US FDA's fluoride move has doctors worried about tooth decay in kids

The announcement came on Halloween, hours before trick-or-treaters around the country started collecting candy: The Food and Drug Administration (FDA) was issuing new recommendations about fluoride supplements and sent warning notices to four companies that sell them.

- Dani Blum

The agency urged doctors to refrain from prescribing fluoride tablets and drops to children under three and to older children who are not at high risk for tooth decay.

Paediatricians and dentists consider fluoride supplements to be a critical tool for combating cavities, especially for children who live in areas without fluoridated water, as roughly 40 per cent of the US population does.

But over recent months, scepticism around fluoride has intensified, as health officials cast doubt on a mineral that has been added to the US water systems since the 1940s with the aim of preventing dental decay.

Health Secretary Robert F. Kennedy Jr. has called fluoride “neurotoxic and carcinogenic” and called for states to ban fluoride in drinking water. In March, Utah became the first to do so.

In the spring, the FDA threatened to ban fluoride supplements, arguing that they could alter the gut microbiome, though there is no significant evidence in humans to back up that claim.

The agency also cited concerns about a link between high levels of fluoride and lower IQ in children, based on research that outside experts have called flawed, and it pointed to an unproven connection between fluoride and thyroid issues.

The new guidelines fall short of a ban. Doctors and dentists will still be able to prescribe fluoride supplements. But the recommendations discourage them from doing so for very young children.