Over the objections of dentists, a Louisiana Senate committee advanced a bill Wednesday that would set an almost impossibly high bar for public systems to add fluoride to their drinking water supply. 

In its original state, Senate Bill 2 by Sen. Mike Fesi, R-Houma, would have prohibited public water systems from fluoridating their water, which is done to prevent tooth decay. The practice began in the United States in the 1940s and is widely supported by major dental and medical associations. 

The Senate Health and Welfare Committee amended the bill to allow fluoridation only if voters approve, which would involve what committee chair and bill co-author Sen. Patrick McMath, R-Covington, described as an “incredibly difficult” process. 

The legislation advanced after the committee approved the amendments, which Sen. Gerald Beaudreaux, D-Lafayette, put forward before ultimately voting against the bill. The changes would allow local residents to vote on whether they want their system to be fluoridated, but only after at least 15% of voters the system services petition for the election. 

McMath likened it to the process for recalling an elected official, a very burdensome process that rarely succeeds in Louisiana. 

The bill, which Louisiana Surgeon General Ralph Abraham supports, is based on the premise that fluoride is harmful. In high doses, the chemical, like many others, can cause adverse health effects. But at the amount present in American water systems, there is scant evidence fluoride presents a health risk. 

“Too much or too little of anything is bad for you, including vitamins and water,” said Anne Jayes, senior policy manager with the Louisiana Public Health Institute. “Too little [fluoride] can lead to poor dental hygiene, cavities and poor bone health, including osteoporosis.”

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At the recommended level of 0.7 milligrams per liter of water, fluoride strengthens teeth and helps prevent decay, especially in communities where access to dental care is limited, Jayes added. 

In places where fluoride has been removed from the water systems, studies have found drastic increases in pediatric dental complications. After Calgary Canada stopped fluoridating its water in 2011, a decision it reversed in 2021, there was a 700% increase in the number of children receiving IV antibiotics at a local hospital for dental infections and abscesses. 

Annette Droddy, executive director of the Louisiana Dental Association, represents nearly 2,000 dentists in Louisiana. She warned the passage of the bill would lead to an increase in state spending for its Medicaid dental program. 

The bill will next be debated by the Senate.