Water fluoridation would become optional in Kentucky under bill advanced by House committee

Update, March 2, 2025: House Bill 16 passed 68-29 in the House on Feb. 26, 2025. It now resides in the Senate, awaiting a committee assignment.

By Sarah Ladd
Kentucky Lantern

If the 31 sponsors of House Bill 16 are successful, Kentucky will let local water systems’ governing bodies decide whether or not to have fluoridated water.

The bill easily passed the House Health Services Committee on Thursday, Feb. 20,  mostly along party lines, 11-4.

Rep. Kim Moser, R-Taylor Mill, the committee’s chair, was the only Republican to oppose it — for now.

“I am still not comfortable with the potential for just adding to our poor oral health, which leads to other medical conditions in our state,” said Moser, a retired nurse, while explaining her vote against the bill.

Moser indicated some edits to the bill might change her mind.

“I will have to see some additional language also that is going to offset our potential Medicaid costs,” she said. Some testified that lack of fluoridated water could add millions in Medicaid expenses for the state.

Moser also said she would “hate putting the burden of voting on this issue on our water district, our unelected officials in our regions.”

The committee vote came after more than an hour of discussion from dentists and other health care workers. Those who spoke against the bill said Kentucky can’t afford the potential fallout of not having fluoridated drinking water, saying it would trickle down to worse oral health and loss of learning for children who will miss school because of tooth pain.

Both sides acknowledged studies showing a mixed bag of results on how exposure to high levels of fluoride affects children’s IQs. Kentucky requires water utilities serving more than 3,000 customers to add low amounts of fluoride to drinking water which, according to the National Institutes of Health, helps prevent cavities and decay,

Co-sponsor Rep. David Hale, R-Wellington, presented the bill because the primary sponsor, Rep. Mark Hart, R-Falmouth, was out sick.

“I want to emphasize this to all the members and everyone here today, this does not mandate removal,” Hale said. “This is not an anti-fluoridation bill.”

The two-page bill makes participation in the fluoridation program optional. It says the decision to have fluoridated water “shall solely be decided by the governing body of a water system that is subject to regulation by the cabinet.”

‘Mass medication’ or equitable cavity prevention?

Dr. John Kall, a Louisville dentist, called fluoridation “mass medication without informed consent.”

Kall questioned the overall safety of fluoride exposure and said, “It’s a very wise choice to play it safe.”

Cindy Batson, a registered nurse who testified in favor of the bill, pointed out that most states leave water fluoridation to local governments. According to the Fluoride Action Network, Kentucky is one of 13 that currently mandate it.

“Having a mandate isn’t the norm for the rest of the country,” Batson said.

Six Kentucky health care professionals testified against the bill.

Steve Robertson, the executive director of the Kentucky Dental Association, said he expects “for every 10% of Kentuckians that are taken off water fluoridation, we can anticipate a $19.1 million increase in Medicaid expenses.”

“While we realize that this is not an anti-fluoridation bill, and I get that, what we are concerned about is if we give the ability for that decision to be made locally, who’s actually going to be making that decision?” he asked. “Will they be elected and truly representing the local population or not? Will it be an appointed board that may not necessarily represent the bulk of the people in the community?”

Kelly Taulbee, the director of communications and development for Kentucky Voices for Health, said access to quality oral health care is already a top barrier to wellbeing throughout the state.

“We believe that action prevention is really the key to improving health and sustaining our economy,” she said. “Kentucky consumers deserve and have a right to clean air and water just to support good health, if nothing else. Regardless of your socioeconomic status, every single one of us in this room is at the mercy of, and we have to rely on, our local water districts to deliver safe, fluoridated water.”

Cristina Perez, a pediatric dentist and the pediatric dental program director at the University of Kentucky, said, “It’s very important for fluoride to be in water.”

“If fluoridation was not in the water, we would go back to seeing levels that we had before water was fluoridated, and that’s about 90% of our children would have decay,” she said. “So it’s very difficult to deal with.”

Dr. Brittany Camenisch, a UK periodontal professor and dentist in Richmond, testified over Zoom that “water fluoridation remains the most effective and socially equitable means of achieving community wide exposure to cavity prevention.”

“Fluoride is successful in preventing cavities. This is a fact. Another fact is that passing this legislative action will harm children in our state,” she said. “There are other ways to improve the health of our population. They require collaboration, research, resources, open minds and purposely thought-out plans to prioritize long-term success. As health care professionals and legislators, we have a duty to protect the public. Our decision should be based on science and not on sensationalized political topics.”