Anti-fluoride activists target Wisconsin cities

Madison has been fluoridating its drinking water for more than 75 years

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Madison began fluoridating its drinking water in 1948, an action that the Centers for Disease Control says reduces tooth decay in children and adults by about 25%. The decision by the city council was part of a strategy meant to reduce cavities, particularly among children with little access to dental care. 

Eight decades later, members of a growing anti-fluoridation movement prompted at least nine Wisconsin municipalities in 2024, including the villages of Hartland and Marshall, the cities of Amery, Lodi, Schofield and Tomahawk, and the town of Rome, to remove fluoride from their drinking water. Anti-fluoride activists like Green Bay’s Brenda Staudenmaier, a plaintiff in a U.S. District Court lawsuit against the Environmental Protection Agency over fluoridated drinking water, are increasingly showing up at municipal water utility meetings to advocate for the removal of a chemical they say poses health risks. 

There are concerns that this movement could gather steam under President-elect Donald Trump — his pick for Health and Human Services secretary, Robert F. Kennedy Jr., is a vocal opponent of fluoridation. For now, though, fluoridating water supplies is a decision left to Wisconsin’s municipalities and is not mandated by the Environmental Protection Agency or other federal agencies, notes Marcus Pearson, public information officer for Madison’s water utility, in an email. 

“We currently (and ultimately) follow the recommendation of Public Health Madison & Dane County with regard to fluoride levels added to drinking water,” says Pearson. 

In response to a federal lawsuit alleging that fluoridated drinking water poses an “unreasonable” health risk under the Toxic Substances Control Act, a U.S. District Court judge ruled on Sept. 24 that the EPA must further regulate fluoridated drinking water, though it is unclear what form those regulations will take. Assistant City Attorney Doran Viste wrote in a Sept. 27 briefing on the ruling that there are various actions the EPA may take beyond “banning the fluoridation of drinking water.”

“For now, and until the EPA acts pursuant to the Court’s order in the Food & Water Watch case, that decision does not have any immediate impact on the Madison Water Utility or [Public Health Madison & Dane County],” Viste wrote.

Madison’s water utility currently fluoridates drinking water at the amount recommended by the U.S. Public Health Service, 0.7 milligrams per liter. Under state law, Wisconsin municipalities must maintain a concentration between “0.6 to 0.8 milligrams per liter” and submit daily reports with samples from their water distribution systems. About 83.6% of Wisconsinites consume fluoridated water, according to reporting by Wisconsin Watch. 

Dominique Brossard, chair of the Department of Life Sciences Communication at UW-Madison, says that water fluoridation emerged as a major national public health initiative in the 1950s. The decision to fluoridate always rested at the local or state level, she says, but that has not stopped fluoridation from being “a hot topic for a long time.” 

Brossard says the issue of control drives the opposition: some people don’t want fluoridated water because they didn’t choose it. She says that while the evidence for the benefits of fluoride is “really clear,” public debate about reassessing fluoride levels is not “bad in itself.”

“People, if they have concerns, should be able to voice them, and then people can accurately address them,” Brossard says. 

Concerns about fluoride grew this year when the National Toxicology Program released a report, primarily based on studies in 10 non-U.S. countries, that consuming fluoride at twice or more the recommended level has an association with lower IQ scores in children.

Dr. Tamim Sifri, owner of Madison dental practice Smart Dental and former president of the Greater Dane Dental Association, says though dental experts are “happy to assess and reassess the report,” it did not establish causation or quantify a change in IQ points. Eighty years of data, on the other hand, shows “community water fluoridation is effective, safe and cheap.”

“No one has ever demonstrated that consuming optimally fluoridated drinking water causes any — not one — ill effect,” Sifri says. “There’s no research, none. ”

The largest group working to eliminate community water fluoridation in Wisconsin is the Fluoride Action Network, a nationwide organization that advises people who wish to remove fluoride from water supplies and maintains a list of fluoridated and non-fluoridated Wisconsin municipalities. Near Madison, Monroe’s city council voted in late October to recommend removing fluoride from the city’s water supply, though the council has not yet approved implementing the removal. Discussions over fluoridated water in Black Earth and Wausau are ongoing, and voters in Ladysmith will weigh in on an advisory referendum on their spring ballots.

Though Kennedy may be the movement’s most prominent figurehead, Brossard says political opposition to community water fluoridation does not fall neatly along partisan lines. 

“You have people on the extreme left that [say], ‘Let’s go back to a more natural way of living our life…and let’s not add chemicals,’” Brossard says. It’s the same sentiment, she says, that Kennedy holds. “There is definitely also an anti-big industry type of element where people equate chemicals with industry.”

Kennedy has said Trump will advise local water systems to “remove fluoride from public water” on the President-elect’s first day in office. But Brossard says that Kennedy would have no power to do so and could only provide guidelines on fluoridation. Sifri says that Kennedy’s anti-fluoridation position would be “in contrast to the CDC — and the agency that he would oversee.” 

Consistent attacks on fluoridation have been draining, Sifri says, adding that at some point his colleagues in dental care are “going to run out of bandwidth to deal with this.” Ultimately, Sifri worries about how defluoridation would affect “the people in the community that can least afford to come to the dentist,” whom he says benefit the most from drinking fluoridated water.

“All you have to do is turn on the tap, right?” Sifri says. “There’s about 50% of the population that doesn’t go to the dentist and [are eating] unhealthy foods, and they’re not brushing. From a population-wide standpoint, there’s no alternative.”