(Photo by Peter Macdiarmid, Getty Images)
Florida Surgeon General Joseph Ladapo — echoing viewpoints propagated by Robert F. Kennedy, President-elect Donald Trump’s pick to become the nation’s chief health official — recommended against community fluoridation of drinking water Friday.
Ladapo, whose past advice on health issues has roundly been criticized by others in the health care arena, had his suggestion rejected by the group that represents Florida dentists, which countered that fluoridation is one of the “most effective and affordable public health measures” around.
Ladapo asserted a “neuropsychiatric risk associated with fluoride exposure,” citing studies that allege exposure to fluoride increases risk of attention deficit hyperactivity disorder (ADHD) and lower IQs.
“It is clear more research is necessary to address safety and efficacy concerns regarding community water fluoridation,” Ladapo, who works for Gov. Ron DeSantis, said in a written statement. “The previously considered benefit of community water fluoridation does not outweigh the current known risks, especially for special populations like pregnant women and children.”
Ladapo estimated that 70% of Florida residents are on community water systems with fluoridated water and included a link for people to find out their communities’ status.
It was the latest in a long list of public health recommendations from Ladapo criticized by associations that represent the people providing the care.
The guidance also comes on the heels of a decision by the Winter Haven City Commission this week to stop adding fluoride to its water supply by Jan. 1 or as soon as reasonably practicable.
The Florida Dental Association countered that fluoride helps prevent tooth decay.
“Adding optimal amounts of fluoride into our community water supplies can prevent at least 25% of tooth decay in children and adults, reducing the need for costly dental treatments. Decades of sound scientific research proves the safety and effectiveness of fluoridation and underscores the importance of continuing community water fluoridation for the well-being of Florida residents,” Dr. Jeff Ottley, president of the Florida Dental Association, said in a statement.
The Centers for Disease Control and Prevention named community fluoridation of drinking water one of the 10 great public health interventions of the 20th Century because of the dramatic decline in cavities since it started in 1945.
There is no mandate, though, for community fluoridation of drinking water. The U.S. Public Health Service recommends fluoride levels for municipalities that do choose to add fluoride to community water supplies.
Ladapo recommendations
Earlier this year, Ladapo advised parents that it was up to them whether to keep their children at home amid a measles outbreak in Broward County — counter to usual guidance from the CDC to keep unvaccinated children at home.
The advice was criticized by Ladapo’s predecessor, Dr. Scott Rivkees, who is now at Brown University, in an interview with the Washington Post.
Ladapo also has expressed deep skepticism of Covid-19 vaccines and the efficacy of face masks to limit exposure to viruses. And he made national headlines in 2021 when he refused to don a mask during a meeting with state Sen. Tina Polsky, who was being treated for cancer and requested that he wear one.
After Trump was elected to a second term, Ladapo’s boss, DeSantis, took to social media to promote him as the best candidate to head the massive Department of Health and Human Services.
Trump picked Kennedy instead, even though he is not a scientist or physician. His appointment is seen by some as a victory for a “medical freedom” movement that arose in response to the Progressive Era idea that health experts should guide policy.
HHS is a sprawling department that includes the Centers for Medicare and Medicaid Services, a high-profile health agency. Trump announced this week that his pick to run that agency is former TV personality and onetime U.S. Senate candidate Mehmet Oz. Oz won the Republican primary in the 2022 Pennsylvania U.S. Senate race but was defeated during the general election by Democrat John Fetterman.
Trump wrote that Oz would “work closely” with RFK Jr., who his nominee for Health and Human Services secretary, “to take on the illness industrial complex, and all the horrible chronic diseases left in its wake.”
Trump has not announced his choice to head the Centers for Disease Control and Prevention or the Food and Drug Administration, two other agencies under the auspices of HHS.
Ladapo’s guidance notes that fluoride is a naturally occurring chemical present in groundwater, rainwater, soil, plants, and foods. He noted that it’s also available from other sources including toothpaste, mouthwashes, and fluoride applications by dental providers.
While evidence shows fluoride strengthens teeth, the guidance says, ” … additional research is being conducted to review the impacts of overall fluoride exposure in the population.”
Ladapo lists alleged safety concerns related to “systemic fluoride exposure” including reducing IQ, cognitive impairment, and attention deficit hyperactivity disorder. The guidance states that studies also show “increased neurobehavioral problems in children whose mothers ingested fluoride during pregnancy.”
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