Former President Trump and former independent presidential candidate Robert F. Kennedy Jr. have raised fluoride in water as a public health measure to be addressed if Trump retakes the White House. Over the weekend, Kennedy wrote on social platform X, "On January 20, the Trump White House will advise all U.S​. water systems to remove fluoride from public water." He then claimed, without citing evidence, that fluoride is "industrial waste" that causes a list of harms. Trump has expressed an openness to this rule, telling NBC News, “Well, I haven’t talked to him about it yet, but it sounds OK to me.” Since Kennedy endorsed the Trump ticket, campaign officials have said the environmental lawyer and prominent conspiracy theorist would have immense influence over public health policy in a second Trump term. They have yet to say what specific role he would have in the administration, though the former president has said he would let Kennedy "go wild on health." Decades of fluoride Community water fluoridation for the prevention of dental cavities has occurred in the U.S. since 1945, and an estimated 72 percent of the U.S. population living on community water systems receives fluoridated water, according to the 2022 National Water Fluoridation Statistics from the Centers for Disease Control and Prevention (CDC). Since fluoride was introduced into community water systems, it has become ubiquitous in U.S. households, especially in toothpastes. In 2015, citing the widespread availability of fluoride, the Commissioned Corps of the U.S. Public Health Service advised a uniform concentration of 0.7 mg/L of fluoride in drinking water. The agency set this recommendation based on the need for cavity prevention balanced against the risk of fluorosis, when excess fluoride exposure in young children affects the outer appearance of teeth, manifesting as white flecks, spots or lines. The addition of fluoride has been cited as one of the top public health achievements of the past century. The dose makes the poison Health groups have stated that adverse effects associated with fluoride occur when people are exposed to high doses, far higher than what is commonly set in community water systems. The American Dental Association (ADA) notes on its website that "toxicity is related to dose." "While large doses of fluoride could be toxic, it is important to recognize the difference between the effect of a massive dose of an extremely high level of fluoride versus the fluoride level currently recommended for public water systems," the ADA states. "Like many common substances essential to life and good health — salt, iron, vitamins A and D, chlorine, oxygen and even water itself — fluoride can be toxic in massive quantities." According to the World Health Organization, excessive fluoride exposure usually occurs during the "consumption of groundwater naturally rich in fluoride." The spread of fluoridated water in the U.S. has been associated with a steep decline in the rates of decayed, missing and filled teeth. The CDC observed in 1999 that the average rate of dental cavities among U.S. 12-year-olds declined by 68 percent from the years 1966-1970 to 1988-1994.