As Fluoride Bans Spread, Who Will Be Hit the Hardest?
Cavities and dental costs are at risk of skyrocketing as a growing number of states consider banning the use of fluoride in public water —and children from low-income households are likely most vulnerable.
In March, Utah became the first state to prohibit adding fluoride to drinking water. A couple months later, Florida followed suit. Several other states are now considering similar bills.
In a recent study published in JAMA Health Forum, researchers projected what would happen if the entire country were to stop adding fluoride to the water supply. The potential impact on both people's oral health and their dental bills was substantial: Tooth decay, the study found, would increase by about 7.5%—representing about 25 million more cavities—and the U.S. would face about $9.8 billion in additional costs over five years, including both what families would have to pay out-of-pocket for dental care and what the government would need to pay for public health insurance.
And those impacts would disproportionately affect children on public insurance plans or without insurance, the researchers found.
Fluoridated water is 'an amazing public health intervention that comes straight from the tap,' says the senior author of the study, Dr. Lisa Simon, an internal medicine physician at Brigham and Women's Hospital, who is also a general dentist.
'Fluoride works for everyone—it benefits adults, it benefits children,' Simon says. 'But the people who derive the most benefit from it are people who have a harder time accessing routine dental care.'
'Unfortunately, in our country, that is more likely to be children and families who are low-income, who rely on public insurance, or who otherwise face challenges in getting to a dentist,' she says.
States' moves to ban the use of fluoride in public drinking water come as the Trump Administration—due in large part to the influence of Robert F. Kennedy Jr., Secretary of the U.S. Department of Health and Human Services (HHS)—has pushed back against the practice. Kennedy has long blasted water fluoridation, claiming it is linked to arthritis, bone cancer, IQ loss, and more, and signaled that HHS will stop recommending it. The Environmental Protection Agency has said that it is studying the potential health risks of fluoride, and the Food and Drug Administration said it is taking steps to remove prescription ingestible fluoride supplements for children from the market.
Some research suggests that fluoride could be associated with lower IQ scores, but only at significantly high levels of exposure—the amount of fluoride that is added to public water, based on federal guidelines, is far lower.
And the majority of public health experts, pediatricians, and dentists insist that water fluoridation is a long-standing practice that is both safe and effective at protecting oral health and fighting cavities and tooth decay.
'It's been touted to be one of the most successful or greatest public health initiatives, right up there with vaccinations,' says Dr. Tomitra Latimer, a pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago.
U.S. localities started adding fluoride to public water in 1945, and the Centers for Disease Control and Prevention (CDC) has credited the public health initiative for the 'dramatic decline in cavities' in the country in the years since. According to the CDC, drinking fluoridated water reduces cavities by roughly 25% in both children and adults.
Tooth decay, though preventable, is one of the most common childhood diseases. And children of color, children who come from low-income households, children on public insurance plans that limit which providers they can see, and children who live in rural areas and have to travel long distances to access care—all of them are at greater risk of developing cavities, according to Latimer. Children with autism also tend to have a heightened risk of developing cavities because they may struggle with brushing their teeth regularly, she says.
While there are alternative sources of fluoride that people can purchase, the cost may be out of reach for many families, Latimer says. That's why, she says, fluoridated water is so critical: It's an easily accessible tool that can help protect the oral health of children who are most vulnerable to cavities. And for generations, it's flowed straight from the tap.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Washington Post
a day ago
- Washington Post
Administration to phase out NIH support of HIV clinical guidelines
The National Institutes of Health's support for federal guidelines that steer the treatment of more than a million HIV patients in the United States will be phased out by next June, according to the agency's Office of AIDS Research, a move that troubled some doctors and raised questions about whether the guidelines themselves will change. It is unclear whether Health and Human Services Secretary Robert F. Kennedy Jr. plans to bring the guidance in line with his own controversial views about an infectious disease that 30 years ago was the leading cause of death for people 25 to 44 years old. The Office of AIDS Research, which is part of the National Institutes of Health, informed members of the panels responsible for the guidelines in a letter that, 'in the climate of budget decreases and revised priorities, OAR is beginning to explore options to transfer management of the guidelines to another agency within' HHS. The guidelines, detailed recommendations on how to diagnose and treat medical conditions, can affect what tests, treatments and medications are covered by insurance companies and Medicare, said Aniruddha Hazra, associate professor of medicine at University of Chicago Medicine. The lack of clarity in the letter caused some in the medical community to worry that switching oversight of the guidelines to another branch of HHS could be a first step by the Trump administration toward more drastic changes in the government's treatment recommendations. 'From a practical standpoint, it's monumental,' Hazra said of the news about the guidelines, which he called the basis for much of the knowledge about HIV. 'The loss of this kind of federal guidance throws everything into the dark,' he said. Hazra described the guidelines as a dynamic document that changes at least once or twice a year as new studies and scientific evidence come to light. Guidelines for HIV are divided into a half-dozen categories, including sets for adults/adolescents, pediatric patients, pregnant women and HIV patients who are displaced by natural disasters. The webpage listing the guidelines now says they are 'being updated to comply with Executive Orders,' raising the question of whether sections dealing with care for transgender people with HIV may be changed or eliminated. The letter sent to panel members did not say specifically if or how the clinical practice guidelines might change, only that 'Together, we now have an opportunity to develop a proactive, careful transition plan for each Panel.' The letter noted that 'a special session on guidelines sustainability planning' has been scheduled for Thursday with panel leadership and the Office of AIDS Research Advisory Council. Officials at NIH referred questions to the Department of Health and Human Services, which did not respond to emails requesting clarification of the letter. Kennedy has long espoused controversial views about HIV, suggesting that contrary to widely held medical belief, the virus was not the cause of AIDS. In a video posted on Twitter in 2023, Kennedy tells an audience, 'A hundred percent of the people who died at first, the first thousand who had AIDS, were people who were addicted to [a class of drugs called] poppers. … They were people who were part of a gay lifestyle. They were burning the candle at both ends, and they were taking a lot of injectable drugs.' Under Kennedy, HHS has terminated hundreds of millions of dollars in HIV-related research grants. The department closed its Office of Infectious Diseases & HIV Policy that coordinated the federal response to the virus. At the same time, the Centers for Disease Control and Prevention lost staff in its HIV prevention division who conducted studies and surveillance, ran health campaigns and supported local prevention programs. 'These guidelines serve as a reference for the world in addition to caring for people in the U.S.,' said Theodore Ruel, chief of the Division of Pediatric Infectious Diseases and Global Health at UCSF Benioff Children's Hospital, and co-chair of one of the panels responsible for the guidelines. 'It is disappointing that such a key guideline about HIV for children in the USA will no longer be supported by the NIH,' said Ruel — whose panel examines antiretroviral therapy for the medical management of children living with HIV — stressing that he was not speaking for the other panelists. 'I am concerned that we are unlikely to find a new home that can maintain the same depth, quality, access and capacity for real-time updating.' He expressed faith that the panelists would push to find a home for the guidelines where they can continue to offer 'science-driven support' for doctors and patients. James M. Sosman, medical director for UW Health's HIV Care and Prevention Program, who has been caring for people with the disease for decades, said that having the guidelines under the auspices of the Office of AIDS Research made sense. 'Would I look to move that? I'm reluctant because it's like, 'Hey, if you've got a guy that's hitting home runs at third base, don't move them to first base,'' Sosman said. 'I mean if it's working out, why are you disrupting this for costs that don't seem that great.'
Yahoo
a day ago
- Yahoo
Medicare go-broke date pushed up three years in latest trustees report
This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. A key trust fund underpinning Medicare's hospital benefit will go broke three years earlier than previously expected absent congressional action, threatening benefits for seniors, according to the Medicare trustees' annual report released Wednesday. The Medicare Hospital Insurance trust fund will be depleted in 2033, instead of 2036, as Medicare spending continues to outpace the program's income, the trustees — a group comprised of the HHS, Treasury and Labor secretaries, along with the Social Security commissioner — warned. The bleaker outlook is due to higher-than-expected spending for hospital care, hospice services and physician-administered drugs. The trustees called on Congress to act quickly to stabilize Medicare, though near-term action is unlikely as the Republican majority focuses on advancing their reconciliation megabill. Medicare has been teetering on the edge of insolvency for a while. But the latest report from Medicare's trustees is more dire than last year's, which projected Medicare would become insolvent in more than a decade. Now, Medicare's hospital trust fund will start running out of money in eight years — when today's 57-year-olds first become eligible for the program. The looming go-broke date is a result of the fund's substantial shortfall as Medicare costs continue to grow rapidly, trustees said in the report. Medicare costs are expected to increase from 3.8% of the gross domestic product in 2024 to 6.2% in 2050 before reaching 6.7% in 2099, the report projects. Costs to another fund that pays Parts B and D, called the Supplemental Medical Insurance trust fund, are also climbing, increasing pressure on beneficiary budgets and the federal budget. (Though, the Supplemental Medical Insurance trust fund is largely funded by premiums and general revenue that resets each year and doesn't face the same solvency concerns.) This year's estimates, which are based on current payment rates, could be conservative, trustees said. Under an alternate scenario, in which provider payments grow at a rate more consistent with underlying medical costs — a change aggressively lobbied for by physician associations — Medicare spending will rise to 8.8% of the GDP in 2099 rather than 6.7%, according to the report. The precarious footing of the federal insurance program, which covers almost 69 million people in the U.S., is due to the country's underlying demographic shifts, according to experts. More and more Americans are aging into Medicare, while at the same time the number of workers paying into its trust fund is dropping. More seniors are also selecting privatized Medicare Advantage plans, which are more expensive than traditional Medicare coverage. If and when the U.S. hits Medicare's go-broke date, the hospital trust fund, which pays hospitals and providers of post-acute services and also covers some of the cost of private Medicare Advantage plans, will have inadequate income to fund those benefits. Medicare payments would immediately be cut by 11%, according to the report. Those cuts would grow over time, likely disrupting services for seniors and reimbursement for providers. It's worth nothing that there's a significant degree of uncertainty in trustees' projections, which vary based on macroeconomic forces in a given year. For example, in 2020, in the early throes of COVID-19, the board predicted the hospital trust fund would run out by 2026. That deadline was pushed back to 2028 and then 2031 in subsequent years' reports, amid a broader economic rebound and more care shifting to cheaper outpatient settings. Still, the fund hasn't met the trustees' test for short-range financial adequacy since 2003, and has triggered funding warnings since 2018. To date, Congress has not allowed Medicare to go under. But legislators' lack of action despite years of warnings is a source of heartburn for budget hawks, Medicare advocates and physician lobbies. Experts say lawmakers need to act soon given many reforms to stabilize Medicare could take a few years to go into effect. 'The projections in this report show that change is needed to address Medicare's financial challenges,' the Medicare trustees wrote in their report. 'The sooner solutions are enacted, the more flexible and gradual they can be.' According to the Committee for a Responsible Federal Budget, restoring Medicare solvency would require Congress to boost the payroll tax rate by 14% or reduce Medicare spending by 9% — both politically unappetizing proposals. Other reforms that could curb Medicare spending, like implementing site-neutral payments or reducing overpayments in MA, have more bipartisan support but aren't a policy priority on the Hill. Republicans are currently focused on hammering out legislation to extend tax cuts from President Donald Trump's first term, cut green energy programs, fund border control and curb Medicaid spending. 'We are running out of time to phase in changes gradually and avoid harsh cuts, sharp tax increases, or unacceptable borrowing. Demagoguing this issue may be politically expedient, but it will ultimately prove ruinous for the tens of millions of Americans that rely on the programs,' Maya MacGuineas, the president of the CRFB, said in a statement Wednesday. Recommended Reading Medicare go-broke date extended to 2036, but warning bells continue ringing
San Francisco Chronicle
2 days ago
- San Francisco Chronicle
Trump administration orders California to remove ‘disturbing gender ideology' from sex ed program
The Trump administration has given California 60 days to strip all references to gender identity from a federally funded sex education program or risk losing its funding. In a letter sent Friday to the California Department of Public Health, the U.S. Department of Health and Human Services' Administration for Children and Families called the state's Personal Responsibility Education Program 'noncompliant' with federal law. The agency cited 'disturbing gender ideology content,' including passages explaining that gender identity can differ from biological sex and that some individuals identify as transgender or nonbinary. 'The Trump Administration will not tolerate the use of federal funds for programs that indoctrinate our children,' said Andrew Gradison, ACF's acting secretary, in a statement. 'The disturbing gender ideology content in California's PREP materials is both unacceptable and well outside the program's core purpose.' PREP, which receives approximately $6 million in federal support, is designed to educate youth on contraception, abstinence and preventing sexually transmitted infections. California officials said the program targets vulnerable populations, such as youth in homeless shelters and juvenile justice facilities. Among the flagged content were educational materials describing gender identity as a 'deep-seated, internal sense' and including terms such as 'cisgender,' 'transgender' and 'genderqueer.' The agency stated that such material exceeds the scope of PREP's authorizing statute. A spokesperson for California Gov. Gavin Newsom told The Hill that the state was first made aware of the directive through Fox News. 'To be clear: this is NOT California's K-12 sex education curriculum,' the spokesperson noted, calling it an 'effective, evidence-based program model.' The latest announcement comes just days after the Supreme Court upheld Tennessee's law banning gender-affirming medical care — such as puberty blockers and hormone therapy — for transgender minors.
