This spring, Broadway became the third small town in the Shenandoah Valley in about a year to decide to stop fluoridating its drinking water. The move mirrors statewide fluoride bans in Utah and Florida, and skepticism from the U.S. Health Secretary, but remains rare among Virginia municipalities. WMRA's Randi B. Hagi reports.
Timberville was the first to ditch fluoride, with a unanimous town council vote last March. Luray followed suit in June on a split vote. A few weeks ago, Broadway town residents got a notice on their bill that their water supply would no longer be fluoridated as of August 1.
OLIVIA HAIMANI: I was actually a little horrified. I was surprised, and I knew that I had to speak out.
Olivia Haimani is a Broadway resident who spoke in support of fluoride at the May town council meeting.
HAIMANI: I felt that we should have gotten notified that they were thinking about doing this.
Fluoridated tap water has become widespread in the U.S. over the past 80 years, and is touted by proponents as one of the greatest public health achievements of the century for its role in improving dental health. According to the CDC, children with access to drinking water with optimal fluoride levels have 25% fewer cavities than those without. According to the Virginia Department of Health, over 96% of state residents who get their water from a municipal system are getting fluoridated water.
ISABELLE STITT-FREDERICKS: Fluoride works in a couple ways. It prevents the loss of minerals from tooth enamel … so, making it stronger, and it prevents bacterial activity.
Isabelle Stitt-Fredericks is the senior program manager of water for Virginia Health Catalyst, an education and advocacy organization promoting oral and overall health.
STITT-FREDERICKS: Fluoridation helps prevent tooth decay across populations, really regardless of your age, your socioeconomic status, your insurance status, or even your ability to regularly access dental care. There's scientific evidence from the past 80 years, and a lot of real-world monitoring that we do, that still maintains that fluoride is a best practice, and still supported as safe and effective by the CDC and American Dental Association and American Academy of Pediatrics.
Anti-fluoride groups successfully sued the Environmental Protection Agency in recent years, prompting the agency to begin an ongoing review of the health impacts of fluoride in drinking water. That decision was influenced by an analysis of existing research conducted by the National Toxicology Program, which expressed "moderate confidence" in a link between lowered IQ and fluoride levels of 1.5 milligrams per liter of drinking water – just over twice the CDC-recommended amount of 0.7.
Stitt-Fredericks noted much of that research took place in other countries where natural fluoride levels are much higher and less regulated than in the U.S.
STITT-FREDERICKS: I think most importantly, that review did not conclude that the optimally fluoridated levels we see here are unsafe.
They pointed to a longitudinal study published in April by researchers from the universities of Michigan, Minnesota, and Wisconsin –
STITT-FREDERICKS: That followed individuals in Wisconsin … from when they graduated high school to, now they're in their 60s and 70s, and they found that there was no difference in IQ for those who grew up with fluoridation or without.
According to meeting minutes, town council members in Timberville, Luray, and Broadway cited the cost of fluoride (between $5,000 and $20,000 a year), the corrosiveness of the concentrate, and the principle of free choice as reasons to ditch the additive. Additionally, NPR reports the fluoride supply chain has become strained due to conflict in the Middle East, limiting its availability.
After Timberville and Luray pulled the plug, the president of the Virginia Dental Association, Dr. Justin Norbo, sent a letter to Broadway's town council, urging them not to follow suit.
Broadway Mayor Dave Jordan declined to do an interview with WMRA at this time while he weighs community feedback. Timberville Town Manager Austin Garber was not available for an interview in the past week, and Luray Town Manager Bryan Chrisman didn't respond to us.
Haimani feels the Broadway Town Council made their decision with inaccurate information.
HAIMANI: My mom didn't have access to fluoride until she went to college at 18. … The dentist can tell that she did not have access to fluoride growing up. We had a well. … I was lucky that my mom was able to talk to the dentist about that, because she had learned from her own experiences, and I was supplemented with fluoride. I've never had a toothache. But I know lots of people that have … and don't have access to dental care, and they live with a lot of pain and problems.
Fluoride doesn't just get added to our water – depending on the geology of your water source, some amount of it is likely present naturally. Erin Ling, who coordinates the Virginia Household Water Quality Program for the Virginia Cooperative Extension, says there's relatively low fluoride levels throughout most of the Valley and Piedmont regions.
ERIN LING: So in most cases, we're seeing less than 0.5 milligrams per liter of fluoride naturally in the water. There are a couple of pockets, or 'hits,' as we would call them, where the levels are a little bit higher than that.
Ling said statewide, 20% of residents are on well water – in Rockingham County, it's 60%. Her program recommends that those with naturally low fluoride levels in their well water talk to their dentist about fluoride supplements.
LING: Our hope is really just to make sure they're as informed as they can be so that they can make educated decisions about their water systems and their families' health and safety.
Rockingham County does provide treated water to some residents. Their largest system, Three Springs, serves around 18,000 people from McGaheysville to Mount Crawford. It treats 3.8 million gallons of groundwater a day from two wells, with a third under construction.
Treatment Operations Manager Tim Harris pointed out the system's turbidity monitor, showing low levels of sediment in the water.
[machinery humming]
TIM HARRIS: Coming out of the ground, that's better than some places get with finished water.
They won the Best Tasting Water award from a statewide association in 2023, which Harris credits to the purity of the groundwater there, just below Massanutten Mountain, near the South Fork of the Shenandoah River. They get concentrated fluoride in 330 gallon, cube-shaped totes, which the employees have to wear special rubber gloves and an apron to unload.
HARRIS: Every day, 365 days a year, we have to measure the fluoride in the water.
[Harris assembles machine]
He showed me the process – in which a calculator-sized tool called a colorimeter reads how much light passes through a water sample – which is altered by the concentration of fluoride. That day, it was 0.73 milligrams per liter.
HAGI: At what point would you see a reading, would it like be at 0.8, where you're like, "okay, we need to decrease what's going through the pump?"
HARRIS: The technology is so good with these pumps that never happens. If anything, I'll find that the level is too low. It will be, the pipe will be clogged up or something. … It's never high … and that's because our water, gallons per minute, stays the same.
In contrast, water customers' opinions on fluoride – here, as elsewhere in the valley – are all over the map.
