water authorities. The state Department of Environmental Protection oversees the process and requires a permit to add or modify the amount of fluoride in public water.
Water authorities must issue public notices to consumers and medical professionals prior to starting or stopping fluoridation.
Fluoride’s cavity prevention is vital for rural areas that don’t have access to robust dental care, Mancini said. In Meadville, he noticed a signification reduction in tooth decay in children after fluoridation began years ago.
“Some of these little towns, they probably only have one or two dentists. If they leave, they retire, and you don't have anyone replace them. Who's doing that work?" Mancini said. “That's where fluoride comes in because it helps to reduce the incidence of decay.”
To find out if your water contains fluoride, check this interactive map recommended by the state Department of Environmental Protection. Service areas can vary and do not necessarily follow county lines.
Senate Democratic Leader Jay Costa, who is reintroducing a bill to improve coverage for dental care under Medicaid this session, criticized the move to ban fluoride.
“[Sen. Keefer’s] proposed legislation would move us backwards and cause untold damage to decades of cost-effective and successful public health policy,” he said in a statement prior to the bill being formally introduced. “Especially against a backdrop of potential Medicaid rollbacks, this is a difficult proposal to take seriously.”
A co-sponsorship memo by Keefer cited a 2024 JAMA Pediatrics report that “linked higher fluoride exposure to lower IQ scores,” the memo reads.
But the research had “limited data and uncertainty” regarding the connection between lower IQ and drinking water with fluoride at a concentration of less than 1.5mg/L.
The U.S. Public Health Service’s current recommendation for fluoride levels in drinking water is 0.7 mg/L to maximize benefits and reduce risks.
“I don't understand why you would use that as the basis for your bill,” Mancini said. “The [American Dental Association] has like 80 years of research on fluoridation, all positive. So, you know, why aren't those studies being quoted?”
Public water systems must issue a notice to consumers if their water contains more than 2 mg/L of fluoride, following the federal guidelines.
Within 60 days of being passed, the bill would go into effect. After that, water authorities would need to stop adding fluoride within a month.
If the bill were to pass the Senate and House of Representatives, Democratic Gov. Josh Shapiro would have the power to veto it. His office did not respond to a request for comment on whether he would sign it into law.
The bill has been referred to the Senate Environmental Resources & Energy Committee.
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