The Michigan Department of Health and Human Services announced on Thursday, Aug. 6, that four community water systems received fluoridation awards from the Association of State and Territorial Dental Directors.
The awards recognize communities that achieved excellence in community water fluoridation by maintaining a consistent level of fluoride in drinking water, MDHHS said. Michigan was among 26 states that received awards for fluoridation longevity.
Bay Area Water was awarded the 2025 Community Water Fluoridation 10-Year Award, while the public water systems in Jonesville and Schoolcraft were awarded the 2025 Community Water Fluoridation 50-Year Award for continuously adjusting and maintaining the amount of fluoride in drinking water. Marquette received the 2025 Community Water Fluoridation Reaffirmation Award for retaining fluoridation.
“Time tested and cost effective, water fluoridation is one of the best investments that a community can make in maintaining the oral health of all its residents Water fluoridation helps reduce and prevent tooth decay by 25% in children and adults,” said Dr. Natasha Bagdasarian, Michigan’s chief medical executive. “It is recognized as one of the top 10 public health achievements of the 20th century.”
Water fluoridation began in the United States in 1945 and is currently used in approximately 25 countries worldwide, MDHHS said.
The use of fluoride in municipal water systems has been under attack in recent years. Both Florida and Utah have passed laws blocking the use of fluoride in water systems. Other states also introduced bills to do the same or make it optional, although none have passed. Michigan does not mandate fluoridation.
The Fluoride Action Network, which says it is “dedicated to protecting public health by ending water fluoridation and other involuntary exposures to fluoride” said about 90% of Michigan municipal systems fluoridated in 2018.
President Donald Trump chose Robert F. Kennedy Jr., a fluoridation opponent, to run the Department of Health and Human Services and Kennedy has claimed fluoride makes kids “stupider.”
RFK Jr. has said he hopes to remove fluoride from all drinking water in the U.S.
A long-term study published in the journal Proceedings of the National Academy of Sciences on Monday, April 13, 2026, was the first to test the impact of fluoridated water on cognition into late adulthood — long beyond childhood and adolescence, the usual targets of fluoride research. It expands upon previous research published in November 2025, also unique for being the first to analyze population-representative data from the United States up to the age of 60. The study found people who drink fluoridated water have the same intelligence as those who don’t.
While fluoride is a naturally occurring mineral found in the water of many communities, Grand Rapids was the first city in the nation to intentionally add fluoride to its water, on Jan. 25, 1945.
The city was chosen to take part in a study, according to the Grand Rapids Historical Commission, “because of its large population of school-age children, its closeness to Lake Michigan, which is mostly free of natural fluoride, and its proximity to Muskegon, which served as the control city.”
By 1955, the study found a 65% reduction in tooth decay, the commission said.
As more cities added fluoride, by 1975, more than 100 million Americans drank fluoridated water, the Centers for Disease Control said. In 2008, more than 64% of U.S. residents drank fluoridated water.
Here’s what to know about fluoride.
What is fluoride?
Fluoride, a mineral, is naturally present in water, many foods and is available as a dietary supplement, according to the National Institutes of Health.
Foods such as brewed black tea, coffee, shrimp, raisins, oatmeal, potatoes, rice, cottage cheese, pork shops, cheese, bread and many others contain trace amounts of fluoride.
Why is fluoride added to drinking water?
In the early part of the 20th century, medical professionals began noticing that people in some communities had lower incidences of tooth decay. Some of those people also had unusual staining of their teeth, known as fluorosis, John Hopkins school of public health explained.
Over years of research, scientists discovered higher levels of fluoride in the water in those locations, among them, Colorado where concentrations ranged from 2 ppm to 13 ppm.
By the early 1940s, findings of an NIH study of 7,200 children aged 12 to 14 from 21 cities in Colorado, Illinois, Indiana, and Ohio showed children tended to have fewer cavities and less severe decay in cities with more fluoride in the community water supply. The effect plateaued at concentrations greater than 1.0 ppm, the CDC said.
How did Grand Rapids become the first to fluoridate?
In 1945, a 15-year fluoridation trial was launched in four cities, all of which were paired with a control city.
Grand Rapids was paired with neighboring Muskegon; Newburgh, New York, with Kingston; Evanston, with Oak Park; and — in Canada — Brantford, Ontario, with nearby Sarnia, the CDC said.
On Jan. 25, 1945, engineers at the Monroe Avenue Water Filtration Plant began adding sodium fluoride to the city’s water supply, the CDC said. Notably, Grand Rapids’ portion of the study ended early when Muskegon began fluoridating its water.
Do other Michigan cities add fluoride to their water?
Yes, many Michigan cities add fluoride, including Detroit (and its customers), Saginaw, Midland, Bay City, Jackson, Battle Creek, Marquette, Traverse City, Charlotte, Lansing, Flint and Muskegon.
The Michigan Fluoride Action Network, a group that seeks to eliminate fluoridation, says some cities have specifically rejected fluoridation.
How much fluoride is added to drinking water?
While guidance starting in 1962 offered a sliding scale of 0.7 ppm to 1.2 ppm, in 2015, the U.S. Public Health Service updated its guidance to a uniform concentration of 0.7 mg/L of fluoride in drinking water, ensuring cavity prevention benefits while minimizing the risk of dental fluorosis.
What is the controversy over fluoride?
There have been concerns that excessive fluoride levels can affect the IQ of infants.
The National Toxicology Program concluded, with moderate confidence, that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children. The NTP noted there were insufficient data to determine if the fluoride level of 0.7 mg/L recommended for U.S. community water supplies has a negative effect on children’s IQ. The NTP found no evidence that fluoride exposure had adverse effects on adult cognition.
The U.S. Environmental Protection Agency has set a drinking water maximum of 4.0 mg/L. If someone is exposed to levels higher than that for a long time, it can cause a condition called skeletal fluorosis, in which fluoride builds up in the bones. The condition can eventually result in joint stiffness and pain, and can also lead to weak bones or fractures in older adults, the American Cancer Society said.
There also have been concerns, the Cancer Society said, of fluoride contributing to bone cancer, but no studies have confirmed a link.
A long-term study published in the journal Proceedings of the National Academy of Sciences on Monday, April 13, 2026, was the first to test the impact of fluoridated water on cognition into late adulthood — long beyond childhood and adolescence, the usual targets of fluoride research. It expands upon previous research published in November 2025, also unique for being the first to analyze population-representative data from the United States up to the age of 60. The study found people who drink fluoridated water have the same intelligence as those who don’t.
What does the ADA say about fluoride?
The American Dental Association unreservedly endorses the fluoridation of community water supplies as safe, effective and necessary in preventing tooth decay, the group said.
Do other nations use fluoride in public water?
Yes, some other countries add fluoride to public water systems, including Australia, Chile, Ireland, Israel, New Zealand, South Korea, Spain and the United Kingdom. All have seen drops in tooth decay.
Other countries do not add fluoride, including Austria, Canada, Denmark, France, Germany, Iceland, Italy, Japan, Mexico, Portugal and Switzerland. Those countries also, generally, have seen lower levels of tooth decay, according to Harvard.
How much do cities spend on fluoride?
Fluoride is inexpensive, according to the Michigan Department of Environment, Great Lakes and Energy. It costs between 50 cents and $3 per capita per year to fluoridate a community’s water supply. Every dollar spent on fluoridation saves $38 in dental restoration costs, the department said.
Is tooth decay a problem?
Tooth decay remains the most common chronic disease of children aged 5 to 17 years, the DEGLE said. In the U.S., tooth decay affects:
This article originally appeared on Lansing State Journal: Michigan cities honored for fluoridation. Why some groups oppose use
Reporting by Dan Basso, Lansing State Journal / Lansing State Journal
USA TODAY Network via Reuters Connect
By Dan Basso, Lansing State Journal | USA TODAY Network
