Florida is poised to become the second state to outlaw the addition of fluoride to its public water, despite concerns from dentists and public health advocates. 

Lawmakers approved broader legislation Tuesday that included a provision banning “the use of certain additives in a water system.” It now awaits the signature of Gov. Ron DeSantis (R), who has publicly criticized fluoridation efforts. 

Florida Surgeon General Joseph Ladapo issued guidance in November recommending against community water fluoridation, citing its potential health effects.  

Florida’s bill adds to the growing backlash against fluoride. The push to ban the additive comes as Health and Human Services Secretary Robert F. Kennedy Jr. has expressed skepticism and sometimes outright hostility about water fluoridation, which is considered one of the great public health achievements of the 20th century. 

Utah was the first state to ban fluoride in the water supply. The measure is scheduled to take effect May 7. 

Fluoride is a naturally occurring substance that helps to prevent tooth decay by strengthening and rebuilding weakened tooth enamel. Water fluoridation has occurred in the U.S. since 1945, and the Centers for Disease Control and Prevention (CDC) recommends community fluoridation as a cost-effective way to improve Americans’ oral health.    

Major medical associations and public health groups — including the American Academy of Pediatrics, the American Dental Association and the CDC — also endorse adding fluoride to drinking water to help prevent cavities.  

Miami-Dade County Mayor Daniella Levine Cava (D) said in a statement she was “deeply disappointed” with the legislation’s passage.

“A decision like this – which impacts the health and wellbeing of all Florida families – should be left to local communities to determine what is best for their residents,” Levine Cava said. “In Miami-Dade we know that our community trusts dentists, not politicians, on whether or not we should fluoridate, and that’s why I continue to believe that listening to medical experts is the best way to safeguard our health.”

Kennedy and others in the Trump administration have said fluoride doesn’t improve water quality. Since fluoride was introduced into community water systems, it has become ubiquitous in U.S. households, especially in toothpastes. They also cited health risks of it in large quantities. 

Kennedy has called fluoride “an industrial waste” and pledged to get rid of it in the nation’s water supply.  

During a Cabinet meeting Wednesday, he praised Utah for being the first state to ban fluoride, and touted his plan to change federal fluoride recommendations. Kennedy has said he will tell the CDC to stop recommending that cities and states add fluoride to public water systems. 

Kennedy cited a federal report from last year that found an association between high fluoride levels and lower IQs among children, though not at the low levels found in U.S. drinking water. 

“The more you get, the stupider you are, and we need smart kids in this country,” Kennedy said.