How RFK’s War on Fluoride Is Taking Over the Dentist’s Office
Health and Human Services Secretary Robert F. Kennedy has maintained that the target of his war on fluoride is ingested fluoride — specifically that from fluoridated drinking water and oral supplements. But the misinformed policy efforts to ban community water fluoridation and restrict access to fluoride supplements are having spillover effects in dentists’ offices.
Twenty years ago, as a pediatric dental resident in Iowa City Donald Chi had his first encounter with a family that did not want a topical fluoride treatment for their child. At the time, these patients were rare, but not unheard of. Today, in his practice at Odessa Brown Children’s Clinic in Seattle, he estimates that the clinic sees up to six families a day who say no to fluoride.
Some anti-fluoride activists and policymakers have drawn a line between ingested fluoride and the varnishes and gels that are applied by professionals. Topical fluoride usually comes in the form of a quick-drying gel or varnish, and is most often applied by a dental professional or other health care provider. Extensive research shows that it strengthens the enamel of the teeth, prevents tooth decay, and even helps to reverse cavities, especially in high-risk populations like children, who tend to eat sugary diets and brush teeth inconsistently.
That distinction is lost on many lay people. For Chi, the rise of topical fluoride hesitancy can be traced to the unsupported claims about community water fluoridation coming from top policymakers, which has created confusion for parents, sowing the seeds of doubt regarding the safety of fluoride in general.
“That’s all that needed to really create chaos in the system,” Chi said.
Since the 1940s, many municipalities in the U.S. have supplemented drinking water with fluoride, a naturally occurring mineral present in water sources at varying levels. Conspiracy theorists promptly took up fluoridation as a communist plot. Around the same time, dentists in the U.S. began reporting that professionally-applied fluoride solutions reduced cavities in children, and the popularity of topical fluoride grew in dental practices throughout the 20th century.
Today, top health officials like Secretary Kennedy, Food and Drug Administration commissioner Marty Makarty, Environmental Protection Agency administrator Lee Zeldin, and HHS adviser-siblings Casey and Calley Means are platforming suggestions that fluoridated water causes neurological harm or affects the gut microbiome, or that parents should throw out their fluoride toothpaste. The MAHA Commission’s first report listed fluoride alongside environmental health hazards such as forever chemicals and microplastics.
Anti-fluoride activists, influencers, and policymakers lean on a paltry smattering of research as evidence for defluoridation. They often refer to a 2024 report by the National Toxicology Program, which found that studies of other countries with water fluoride levels far higher than those found in most of the U.S. saw correlations with low IQ in children. However, no high-quality studies have ever been conducted in the U.S., where water fluoride concentration is heavily regulated. The Network for Public Health Law described the report as “scientifically deficient.”
“Some of these [studies] have been around since the eighties,” said dentist and epidemiologist Scott Tomar, an expert spokesperson for the American Dental Association. “This is not new, but just nobody before took it seriously because of such poor quality science.”
Melissa Burroughs, the senior director of public policy at the national health nonprofit CareQuest Institute for Oral Health, affirms this: “Those kinds of levels of fluoride are things you would find in toxic waste runoffs. They’re not within the regulatory levels that would be allowed for water fluoridation.”
HHS sowed further confusion in 2025 when the FDA published a report on ingestible fluoride supplements. According to Tomar, the report affirmed that supplements can help to prevent cavities, especially for children who don’t receive enough fluoride through water. However, two FDA press releases in May and October told a different story, claiming that children needed to be “protected” from the supplements, which should be removed from the market. “Most people only probably saw the press release that accompanied that rather than seeing what was really in the report,” said Tomar.
“It’s not only frustrating,” he said of the disparate messaging. “I think it’s dangerous to the public.”
As with any substance, too much fluoride is toxic. The remote village of Hooper Bay, Alaska witnessed this extreme firsthand when a series of mistakes and malfunctions led to the overfluoridation of one well in 1992 (fluoride levels were more than one hundred times the recommended amount), killing one person and poisoning dozens more. States have since honed a web of regulation, certification, training, and monitoring for fluoridation systems. As a result, “community water fluoridation is probably one of the strongest evidence-based preventive strategies we have. Period,” said Chi.
In a statement to TPM, HHS deputy assistant secretary for media relations, Andrew Nixon stated, “Topical fluoride prescribed by health care professionals can be part of the standard of care for patients at high risk of tooth decay. A nutritious diet with little to no added sugars and routine teeth brushing is the best prevention against tooth decay.”
But despite HHS’ focus on ingestible fluoride, anti-fluoride sentiment has spilled over into its other applications. Crunchy mom forums are littered with posts by parents asking for advice on fluoride alternatives when a routine dental visit reveals a mouthful of cavities. Some recommend colloidal silver, which has no evidence for any benefits but has been shown to lead to organ damage. Google searches for phrases like “topical fluoride,” “fluoride varnish,” and “silver diamine fluoride,” as well as popular alternatives like “hydroxyapatite” and “xylitol” all reached ten-year highs in 2024 and 2025.
Some parenting influencers advocate for parents to refuse topical fluoride when they take their kids to the dentist, and to turn to hydroxyapatite toothpaste instead (you can comment “TEETH” for an affiliate link and coupon code). Others, like Kennedy ally and MAHA movement leader Vani Hari, aka the Food Babe, sell their own alternative toothpastes.
For Chi, there is no fluoride-free alternative that comes close to the effectiveness of fluoride for cavity prevention. “As of today right now would I recommend [hydroxyapatite] to families?” he said. “No, there’s not good evidence.” While some early, small studies show some promise for hydroxyapatite, its evidence base is just a drop in fluoride’s bucket. If a parent really doesn’t want to use fluoride toothpaste, Chi recommends they just have their child brush with water instead, rather than wasting their money.
The pull of this disinformation is so strong that not only influencers and patients are falling for it — dentists are, too. Arizona representative and dentist Paul Gosar made an about-face from leading a fluoridation campaign in 2001, to promoting anti-fluoride misinformation in 2022 when it became a more popular stance in the Republican Party.
He’s not the only one catching a ride on the bandwagon. Increasingly, dentists marketing themselves as “biological dentists,” “holistic dentists,” or “functional dentists” are advertising fluoride-free prevention and treatment. Oftentimes credentialed through lesser known organizations such as the International Academy of Oral Medicine and Toxicology or the International Academy of Biological Dentistry and Medicine, these specialties are not recognized by the American Dental Association. Dentist-influencers like Michelle Jorgensen, Mark Burhenne, and Staci Whitman peddle on social media, where their posts about the dangers of fluoride reach hundreds of thousands of followers. Their accounts feature links to their dental practice’s website or Linktree; Jorgensen’s offers two ounces of fluoride-free remineralizing tooth powder for $16.38, while Burhenne recommends a $75 probiotic.
It is no wonder that parents are confused, and increasingly telling their dentists and hygienists to skip the topical fluoride during preventative care visits. Skepticism about fluoride used to be relegated to dark corners of the internet; now, it is promoted by federal and state leaders, hawked alongside natural alternatives by internet doctors, and regurgitated by other parents who desperately want to create safety in an unsafe world for their kids.
But the trend could have problematic implications for our health care system. According to Burroughs, increased hesitancy around topical fluoride at the same time states are considering defluoridating community water sources is building towards “an impending oral health crisis.” The people most impacted will be those who are already the most disenfranchised from the health care system, particularly low-income and rural communities.
“Kids are going to have increased tooth decay, they’re going to have increased cavities, they would need additional fillings, they would need additional tooth extractions,” she told TPM. “You’re going to see more kids showing up in emergency rooms for care needs because a lot of times both topical fluoride options and ingested fluoride options are some of the only prevention that certain communities can access.” If left untreated, cavities can become severe infections that require hospitalization, lead to issues with jaw development or breathing, or even be fatal. In many cases, the cost of those ER visits will be picked up by Medicaid, or by rural hospitals themselves when uninsured or underinsured patients cannot pay.
It is easy to tell people to switch toothpastes and skip varnish at a dentist appointment. Far more difficult is reckoning with the obstacle course that is oral health care in the U.S. Many adult Medicaid and private insurance plans do not cover topical fluoride treatments. Chi has encountered adult patients who refuse fluoride varnish not because they distrust it, but because they cannot afford it. Millions of Americans live in rural dental care deserts and must drive hours to reach a dentist. Families may have to drive even further to find a pediatric dentist, or one of the few dentists who accepts Medicaid due to low reimbursement rates. Due to cuts to Medicaid passed in the 2025 One Big Beautiful Bill Act, states like Idaho, Massachusetts, Virginia, Colorado, and the District of Columbia are considering cutting or capping adult dental benefits. An estimated 10 million adults could lose Medicaid coverage due to new eligibility requirements. Although children are guaranteed dental coverage under Medicaid, research shows that they are more likely to have untreated cavities and less likely to go to the dentist when their parents lose Medicaid.
Anti-fluoride activists like to emphasize diet — one of the most significant risk factors for cavities — as the ideal intervention to replace preventative fluoride. Indeed, increased sugar intake is highly correlated with increased tooth decay. But this single focus places the onus of responsibility on parents to make better choices, rather than addressing systemic problems like food deserts, income inequality, and a lack of public transportation that make those choices impossible for many.
Despite an onslaught of disinformation, a recent CareQuest poll found that people still trust their family doctor or dentist more than any other source of information about fluoride. For Chi, that trust is critical. He has seen dentists immediately jump to education or attempt to convince a hesitant parent, only to see the parent become more resistant. Now, he tries to understand what a parent’s specific concerns are, asks about other sources of fluoride or prevention methods, and requests permission to bring topical fluoride up again in a future appointment.
“Oftentimes it will take a couple of visits, a couple of times of interacting to build that trust where parents will then open up to you,” Chi said.
Chi is open to the possibility that future research could lead his field in new directions, potentially ones that do not include fluoride. But his emphasis on the current body of evidence supporting fluoride is unwavering.
“The real danger of anti-fluoride sentiments that are not evidence-based,” he said, “is that you don’t really need any kind of scientific evidence or truth to base your claims on. All you have to do is raise an ounce of suspicion or doubt. And that’s already done enough to make people worry.”
