Rich “Raz” Razgaitis addresses pros and cons of the removal of fluoridation from our drinking water system, and why it’s important to have filtration and purification at the point of dispense
By Stan Goff, Senior Content Editor
Water fluoridation has been in the news quite a bit lately, with dental and health organizations arguing about its value to the oral health of the public, while some politicians and other groups are in support of eliminating it from public water sources.
Last month Utah became the first state to place a complete ban on community water fluoridation, despite concerns raised by the American Dental Association and others. Utah’s ban came weeks after water fluoridation skeptic Robert F. Kennedy Jr. was sworn in as U.S. health secretary.
In an effort to shed more light on water fluoridation and on the importance of clean water overall, Dentistry Today asked Rich “Raz” Razgaitis, CEO and co-founder of water purification company FloWater a series of questions. Here, he shares his thoughts on the topic.
Dentistry Today (DT): Who will be the most impacted by the decision to change recommendations around fluoride and the pros and cons ofremoving fluoride from drinking water?
Raz Razgaitis: First, let’s start with some of the pros and cons of the removal of fluoridation from our drinking water system.
On the pro side of removal: there’s increasing concern that fluoride is a neurotoxin at higher levels, and that adding it to the water supply—without controlling individual dosage—is outdated public health policy. There is some data that suggests kids with higher levels of fluoride have lower IQs. Removing this from systemic consumption, so that it can be applied topically or orally, ensures the beneficial effects of fluoride are retained, without some of the potential downsides of its consumption.
On the con side: eliminating it without replacing it with other access to fluoride treatments for at-risk populations could increase disparities in dental health outcomes. The data is quite clear that fluoride has demonstrated a ~ 25% reductionin tooth decay. The concern is that the removal of fluoride from our drinking water would translate into worse dental health for children, especially for those who don’t regularly access dental care or fluoridated toothpastes/mouthwash.
Positively, if recommendations are adopted and fluoride is removed, then clearly the population that wants free choicewill be the beneficiaries—but so will any and all adults. There is no benefit to fluoridated water for adults, though there appears to be some marginal benefit to oral/topical fluoride treatment for the adult population. However, if fluoride is removed from our drinking water, the topic that doesn’t receive enough attention is the risk for those more impacted, which will be marginalized communities and children, particularly those without access to regular dental care or the resources to be provided fluoridated toothpaste or mouthwash.
Passive prevention of tooth decay is one of the original arguments for adding fluoride to tap water, and generally speaking, most people and healthcare professionals agree on the positive impact of fluoride for teeth. But here’s the problem: when fluoride was introduced into the water supply in the 1940s, the context was completely different. We didn’t have fluoridated toothpaste, topical fluoride treatments, or the level of oral hygiene awareness we do now.
So, there’s good reason to remove fluoride from our drinking water, provided that there is a clear countermeasure and solution that provides for alternative applications of fluoride—topically via a dental office or toothpaste and mouthrinse—while also solving for how to ensure children in marginalized communities can have this same access when fluoride is removed from drinking water.
DT: Should the conversation around fluoride take priority over the need to remove PFAS?
Razgaitis: This is a great question, one I’m asked frequently about various contaminants in our drinking water, and what’s the “worst” that we should be solving for first. It’s tough to answer, because it’s a little bit like answering the question “of the 6,000 chemicals that go into making cigarettes bad, which is the worst?” My answer is that we have a systemic crisis with our drinking water in the United States that includes various amounts of other heavy metals, pharmaceuticals, herbicides, and pesticides, that include contaminants such as per- and polyfluoroalkyl substances (PFAS) and lead.
PFAS are known as “forever chemicals” for a reason. They bioaccumulate, they’re tied to serious health risks such as cancer, hormone disruption and reproductive issues, and they’re in the blood of nearly every American. It’s estimated that over the last few years more than 200 million Americans have been drinking tap water contaminated with PFAS. Worse, it’s estimated that over 50% of Americans (including kids) have consumed leaded tap water over the last fiveyears, and still to this day, there is no federal mandate on lead levels and appropriate testing required (largely, governed by states and municipalities now). Lead, a known neurotoxin that can have devastating effects on childhood development, is my number one crisis in the United States, and it can’t be easily solved due to the aged infrastructure. PFAS is high on the list, along with other contaminants.
The level of work we need to do in the United States is through appropriate regulatory and policy reform, investment in upgrading water treatment plants, replacing or improving very aged infrastructure, and finally, recognizing that we now live in a world where we must treat our water twice. This means, specifically, we need to have a filtering or (ideally) a purification device wherever we’re accessing tap water. Municipal water does the best job it can to get the water to us, yet we need to have filtration and purification at the point of dispense to ensure we’re not drinking a chemical cocktailfrom our tap.
DT: What most Americans don’t realize about the outdated infrastructure behind U.S. tap water, and why weshould be demanding better solutions now more than ever?
Razgaitis: Most people assume that what comes out of the tap is safe because “someone” is making sure it is. But thetruth is, much of the U.S. water infrastructure is 50 to 100 years old. Pipes are aging, treatment facilities are outdated, and the regulatory system hasn’t caught up with the sheer number of chemicals we’re now exposed to. We’re talking about over 50,000 chemicals used in the U.S.—and fewer than 100 are regulated in drinking water. That’s a massive gap. Add to that microplastics, pharmaceuticals, pesticides, industrial runoff, and you start to realize: clean water doesn’t happen by accident. It takes awareness, demand, and modern solutions. Some of these solutions are long-term (such as policy, regulatory, and upgrading infrastructure). Others are immediate that consumers, business owners, and school administrations can take control of now, by installing new technology filtration and purification designed to address and solve today’s problems.
DT: Can you speak to the importance of safe water protocols for both dental staff and patients?
Razgaitis: Absolutely. Whether it’s a dentist’s office, school, hospital, fitness center, or workplace, water quality impactseveryone. For patients or vulnerable populations like children, the elderly or people with compromised immune systems, contaminated water can lead to serious illness. For staff, it’s about long-term exposure and cumulative health effects.
Safe water should be a non-negotiable standard in every environment, especially those tied to care and wellness. In a world where 70% of Americans are chronically dehydrated, we absolutely need to drink more water. In a country where 50,000 chemicals are in use in the U.S., and the average person is eating or drinking one credit cards worth of plastic every week, we need to ensure that the water they are consuming is clean, trusted, and tastes great—which is why weneed to take measures into our own hands and install filtration and purification systems to address these issues while larger and important measures, which will take many years, are improved.
DT: Why has fluoride become such a controversial topic lately, and how does this align or conflict with positions from major health organizations?
Razgaitis: The controversy has resurfaced because people are starting to question legacy health policies more critically—and fluoride is one of those “set it and forget it” decisions from a different era. Add in the rise of wellness influencers, mistrust in public health institutions post-COVID, and a growing awareness of environmental toxins, and you’ve got aperfect storm for questioning the status quo. Organizations like the ADA still stand by fluoride as a safe and effective public health tool. But more recent studies are pointing to potential risks at even relatively low levels—especially for infants and young children. So, the science is evolving, and public opinion is catching up faster than regulatory policy is.
DT: Is there anything else you believe is critical for readers to understand about the state of water safety in the U.S.?
Razgaitis: Yes—clean water isn’t a given. It’s not just about what’s regulated, but about what’s not. And there’s adangerous assumption that government oversight guarantees safety. Flint, Michigan showed us otherwise. We’ve got to move from passive trust to active demand—for transparency, updated standards, and real investment in infrastructureand individual/organizational accountability and proactivity to take measures into our own hands and ensure we’redrinking filtered and purified water. This is one of the most basic things we need to get right as a country. Water is health. Water is equity. Water is the foundation. And we’ve waited long enough to fix it.
