It’s the latest twist in a lawsuit that’s had more than a few over nearly a decade: Last week, the Ninth Circuit Court of Appeals overturned the 2024 ruling against the EPA in the fluoridation case brought under the Toxic Substances Control Act (TSCA).
It was a twist that the American Dental Association (ADA) promptly “applauded” in its news release before reaffirming its support for community water fluoridation.
It’s kind of a weird reaction, considering that this latest ruling had little to do with the case for or against fluoride. It was mostly about procedure — specifically, how scientific evidence was handled during the earlier proceedings.
At the center of the appeal was US District Judge Edward Chen’’s handling of evidence related to the National Toxicology Program’s report on the potential effects of fluoride exposure on brain development. The appeals court found that the lower court had overstepped its role.
“The district court’s ‘takeover’ of the evidentiary presentation” ultimately constituted “an abuse of discretion,” the judges wrote in [the] appeals court ruling. “Here, the district court effectively provided its own factual presentation,” the memo said.
The case now returns to the lower court for further proceedings.
Taking a biological approach to dental care, we believe there’s good reason to take the science surrounding fluoride risk seriously, especially when it comes to ingesting fluoride and cumulative exposure over time. The impact on developing minds is only part of the problem. As the IAOMT notes, “Exposure to fluoride is suspected of impacting nearly every part of the human body, and the potential for harm has been clearly established in scientific research.”
That issue of cumulative exposure is an important one whenever talk turns to matters of fluoride safety. Public policy focuses on how much fluoride is in the water. This is different from matters of dosage.
Not only do people drink very different amounts of water each day; fluoride exposure extends far beyond the tap alone. We also ingest it through processed foods and beverages made with fluoridated water,as well as certain pharmaceutical drugs and other sources. Of course, it’s also present in oral hygiene products galore, which provide another — albeit non-ingested — opportunity for exposure.
Because fluoride is so much more prevalent today than it was even a few decades ago, the potential is there for much higher total exposures. Depending on their diet, tap water intake, age, body size, and overall health, two people living in the same community may get very different dosages, despite their drinking water being “optimally” fluoridated,.
Whatever ultimately happens in the courts, these broader questions about fluoride exposure, individualized risk, and informed consent won’t be going away anytime soon.
