In the United States, tap water is typically enriched with fluoride, a substance that fights tooth decay. Fluoride prevents cavities and strengthens the enamel of the teeth, which is why the process of water fluoridation has long been used for dental protection.

This is why when the capital of Alaska voted to take fluoride out of its drinking water, it had a prominent effect on the citizens of Juneau.

Why did the people of Juneau take fluoride out of their water?

For years, there have been myths insisting that drinking fluoridated water could lead to health complications. One of the largest concerns was that fluoride ingestion would lead to a bone cancer called osteosarcoma.

These myths have been mostly debunked, but the city of Juneau held on to concern that fluoridated water would cause its residents harm. After years of debate in Juneau, public health policy for the city was changed: in 2007, their drinking water was no longer permitted to contain fluoride.

The consequences of drinking water without fluoride

At the time, people weren’t sure exactly what would happen when a population suddenly stopped fluoridating their drinking water. However, in a 2018 study published in the journal BMC Oral Health, the effects of Juneau’s decision were revealed.

Removing fluoride from Juneau’s water led to both an increase in cavity frequency and, subsequently, the overall cost of dental care for children and adolescents.

In the study, which was led by Jennifer Meyer from the University of Alaska Anchorage, records of all the children and adolescents in Juneau who accessed dental services through Medicaid were examined.

Dental claims of 853 children and teenagers who received dental care in 2003 were compared with records of 1,052 children and adolescents who received dental care in 2012 (five years after Juneau had voted for the cessation of drinking water fluoridation).

What the researchers discovered was that “the odds of a child or adolescent undergoing a dental procedure in 2003 was 25.2% less than that of a child or adolescent in 2012.”

This means that, despite fear-mongering myths, fluoride does appear to have a protective effect on oral health. Removing it from community water led to both an increase in cavity frequency and, subsequently, the overall cost of dental care for children and adolescents.

These results solidified the benefits of optimal drinking water fluoridation and showed the consequences (cost and health-wise) when fluoridation is discontinued in a community.

Community water in Juneau still contained a small quantity of fluoride (because the mineral occurs naturally in water even after artificial cessation), but the quantity wasn’t optimal.

According to Medical News Today, fluoride levels in Juneau’s water sources were 10 times lower than the optimal levels for cavity prevention and overall oral health.

Perhaps this research will act as a warning against further fluoride bans in other cities. It appears the benefits of fluoride outweigh any risks.