The U.S. Food and Drug Administration (FDA) announced that it will undertake a comprehensive review of all prescription fluoride supplements formulated for children, with a target completion date of October 31, 2025. Though the agency has not yet determined whether it will ultimately prohibit these products or request their voluntary withdrawal from the market, the move represents a significant reassessment of a decades-old public health measure.

Fluoride, a naturally occurring mineral, has long been credited with strengthening tooth enamel and reducing the incidence of cavities. According to the Centers for Disease Control and Prevention (CDC), it works by both preventing and repairing the acid-induced damage caused by oral bacteria—damage that, if left unchecked, can lead to tooth decay and even tooth loss. Good oral hygiene and regular dental checkups remain the cornerstone of cavity prevention, experts note, and poor dental health has also been linked to broader health concerns, including an increased risk of heart disease.

Despite its widespread endorsement, fluoride’s safety profile has come under recent scrutiny. In its announcement, the FDA cited emerging research suggesting that ingested fluoride may alter the gut microbiome and has been tentatively associated with thyroid disorders, weight gain and, in some studies, reduced cognitive function in children. These findings have yet to be confirmed by large-scale clinical trials, and opinions within the medical community remain sharply divided.

The U.S. Health Secretary Robert F. Kennedy Jr., who has previously expressed scepticism about the safety of fluoridation, applauded the FDA’s decision as “long overdue.” Last month, he hailed Utah’s decision to cease the addition of fluoride to public water supplies and called on other states to follow suit. “It makes no sense to have it in our water supply,” he told reporters in Salt Lake City.

However, many dental professionals stand by fluoride’s proven benefits. Dr. Aaron Yancoskie, associate dean at Touro College of Dental Medicine in Hawthorne, New York, recently told CBS News that “there is excellent, solid data going back 75 years showing that fluoride is both safe and extremely effective at reducing cavities by strengthening tooth enamel.”

As the FDA review proceeds, parents and caregivers are urged to consult with their family dentist before making any changes to their children’s fluoride intake. Below are practical steps families can take to maintain optimal oral health and minimize any potential risks:

1. Follow Professional Guidance: Always use fluoride supplements only if prescribed by a qualified dentist or paediatrician, and adhere strictly to the recommended dosage.

2. Monitor Toothpaste Use: For children under six, use only a pea-sized amount of fluoride toothpaste, and encourage them to spit out excess rather than swallow it.

3. Maintain Good Hygiene: Reinforce daily brushing (twice a day) and flossing habits, and schedule routine dental checkups every six months.

4. Balance Dietary Fluoride: Be aware of other sources of fluoride—such as municipal water, processed beverages and certain foods—to avoid excessive cumulative intake.

5. Stay Informed: Keep up with updates from the FDA and trusted professional organizations. Should any products be removed or relabeled, timely information will help you make the safest choices for your family’s dental care.

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