What Should I Do if Fluoride Is Removed From My Tap Water?
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5 Ways to Protect Your Teeth (and Your Kids’ Teeth) Without Fluoride in Your Drinking Water

5 Ways to Protect Your Teeth (and Your Kids’ Teeth) Without Fluoride in Your Drinking Water
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Published on June 3, 2025
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As more U.S. communities remove fluoride from public water supplies over health concerns, you may need to switch up your approach to caring for your teeth.

That’s because fluoridated tap water is a proven tool to prevent cavities, even for people who use fluoridated toothpaste, according to the American Dental Association (ADA) — hence why most of the country added it to drinking water supplies decades ago.

“Removing fluoride from drinking water increases the risk of cavities for everyone, especially for people who don’t have regular access to dental care,” says Marcelle Nascimento, DDS, PhD, a dentist, professor, and an assistant dean of clinical research at the University of Buffalo School of Dental Medicine in New York.

Poor oral health is linked to a wide range of other medical issues, including cardiovascular disease, infections of the heart chambers or valves, pregnancy and birth complications, and pneumonia, according to Mayo Clinic.

But opposition to fluoride by Health and Human Services Secretary Robert F. Kennedy Jr. — and research linking exposure to extremely high levels of fluoride with low IQ in children — is prompting more states and municipalities to remove the mineral from their water.

What to Do if Fluoride Is Removed From Your Water

If fluoride is removed from your tap water, there are steps you can take to protect your teeth and your children’s teeth.

Note, however, Dr. Nascimento adds, that “none of these alternatives offer the same consistent, low-level exposure to fluoride throughout the day as fluoridated drinking water.”

1. Brush Your Teeth With Fluoridated Toothpaste

The one thing you should absolutely do is brush your teeth with fluoridated toothpaste. “This helps remove plaque and delivers fluoride directly to the teeth, strengthening enamel and helping prevent and reverse early decay,” Nascimento says.

When communities around the country started adding fluoride to public water supplies more than a half century ago, the mineral typically wasn’t in toothpaste as it is today, according to the U.S. Centers for Disease Control and Prevention (CDC).

The benefits of fluoride in drinking water have been less pronounced since people began routinely using toothpaste that contains fluoride.

When you use toothpaste with fluoride, you should spit it out and avoid swallowing it, according to the ADA — but don’t rinse with water after you’re done, so the fluoride will stay on your teeth longer.

You should monitor your kids’ use of fluoridated toothpaste, supervise brushing, and make sure children use only a pea-size dab until they’re about 7 years old.

2. Use Fluoridated Mouthwash and Rinses From the Drugstore

Fluoridated mouth rinse is a concentrated fluoride solution that may be used daily or weekly. The fluoride from the mouth rinse sticks to the tooth’s surface and your saliva to help prevent cavities, according to the CDC.

You can buy mouthwashes and rinses with low concentrations of fluoride at the drugstore without a prescription.

A meta-analysis of fluoride mouthwashes and rinses used by children and teens found these helped reduce cavities by 27 percent in permanent teeth.

3. Ask Your Dentist for Prescription Fluoride Gels or Chewables

If you or your kids are cavity-prone or at high risk for cavities based on factors like your eating habits, your dentist may choose to prescribe higher-strength doses of fluoride than you can get from regular toothpaste.

These options often come in the form of gels, chewable tablets, or lozenges.

Note, however, that the current U.S. Food and Drug Administration (FDA) is taking steps to remove prescription fluoride supplements for infants and toddlers from the market.

4. Get a Fluoride Varnish at the Dentist

A dentist, pediatrician, or other licensed health professional can apply varnishes with higher concentrations of fluoride directly to the teeth. This can keep a small amount of fluoride in close contact with teeth for many hours, per the CDC.

The ADA recommends fluoride varnishes for children and adults at high risk of cavities who don’t have fluoride in their drinking water, reapplied every three to six months. Teens with braces might need fluoride varnish more often.

People with lower risk of cavities and good oral health might consider varnishes every six months, per the ADA.

5. Eat Less Sugar

What you eat can make a big difference when it comes to your risk of cavities, according to the World Health Organization (WHO). Sugar and refined carbohydrates are the biggest dietary cause of cavities, and cutting back on these foods can improve your oral health.

Cavities develop over time as acid produced from the breakdown of sugars in the mouth gradually erodes the enamel, which normally provides a strong, protective outer layer to teeth; eventually the acid causes the dentin, an inner layer of weaker tissue that’s just underneath the enamel, to decay, per WHO.

Avoiding added sugars in your diet goes a long way to preventing this erosion process from starting and can prevent cavities. Limit added sugars to 5 to 10 percent of your diet throughout your life, starting in childhood, to prevent cavities.

“Cavities in baby and adult teeth can have lasting effects on a child’s health, development, and quality of life,” Nascimento says. A sugary diet is also a problem for teens that’s often compounded by poor brushing habits and by orthodontics that can trap bacteria in the mouth.

For older adults, the cavity risk from too much sugar may be compounded by dry mouth, and other health issues can increase the risk of tooth decay, Nascimento adds.

The Takeaway

  • Fluoridated water reduces the risk of cavities, even for people who use fluoridated toothpaste.
  • The easiest thing you can do to prevent cavities without fluoridated drinking water is brush your teeth daily with a fluoride toothpaste.
  • Some people who are more prone to cavities may want to ask their dentist about fluoride varnishes or other prescription fluoride supplements for cavity prevention.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Fluoride in Water. American Dental Association. 2024.
  2. Oral Health: A Window to Your Overall Health. Mayo Clinic.
  3. Timeline for Community Water Fluoridation. U.S. Centers for Disease Control and Prevention. May 15, 2024.
  4. Iheozor-Ejiofor Z et al. Water Fluoridation for the Prevention of Dental Caries. Cochrane Database of Systematic Reviews. October 4, 2024.
  5. How Fluoride Helps to Prevent Tooth Decay. American Dental Association. 2025.
  6. About Fluoride. U.S. Centers for Disease Control and Prevention. May 15, 2024.
  7. Marinho VC et al. Fluoride Mouthrinses for Preventing Dental Caries in Children and Adolescents. The Cochrane Database of Systematic Reviews. July 29, 2016.
  8. FDA Begins Action To Remove Ingestible Fluoride Prescription Drug Products for Children from the Market. U.S. Food and Drug Administration. May 13, 2025.
  9. Community Water Fluoridation Frequently Asked Questions. U.S. Centers for Disease Control and Prevention. May 15, 2024.
  10. Weyant R et al. Topical fluoride for caries prevention. Journal of the American Dental Association. November 2013.
  11. Sugars and Dental Caries. World Health Organization. November 9, 2017.
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Elizabeth Simpson, DDS

Elizabeth V. Simpson, DMD

Medical Reviewer

Elizabeth V. Simpson, DMD, is a clinical associate professor at the Indiana University School of Dentistry in Indianapolis. The bulk of her practice has been in the public health setting.

She attended the University of Notre Dame, where she was a science pre-professional studies major. After college, she worked in the Indianapolis public schools as a bilingual teaching assistant, which is when she decided to become a dentist. She graduated from Tufts University School of Dental Medicine in 2010 and did a general practice residency at Meharry Medical College School of Dentistry.

Dr. Simpson has completed two leadership programs. In one for the Indiana Dental Association, she started a mentoring program pairing high school students from underrepresented groups who were interested in pursuing dentistry with dental students also from underrepresented groups from the Indiana University School of Dentistry. In an American Dental Association program, she started a tooth-brushing program at an elementary school in Indianapolis.

Simpson writes for an American Dental Association blog and has participated as a speaker and panelist at several conferences, including for the Christian Dental Association, American Student Dental Association, and American Association of Women Dentists, as well as for the American Dental Association's Smile Con.

She is fluent in Spanish and speaks conversational French and Portuguese.

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Lisa Rapaport is a journalist with more than 20 years of experience on the health beat as a writer and editor. She holds a master’s degree from the UC Berkeley Graduate School of Journalism and spent a year as a Knight-Wallace journalism fellow at the University of Michigan. Her work has appeared in dozens of local and national media outlets, including Reuters, Bloomberg, WNYC, The Washington Post, Los Angeles Times, Scientific American, San Jose Mercury News, Oakland Tribune, Huffington Post, Yahoo! News, The Sacramento Bee, and The Buffalo News.
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