Veto coming? Dentists join Miami-Dade mayor to endorse fluoride in tap water

As she considers issuing a veto to keep fluoride in Miami-Dade County’s tap water, Mayor Daniella Levine Cava on Monday assembled a group of medical experts who back the long-standing practice aimed at improving dental health.

“It’s important to have fluoride in the water, especially at a young, early age,” said Dr. John Nelson, a Miami dentist and president of the Miami-Dade Dental Society. “When you’re developing those permanent teeth, it’s very, very important to have that fluoride in the water so that when one’s teeth come into the mouth, they’re nice and strong.”

Levine Cava has until Friday to veto legislation ordering the county’s Water and Sewer Department to stop adding tiny amounts of fluoride to drinking water for the first time since the 1950s. Backers of the legislation cited health concerns about ingesting fluoride — fears embraced by Florida Surgeon General Joseph Ladapo, who came to Miami to advocate for the legislation.

The legislation to end fluoridation passed the County Commission April 1 on a bipartisan 8-2 vote, with three commissioners absent. It takes a maximum of nine votes to override a mayor’s veto, leaving the county’s Democratic mayor a narrow margin of error if she wants to use her authority to try and reverse the board’s order.

If Levine Cava issues a veto, the override vote would occur at the start of the commission’s next meeting, which is May 6. If she doesn’t, the legislation orders a halt to fluoridating water in Miami-Dade within 30 days.

“The decision to continue fluoridating our water here is not one I take lightly,” Levine Cava said Monday. “It is essential that we carefully weigh all the facts, hear from experts and consider the voices of parents, doctors and community members.”

While she hasn’t revealed her plans, Levine Cava had said before the vote that she supports keeping fluoride in the county’s drinking water. Each of the medical professionals invited to speak on Monday had the same view.

In her opening remarks, Levine Cava listed the major medical groups still backing fluoridation, saying “they recognize that it is safe and effective for protecting dental health for all members of our community.”

The roundtable discussion marked the first time fluoride advocates were granted extended time to address the issue in County Hall since the debate began earlier this year.

The legislation’s Republican sponsor, Commissioner Roberto Gonzalez, only invited Ladapo and other critics of fluoridation for the one committee hearing on the issue, held last month. Ladapo was also allowed to address commissioners immediately before their afternoon vote on April 1. Dentists arguing to keep fluoride in the water were limited to 60 seconds of remarks during the meeting’s public comment segment in the morning.

While the media was invited to the mayor’s roundtable on Monday, commissioners were not. After the program started, Gonzalez took an empty seat at the end of one of the tables set up for the session’s speakers.

“I’m a little disappointed because I had no idea this was going on,” Gonzalez said after thanking the speakers for their participation. “It’s always important to sit down and have these conversations.”

On Monday, Gonzalez cited a federal judge’s 2024 ruling in a case brought by fluoridation opponents. The ruling cited a federal report that raised concerns about high fluoride consumption by pregnant women and developmental issues with their children. Gonzalez noted he consulted with “Florida’s top doctor” on the issue, referring to Ladapo.

Multiple speakers invited by Levine Cava took issue with the federal study and noted the judge’s ruling did not conclude fluoridated drinking water posed a health hazard — only that the risk of potential harm is high enough to make the Environmental Protection Agency consider regulatory actions on fluoride in water. That can range from a warning to banning the substance from water supplies altogether.

The sharpest comments of the day came from Dr. Aileen Marty, a professor at Florida International University’s medical school.

“I want to be very clear that the levels that are in Miami-Dade County’s water are safe,” Marty said to Gonzalez from the far end of the table. “Not only are they safe, sir, they’re necessary for the health and well-being of the children and adults in this county. … I think you need to be very careful with what you’re saying.”

On Ladapo, Marty added: “Just because he’s surgeon general doesn’t make him the top doctor.”

Monday’s guest speakers included one fluoride skeptic: David Tanner, a North Miami Beach resident who shared concerns about having a baby on the way who will be drinking infant formula mixed with fluoridated water if the Gonzalez legislation doesn’t become law. “Why risk trading brain health for tooth health ... ?” he asked via a phone connection piped in the meeting room.

Multiple speakers cautioned against viewing fluoridation as only an effort to reduce cavities. They said poor dental health left untreated — as is more likely in families with limited income — can lead to hospitalization and surgery. Drinking fluoridated water, they said, reduces that risk while presenting no health hazards.

Nelson, the head of the Miami-Dade Dental Society, pointed to a study out of Canada that found babies were more likely to have cavities in Calgary, which ended fluoridation in 2011, than they were in Edmonton, which never stopped the practice. Calgary has since reversed course, with fluoride set to return to drinking water there this spring.

“Miami-Dade County’s level of fluoride, which is protective, has been deemed safe by all current evidence,” said Dr. Cheryl Holder, an FIU medical professor who focuses on care in low-income communities. “We are currently giving the safe levels, and that’s what my patients need.”

This article updated the quote from David Tanner, who provided a copy of the prepared remarks he delivered by phone at the meeting.

This story was originally published April 7, 2025 at 5:05 PM.