The EPA released the Protocol for Developing the Fluoride Human Health Toxicity Assessment, a pivotal step in its expedited review of public health risks from fluoride in drinking water under the Safe Drinking Water Act, on Aug. 3.
The toxicity assessment protocol sets the scientific methodology EPA will use to evaluate fluoride’s health effects, including potential neurological impacts that have been the focus of recent research, the agency said.
HHS Secretary Robert F. Kennedy Jr. has publicly advocated for reconsidering the federal recommendation on water fluoridation, which has been a public health standard since the 1940s. Community water fluoridation currently reaches approximately 73 percent of the U.S. population served by public water systems.
The review is separate from but related to a 2024 federal court ruling that found EPA had not adequately regulated fluoride’s neurological risks. The court ordered the agency to take further action, and the toxicity assessment protocol is part of that response.
Fluoridation has been endorsed for decades by the American Dental Association, the American Medical Association and the CDC as one of the most effective public health interventions for preventing tooth decay. Critics have raised concerns about potential effects on brain development, particularly in children.
A change to federal fluoridation policy could affect the oral health of more than 200 million Americans and represents one of the most consequential public health policy reassessments in a generation.
The protocol will guide the scientific evaluation that ultimately determines whether EPA adjusts the maximum contaminant level for fluoride in drinking water.