ADA Urges Deliberate EPA Fluoride Review After Ninth Circuit Ruling

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Posted: June 10, 2026

ADA Urges Deliberate EPA Fluoride Review After Ninth Circuit Ruling

Edited by Dentaltown staff

The American Dental Association has urged the U.S. Environmental Protection Agency to take a more deliberate approach to its ongoing review of fluoride’s potential health effects, days after a federal appeals court vacated a ruling that had pressured the agency to move quickly.

In a May 28 letter to the EPA’s Office of Water, the ADA asked the agency to incorporate several recently published studies on fluoride exposure, cognition, and community water fluoridation into the systematic literature review supporting its Human Health Toxicity Assessment for fluoride. The letter was signed by ADA President Richard Rosato and Executive Director Nader Nadershahi.

The letter followed a May 21 decision by the U.S. Court of Appeals for the Ninth Circuit in Food & Water Watch v. EPA. The panel vacated a September 2024 federal district court ruling that had found fluoride in drinking water poses an unreasonable risk under the Toxic Substances Control Act and had directed the EPA to respond. The appeals court ruled on procedural grounds, finding that the lower court abused its discretion by “commandeering” the case, and did not decide whether fluoride at 0.7 milligrams per liter poses an unreasonable risk. The case was returned to the district court.

The ADA argued that with the lower court’s order vacated, the EPA is no longer operating under the court-imposed rationale that led it to expedite the assessment with an emphasis on neurodevelopment and dental fluorosis. The Association submitted studies for the agency’s consideration, including research published in The Journal of the American Dental Association, Science Advances, and the Proceedings of the National Academy of Sciences, and said several do not support an association between water fluoridated at recommended levels and neurodevelopmental outcomes.

ADA President Rosato said the appellate court recognized that the lower court had “improperly overstepped its role” by relying on materials neither party presented. The ADA, which maintains that community water fluoridation at recommended levels is safe and effective in preventing tooth decay, said it would continue working with the EPA as the review proceeds.

The EPA opened its fluoride toxicity assessment earlier in 2026 to inform potential revisions to the federal drinking-water standard under the Safe Drinking Water Act. The case now returns to the district court for reconsideration based on the record from the first bench trial.

Sources:
ADA News, “ADA calls for ‘deliberative approach’ in EPA fluoride review,” May 29, 2026: adanews.ada.org/ada-fluoride-deliberative-approach
U.S. Court of Appeals for the Ninth Circuit, Food & Water Watch v. EPA, No. 25-384, filed May 21, 2026: cdn.ca9.uscourts.gov/memoranda/25-384


ADA Urges Deliberate EPA Fluoride Review After Ninth Circuit Ruling

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