07/27/2025 / By Ramon Tomey
Fluoride supplements banned by the Food and Drug Administration (FDA) are a “tough thing to defend,” the agency’s Dr. George Tidmarsh has admitted.
Tidmarsh – who was recently appointed as director of the FDA’s Center for Drug Evaluation and Research – made this admission during a public hearing Wednesday, June 23. The meeting organized by the Reagan-Udall Foundation for the FDA saw pro- and anti-fluoride advocates clash. Tidmarsh criticized pro-supplement presentations for lacking data. (Related: FDA taps former pharma executive Dr. George Tidmarsh to lead the Center for Drug Evaluation and Research.)
“What this is saying is that the fluoride in water was causing a cognitive decrease in the younger children,” he said, referencing a study from January published in JAMA Pediatrics. According to the paper, early fluoride exposure was linked to a decrease in children’s IQ scores.
“And the randomized studies say that there is no benefit. So that’s a tough thing to defend.”
The public hearing also saw doctors critical of water fluoridation in attendance – among them Dr. Christine Till of York University in Canada, whose work ties fluoride to thyroid disorders. Dr. Bill Osmunson of the Fluoride Action Network, meanwhile, dubbed the practice a “hoax,” noting cavities persist in low-income children regardless of supplementation.
Advocates of water fluoridation were also present, including the American Dental Association and the American Academy of Pediatrics. Pediatric dentist Dr. James Bekker, a member of the Utah Dental Association, warned of “very disturbing things” that could happen if water fluoridation were stopped.
But Tidmarsh took umbrage at Bekker’s remarks, pointing out that the Utah dentist’s remarks lacked evidence. The FDA director compared it to Osmunson’s presentation, which mentioned that no randomized controlled trials had ever been conducted on the supplements.
In May, the FDA issued a ban on prescription fluoride drops and tablets for children. FDA Commissioner Dr. Marty Makary stated that ingested fluoride – unlike topical applications in toothpaste – harms gut bacteria, immune health and brain development.
The FDA’s decision hinges on mounting research, including a 2024 National Toxicology Program report linking fluoride exposure above Centers for Disease Control and Prevention (CDC) guidelines to lower IQ scores in children globally. This has prompted states like Utah and Florida to end water fluoridation.
Historical context underscores the stakes: Fluoride supplements, never FDA-approved, were grandfathered into use in the 1940s after sodium fluoride’s initial role as a pesticide. By 2016, watchdog groups petitioned for their removal, citing the CDC’s admission that fluoride’s benefits are topical, not systemic.
Tidmarsh noted that while rigorous studies could revive supplements, the agency errs on caution for now. “When it comes to children, we should prioritize safety,” he remarked.
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