A Potential Ban and the Debate Over Tooth Decay Prevention

The Trump administration is considering a ban on fluoride tablets and drops, commonly prescribed to children lacking access to fluoridated water and at high risk of tooth decay. The Food and Drug Administration (FDA) held a public meeting to discuss the issue, featuring both supporters and opponents of the supplements. While dentists widely support the tablets, the meeting focused on identifying safety concerns and potential risks. A final decision is expected by the end of October.

The meeting included speakers with opposing viewpoints. Some, like Dr. Bill Osmonsun and Dr. Bruce Lanphear, are known fluoride skeptics. Lanphear's research, suggesting a link between maternal fluoride intake and lower IQ levels in children, was cited. Others, such as Dr. Charlotte Lewis and Dr. Jayanth Kumar, presented counterarguments.

The potential ban has raised concerns among dental professionals. Dr. James Bekker, a pediatric dentist, stated that there is no alternative if the supplements are removed from the market. Critics argue that the risks of fluoride exposure during early childhood outweigh the benefits of preventing tooth decay, which can lead to pain, infection, and other health issues.

Areas without fluoridated water are likely to see an increase in cavities. Dentists frequently prescribe fluoride supplements, especially in areas without community water fluoridation. These prescription-only tablets and drops have been used for decades to prevent tooth decay. Studies have shown that these supplements can reduce cavity rates in children.

The supplements are particularly important for families in areas without fluoridated water, those without dental insurance, or those who cannot afford regular dental visits. Untreated cavities can cause significant damage. Major public health groups recommend prescribing supplements for children starting at 6 months if the water supply isn't fluoridated.

Fluoride supplements are typically given to children from age 5 until they have their permanent teeth. Babies receive drops until they are old enough to chew tablets. Over-the-counter vitamins and supplements do not contain fluoride. Fluoride is only available over the counter in toothpaste and mouthwashes.

The FDA commissioner, Dr. Marty Makary, has raised concerns about the supplements, including their potential impact on the gut microbiome. He also objects to the supplements because they were in use before Congress mandated that drug manufacturers show that their products were not only safe but also effective, so they were never required to go through the approval process.

Some critics have long been concerned about the lack of rigorous data showing their potential health effects and how they protect kids’ teeth. However, others, like Dr. Bekker, maintain that the safety and efficacy of fluoride supplements for children have been established.