Fluoride shortage challenges US water utilities as Middle East war disrupts supply

Several US water utilities are reporting difficulty keeping fluoride at recommended levels, after supply problems linked to the Middle East war. The Association of Metropolitan Water Agencies said a small number of systems had flagged disruptions in recent weeks. Fluoride is added as a public health step to help prevent tooth decay.

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The supply issue centres on fluorosilicic acid, a key chemical used for water fluoridation. The US Environmental Protection Agency lists Israel among the world’s leading exporters of this product. EPA data also places the United States among the top five importers, which makes overseas supply changes important for utilities.

Fluoride shortage and the Middle East war supply chain

Dan Hartnett, chief policy officer for the Association of Metropolitan Water Agencies, said at least one Israeli supplier faced staffing problems. Many employees were called into active military service, Hartnett said. As a result, production dropped and less material reached the US market, causing shortages.

So far, the number of affected utilities is limited, yet the impact reaches large populations. Hartnett said the shortage is affecting hundreds of thousands of people. Hartnett also warned that if the conflict continues, extra strain may hit supply routes. That could expand shortages to more communities.

Fluoride shortage and reduced levels at WSSC Water

WSSC Water in Maryland, the country’s eighth largest water and wastewater utility, is among those managing limited supply. On April 7, officials said fluoride would drop to 0.4 milligrams per liter. That is lower than the recommended 0.7 milligrams per liter for fluoridated water.

Chuck Brown, a spokesperson for the utility that serves 1.9 million customers, said the timeline remains unclear. "we feel confident that well be able to stretch that out for a couple more months.\" Brown said officials did not know how long the disruption would continue.

In Pennsylvania, the borough of Lititz reported a temporary pause in fluoridation. The borough told water customers it had to stop adding fluoride for a couple of weeks last month. Officials linked the change to supply limits, similar to issues reported by other utilities.

Fluoride shortage and dentist guidance for families

Utilities add fluoride on a voluntary basis to support oral health, so reduced levels do not make tap water unsafe. Dr. Scott Tomar, an American Dental Association expert on community water fluoridation, said short drops are usually not a major worry. Tomar said, \"A few months drop in fluoride levels is probably not a cause for concern for most people,\"

Tomar pointed to research in places that ended fluoridation, including Calgary, Canada, Juneau, Alaska, and Israel. Those studies found the main effects show up across years, not weeks. Tomar said, \"Based on the best available information we have, below about 0.5 milligrams per liter, youre probably not going to see effective preventive exposure,\"

Tomar said children are likely to face tooth decay first if low levels persist. Tomar explained that fluoride helps strengthen enamel while teeth are still forming. Tomar advised brushing twice daily with fluoride toothpaste and keeping regular dental visits. Tomar also said people should speak to a dentist before using supplements.

Fluoride shortage and wider debate over fluoridated water

Research has found fluoridation remains helpful even with fluoride toothpaste and other sources. US Centers for Disease Control and Prevention data says nearly two-thirds of the US population receives fluoridated drinking water. The practice was long treated as a major public health step, linked to fewer cavities.

The American Dental Association says fluoridation has cut tooth decay by more than 25% in children and adults. Yet false claims about fluoride safety have spread in recent years. Last year, Utah became the first state to ban public water fluoridation. Health Secretary Robert F. Kennedy Jr. has also questioned its safety and limited fluoride use.

Tomar said safety concerns do not match evidence at standard US levels. \"The levels we use in the United States is perfectly safe,\" Tomar said. \"Despite a lot of the misinformation, there are no adverse health effects associated with the levels we use in our drinking water.\" Utilities continue to track supply, while advising residents to follow routine dental care.

With inputs from PTI