The U.S. Centers for Disease Control and Prevention has long considered fluoridation of drinking water one of the 20th century’s greatest public health achievements, aiding in the prevention of dental disease in children and adults. But officials in the City of Ridgeland, Mississippi, are now considering whether or not to permanently end its water fluoridation program.
Data collected by the Mississippi State Department of Health shows that “the City of Ridgeland’s fluoride feeding system has been off since February of 2022, based on their last reported sample,” MSDH’s External Affairs and Media Relations Director Greg Flynn said in a Dec. 4 statement to the Mississippi Free Press.
Although Flynn said that fluoridation of public drinking water is “entirely voluntary,” public health advocates told the Mississippi Free Press that permanently discontinuing fluoridation of the City’s public water could affect the dental health of the thousands of customers receiving water from the municipality.
More Cities Consider End To Fluoridation
The Mississippi Department of Health’s Bureau of Public Water Supply Community Water Fluoridation Discontinuation Policy states that fluoride “occurs naturally in most sources of water at varying levels” in Mississippi.
Community water fluoridation is the controlled process of adding additional amounts of the mineral to public drinking water. The CDC recommends an optimal fluoridation level of 0.7 milligrams per liter to balance the prevention of dental disease while limiting the risks of overexposure.
The Ridgeland Board of Aldermen voted on Dec. 2 to initiate the Mississippi Department of Health’s Community Water Fluoridation Discontinuation Process. The Rankin County city joins the North Lamar Water Association and the City of Poplarville, which also recently started exploring ending public water fluoride programs.
Ridgeland Mayor Gene F. McGee was not available for an interview for this story on Dec. 4, his chief of staff, Lisa Walters, told the Mississippi Free Press.
She instead emailed a statement, which said that “this initial step does nothing more than open the door for learning and discussion.”
“Beginning this phase will help ensure that the MSDH can provide education to the Mayor and Board of Aldermen so a decision can be made to initiate step 2 of the consideration process,” the statement continued. “As always, our priority is the safety of our community and giving thoughtful consideration to those who may be affected by any future decision. This process is expected to take 3-6 months at the maximum.”
On Dec. 5, McGee responded to an inquiry about what spurred city leadership to consider doing away with fluoridation.
“It is for several reasons,” he said in a statement to the Mississippi Free Press.
Those reasons include the costs of fluoridation, “various opinions on the use of fluoride,” and city officials wanting “education on the matter before considering to proceed with a public hearing,” McGee said.
State Doesn’t Mandate Adding Fluoride to Water
Opponents of fluoridation include U.S. Secretary of Health and Human Services Robert F. Kennedy Jr., a longtime anti-vaccine activist with an extensive history of promoting unscientific claims and conspiracy theories. Some fluoride opponents make uncorroborated claims that exposure to fluoride, even at recommended levels, affects children’s brain development.
However, health-care advocates, doctors and dentists have touted the effectiveness of controlled amounts of fluoride in preventing dental decay or cavities.
“For more than 70 years, the best scientific evidence has shown that adding fluoride to community water supplies is safe and effective,” the American Dental Association reports. “Adding fluoride to water is very much like adding vitamins and minerals to certain foods and drinks, a step that helps us get the nutrients we need. Examples include the iodine added to salt, vitamin D in milk or calcium added to orange juice.”
Despite documented benefits of controlled additions of fluoride to public drinking water, the State of Mississippi does not require municipalities to participate in public water fluoridation, Bill Moody, Director of the MSDH’s Water Bureau, told the Mississippi Free Press in a Dec. 9 interview.
“It’s not a Safe Drinking Water Act-mandated requirement,” he said, adding that some municipalities struggled to find the chemicals or supplies needed to keep the systems running during the height of the COVID-19 pandemic. Others cite the costs of repairing the infrastructure or buying new equipment altogether.
Because of an absence of laws on the issue, Moody said, there is virtually nothing stopping municipalities from moving to discontinue their community water fluoridation programs.
When city leaders want to explore the process, MSDH’s role is primarily to make sure officials are educated on the benefits of fluoride and that the public is adequately notified when officials move to stop the practice, Moody said.
On the federal level, the Environmental Protection Agency only requires that a water provider must not overexpose customers to the mineral, KFF reports.
“According to the EPA, fluoride is voluntarily added to some drinking water systems as a public health measure to help reduce the incidence of cavities among the population. The decision to fluoridate a water supply is made by the State or local municipality, and is not mandated by EPA or any other Federal entity,” the FDA website states.
MSDH requires a multi-step process before a municipality ends public water fluoridation.
First, city officials must let the agency know that they would like to initiate the discontinuation process. Then, MSDH personnel have an in-person meeting with city officials to educate them on the benefits of community water fluoridation. Next, officials vote on whether or not to continue discontinuation efforts, notifying customers of that decision and allowing the public, including health-care professionals, to give feedback before a final decision is made.
“The discontinuation policy is there to try and ensure the customers are informed. Customers can request from the water provider that the system resume or start fluoridation, just as there is nothing prohibiting the water provider from discontinuing use,” Flynn told the Mississippi Free Press.
Dentists Warn of Public Health Implications
Dr. Tiffany Green, a pediatric dentist and resident of Ridgeland, told the Mississippi Free Press in a Dec. 5 interview that most of the research cited by those advocating for an end to public water fluoridation is irrelevant to practices in the U.S.
“The studies that talk about lowering IQ, none of them come from the United States,” Green said. “And the average fluoride level in all of those studies—as opposed to 0.7 milligrams per liter—it’s going to be 1.5 milligrams, so it’s more than twice (what is recommended).”
Researchers with the American Association for the Advancement of Science agree.
“Recent evidence about the negative effects on adolescent IQ of exposure to very high levels of fluoride—levels far exceeding those experienced by almost everyone in the United States—has been cited in efforts to curtail water fluoridation practices in many states and municipalities,” a November 2025 study on the effects of childhood fluoride exposure states. “Citing this evidence—virtually none of which comes from the United States and most of which does not account for other confounding exposures—critics of water fluoridation policies argue that the downsides to water fluoridation outweigh its benefits for oral health.”
“We find robust evidence that young people who are exposed to typical, recommended levels of fluoride in drinking water perform better on tests of mathematics, reading and vocabulary achievement in secondary school than their peers who were never exposed to sufficient levels of fluoride,” the report continues. “People who were exposed to typical, recommended levels of fluoride in adolescence may perform better on assessments of cognitive functioning at age ~60, but results of those models are inconclusive.”
Green said the City of Ridgeland’s exploration into ending fluoridation comes at a time when dental disease in children appears to be on the rise.
“I have also spent the past couple of days in communication with colleagues around the metropolitan area after finding out that most of the metro area has not fluoridated since at least 2022, but probably before then. All of us have seen an increase in dental diseases. The local pediatric dental community is seeing it. It’s worse, to me, than it has been in the past 10-15 years,” she said.
“In my opinion, if you were concerned about the overall health of the children and citizens of Mississippi, specifically the City of Ridgeland, then adding fluoride to the water is ultimately going to benefit their oral health, which will ultimately benefit their overall health,” Green continued.
And while Ridgeland officials say ending fluoridation could save the City money, Mississippi Dental Association President Charles Belknap told the Mississippi Free Press that defluoridation could cost residents down the line in increased oral health-care costs.
“If we eliminate water fluoridation in the state, we’re going to have a significant increase in dental cavities in the population,” Charles Belknap warned in a Dec. 3 interview.
“Some states have had statewide bans—I’m thinking of Florida and Utah that have some form of statewide bans,” he continued. “We would not recommend having any statewide ban on water fluoridation or on fluoride-containing products in the state. As for public health, that will significantly decrease our ability to be able to fight this disease.”