Some U.S. water utilities are reporting interruptions in their supply of fluoridation chemical after the conflict in the Middle East disrupted production and exports, officials say. Fluoride is intentionally added to many community water systems as a public‑health measure to reduce tooth decay.
Why This Is Happening
The U.S. Environmental Protection Agency identifies Israel as one of the world’s leading exporters of fluorosilicic acid, the common source of fluoride used for community water fluoridation. The United States is among the top five importers of this chemical. According to Dan Hartnett, chief policy officer for the Association of Metropolitan Water Agencies, at least one Israeli supplier has seen reduced output after many employees were called into active military service.
“That has led to decreased production, and supply shortages for the U.S. market,” Hartnett said.
Which Utilities Are Affected
The number of affected systems so far is small, but the shortages already affect hundreds of thousands of residents. WSSC Water, the eighth‑largest water and wastewater utility in the United States, serving about 1.9 million people in Maryland, announced on April 7 that it had lowered fluoride levels from the recommended 0.7 mg/L to 0.4 mg/L while supplies are stretched. In Pennsylvania, the borough of Lititz temporarily paused fluoridation for a couple of weeks because of supply problems.
Health Impact And Expert Guidance
Adding fluoride to drinking water is a voluntary public‑health practice aimed at preventing cavities. Utilities and health experts say a short, temporary drop in fluoride concentration is unlikely to pose a safety risk for drinking water. Dr. Scott Tomar, a community water fluoridation expert with the American Dental Association, noted that a decline lasting a few months probably won’t be a major concern for most people.
“Based on the best available information we have, below about 0.5 milligrams per liter, you’re probably not going to see effective preventive exposure,” Tomar said, explaining why prolonged reductions matter.
Tomar and other experts emphasize that younger children are most vulnerable because fluoride strengthens enamel while teeth develop. Research from communities that ceased fluoridation — including Calgary, Juneau and parts of Israel — shows that reduced fluoridation can increase tooth decay over years, particularly among children.
FILE - In this Jan. 7, 2011 file photo, water flows from a water fountain in Concord, N.H. (AP Photo/Jim Cole, File)(ASSOCIATED PRESS)
Practical Advice For Residents
Residents in affected areas are advised to:
- Brush twice daily with fluoride toothpaste and supervise young children to ensure they use the correct amount;
- Maintain regular dental checkups and professional guidance;
- Consult a dentist before starting fluoride supplements or other treatments if they are concerned about exposure.
Public‑health research indicates community water fluoridation offers benefits even where fluoride is also available through toothpaste and other products. The Centers for Disease Control and Prevention reports that nearly two‑thirds of the U.S. population receives fluoridated drinking water. The American Dental Association credits fluoridation with reducing tooth decay by more than 25% in children and adults.
Controversy And Misinformation
Despite the long record of public‑health endorsements, misinformation and political opposition have grown in recent years. In 2023, Utah became the first state to ban public water fluoridation, and some public figures have questioned the practice’s safety. Experts quoted in this report maintain that the fluoride concentrations used in U.S. water systems are safe and that there are no adverse health effects associated with those levels.
Bottom line: Short, temporary supply interruptions are unlikely to create immediate health risks, but communities and parents should monitor local advisories and follow routine dental and hygiene recommendations while utilities manage limited supplies.
Reporting note: The Associated Press Health and Science Department receives support from external foundations but is solely responsible for its content.
