The U.S. Food and Drug Administration has begun the process to eliminate fluoride drops and tablets prescribed to children to prevent tooth decay.
Though fluoride helps prevent cavities, the supplements have been linked to weight gain, thyroid issues, decreased IQ and altered gut microbe, the FDA said Tuesday. The agency seeks to complete a safety review and public comment period by Oct. 31 as part of "appropriate action" to remove them from the market.
MORE: Hearing aids can be a tool for combating loneliness among seniors
Fluorinated toothpaste and mouthwash will remain on the market.
"Ending the use of ingestible fluoride is long overdue," Health and Human Services Secretary Robert F. Kennedy said in a statement.
Kennedy also has vowed to try to eliminate fluoride added to public drinking water, previously calling it "an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease."
But the American Academy of Pediatrics and the American Dental Hygienists Association say adding recommended levels of fluoride to public water systems has been a transformative public health measure.
"Rigorous reviews of fluoride safety have consistently found no credible evidence linking it to systemic or adverse health issues," the American Academy of Pediatrics notes. "… optimal fluoridation does not pose a detectable risk of cancer or other serious health issues."
Fluoride is a naturally occurring mineral used to reduce the risk of tooth decay. At the recommended level, fluoride in drinking water reduces cavities by about 25%, according to the Centers for Disease Control and Prevention. In 1999, the CDC named the fluoridation of water one of the 10 great public health achievements.
Public water systems began adding fluoride in 1945. Philadelphia fluorinates its drinking water.
"Fluoride and regular dental hygiene visits remain essential components of comprehensive cavity prevention, especially for those who lack resources for routine dental care," Erin Haley-Hitz, president of the American Dental Hygienists' Association, said in a statement responding to the FDA's announcement Tuesday.
But FDA Commissioner Marty Makary said the "best way to prevent cavities in children is by avoiding excessive sugar intake and good dental hygiene, not by altering a child's microbiome."
One of the two literature reviews the FDA cited only found a possible negative impact of fluoride on gut microbe to be at high doses. At low doses, the effect of fluoride on the gut was found to be "harmless" and even to have "positive effects."
A report from the National Toxicology Program concluded that "higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter," were "associated with lower IQ in children." But the report drew on flawed studies that were not supported by scientific research, Dr. Charlotte Lewis, a pediatrician at Seattle Children's Hospital, said in a November interview with Johns Hopkins Bloomberg School of Public Health.
The CDC does not mandate that communities add fluoride to drinking water. Earlier this month, Utah became the first state to ban fluoride in drinking water. In other states, some municipalities have done likewise.
