CHICAGO, APRIL 25, 2025 — The American Dental Association (ADA) strongly opposes the dangerously irresponsible comments made by Louisiana Surgeon General Dr. Ralph Abraham about community water fluoridation.
“As doctors, we pledge to do no harm. It is gravely irresponsible that a physician who has taken this oath would dismiss more than 80 years of evidence-based, proven research demonstrating that the amount of fluoride added to community water systems is safe and effective at helping to prevent cavities,” said Brett Kessler, D.D.S., president of the American Dental Association. “The data Dr. Abraham referenced is riddled with limitations, inapplicable to the United States and will do harm to Louisiana’s most vulnerable citizens.”
The ADA stands strongly with the Louisiana Dental Association, New Orleans Department of Health, and the other local pediatric health care groups who came out in strong opposition of this ban. Rural Louisiana residents are already coping with a lack of access to dental care. Fluoride treatments, tablets and toothpastes cannot replace the benefits that community water fluoridation provides.
Fluoridated water provides a constant low level of fluoride during the day to remineralize, or repair, the damage caused to enamel from sugary and acidic foods and drinks. Using fluoride toothpaste in the morning and before bedtime offers more concentrated protection, and fluoridated water protects teeth throughout the day. “It’s like seatbelts and airbags in our car; each offers specific benefits that are very powerful when combined,” Dr. Kessler said. “We have both water fluoridation and fluoride in toothpastes because they work together to provide additional layers of protection and prevention.”
Fluoride has been called “nature’s cavity fighter” because it occurs naturally in varying amounts in water sources such as rivers, lakes and even the oceans. Fluoride helps rebuild weakened tooth enamel and reverses early signs of tooth decay. When the natural level of fluoride in drinking water is very low, communities can add a small amount to bring it to a level to help prevent tooth decay. The current recommended amount of fluoride in water is 0.7 parts per million (ppm) water which is comparable to approximately 1 inch in 23 miles or 1 minute in 1,000 days.
While some recent studies have shown that sustained exposure to high levels of fluoride above 1.5 parts per million could negatively impact health, that amount is more than twice the 0.7 ppm recommended for community water fluoridation.
As a science- and evidence-based organization, the ADA welcomes continued study and evaluation of the safety and effectiveness of water fluoridation and continues to strongly support community water fluoridation at its current recommended level. “The ADA stands ready to support a comprehensive study of fluoride at the optimal level used in U.S. based community water supplies,” said Dr. Kessler.
Dental disease is one of the most common chronic diseases, five times more common than asthma. The infection and pain from untreated dental decay results in 34 million lost school hours for children and 92 million hours of work lost for adults, according to the U.S. Centers for Disease Control and Prevention.
“As the nation’s leading voice for oral health, the ADA will continue to support public health policies that are guided by scientific rigor and statistically significant, evidence-based data,” Dr. Kessler said. “Public health policy is not built upon a few weak studies. Irrationally banning community water fluoridation now will harm our communities for generations to come.”
For more information on community water fluoridation and ADA advocacy, visit ADA.org/fluoride.