Iran War Disrupts Fluoride Supply, Affecting US Water Utilities
Some U.S. water utilities are reporting that the ongoing conflict in the Middle East, particularly involving Iran, is disrupting their ability to maintain recommended fluoride levels in drinking water. This issue highlights unexpected global supply chain vulnerabilities affecting public health infrastructure.
What's Driving the Fluoride Shortage?
Israel is one of the world's top exporters of fluorosilicic acid, a key ingredient used in water fluoridation, according to the U.S. Environmental Protection Agency. EPA data also shows the U.S. is among the world's top five importers of this product.
Dan Hartnett, chief policy officer for the Association of Metropolitan Water Agencies, explained that at least one Israeli supplier has been facing workforce challenges because many employees have been called into active military service due to the war. "That has led to decreased production, and supply shortages for the U.S. market," he said.
Not Every Water System Is Affected
The number of water utilities affected so far is small, but the shortage is impacting hundreds of thousands of people. Hartnett warned that as the conflict continues, "there will likely be additional stressors placed on the supply chain, leading to shortages in additional communities."
WSSC Water in Maryland, the country's eighth largest water and wastewater utility, is among those facing a shortage. On April 7, utility officials announced they were lowering the fluoride level in the water to 0.4 milligrams per liter, down from the recommended 0.7 milligrams per liter.
Chuck Brown, spokesperson for the utility serving 1.9 million customers, said officials did not know how long the shortage would last, "but we feel confident that we'll be able to stretch that out for a couple more months." In Pennsylvania, the borough of Lititz told its water customers it had to halt fluoridation for a couple of weeks last month due to supply issues.
What Dentists Say You Should Do
Water utilities add fluoride voluntarily to improve communities' oral health, so lower levels have no effect on drinking water safety. Dr. Scott Tomar, an American Dental Association community water fluoridation expert, stated that a few months' drop in fluoride levels is probably not a cause for concern for most people.
Research from places that stopped fluoridating their water—such as Calgary, Canada; Juneau, Alaska; and Israel—has found that lower levels can have an impact over the span of years. "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," he said.
Tomar noted that younger children would be the first to experience tooth decay, as fluoride strengthens enamel during tooth development. He recommends people in shortage areas:
- Brush twice a day with fluoride toothpaste.
- Keep up with routine dental appointments.
- Consult a dentist before taking fluoride supplements if concerned about insufficient intake.
What Else Should You Know About Fluoride in Water?
Research shows water fluoridation is beneficial even when fluoride is available through toothpaste and other means. Nearly two-thirds of the U.S. population receives fluoridated drinking water, according to CDC data.
The addition of low levels of fluoride to drinking water was long considered one of the greatest public health achievements of the last century. The American Dental Association credits it with reducing tooth decay by more than 25% in children and adults.
However, misinformation about fluoride's safety has proliferated. Last year, Utah became the first state to ban public water fluoridation, and Health Secretary Robert F. Kennedy Jr. has repeatedly sown doubt about its safety, restricting its use for dental health.
Tomar emphasized, "The levels we use in the United States are perfectly safe. Despite a lot of the misinformation, there are no adverse health effects associated with the levels we use in our drinking water."
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
