IMPACT PLAYERS: Why Fluoride Matters & Miami-Dade County's challenge

There she was, Miami-Dade County Mayor Daniella Levine Cava sitting in the middle of a standout panel of medical experts and research gurus speaking first as a Mother, Grandmother and of course, Mayor. She engaged the community as she expertly explained why she called the gathering and what was to come on May 3rd 2025- the vote on Fluoride in the county.

It was Cassandra who took over form there, handing the microphone over and moving the dialogue along at a swift and lively pace. Media and civic leaders alike got a healthy dose of reality regarding the fluoride debate.

The recent decision by Miami-Dade County Mayor Daniella Levine Cava to veto Resolution No. R-370-25, which aimed to halt water fluoridation in our county, is a powerful testament to the unwavering commitment to public health and the well-being of our nearly three million residents. This veto, supported by a united front of esteemed dentists, physicians, researchers, and community leaders, underscores the profound significance of water fluoridation as a safe, effective, and equitable cornerstone of preventive dental care.

"For over six decades, since the Eisenhower era – a time when sock hops were all the rage and teeth, apparently, were just as susceptible to decay – Miami-Dade County has wisely embraced water fluoridation. To even think about discontinuing this would have been a rather significant step backward, like trading in your high-tech, multi-functional hybrid automobile for a unicycle, potentially leaving the dental health of our community, especially our most vulnerable families with limited dental resources, in a rather precarious position.

The press conference, orchestrated by Arnold, featured a wildly impressive lineup; think the Avengers, but for oral health, featuring Dr. John Nelson, president of the Miami-Dade Dental Association and other medical leaders, civic legends and County personnel. They served as a rather compelling reminder of the overwhelming scientific agreement on fluoride's benefits. It wasn't just informative; it was, as someone astutely noted, a 'masterclass in methodology, insight, science, research, and cultural awareness.'

In other words, they brought the receipts, the charts, and probably a few very convincing smiles, all highlighting the thoroughly evidence-based reasons why we should stick with this vital public health initiative. After all, who wants a community where the most common accessory is a toothbrush and a look of mild discomfort?

Mayor Levine Cava’s statement resonated deeply with the core principles of public health: protection, prevention, and equity. As she aptly stated, "Water fluoridation is a safe, effective, and efficient way to maintain dental health in our county – and halting it could have long-lasting health consequences, especially for our most vulnerable families." Her decisive action reflects a profound understanding of the potential ramifications of removing this crucial element from our water supply. Let's delve deeper into the compelling reasons why fluoride is not just beneficial, but essential for the oral health of our community:

The Unwavering Science

Behind Fluoride's Benefits:

The scientific evidence supporting the benefits of fluoride is robust and spans decades of rigorous research. Numerous studies conducted worldwide have consistently demonstrated its effectiveness in preventing and even reversing the early stages of tooth decay. Fluoride works through several key mechanisms:

Strengthening Tooth Enamel: Our Natural Defense: Tooth enamel, the outermost protective layer of our teeth, is constantly under attack from acids produced by bacteria in plaque after we eat or drink. Fluoride plays a crucial role in strengthening this enamel, making it more resistant to these acid attacks. It integrates into the enamel structure, forming a stronger, more acid-resistant mineral called fluorapatite. This enhanced resistance acts as a shield, protecting our teeth from the initial stages of decay.

Preventing Cavities: A Proactive Approach to Oral Health: By fortifying the enamel and

slowing down the demineralization process (the loss of minerals from the tooth), fluoride significantly reduces the incidence of cavities, also known as dental caries. Cavities are not just a minor inconvenience; they can lead to pain, infection, tooth loss, and even systemic health issues if left untreated. Water fluoridation provides a continuous, community-wide approach to cavity prevention, reaching individuals regardless of their access to dental care or their individual oral hygiene practices.

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The Fluoride information deep-dive was perfectly paced and packed with insight with Dr. Cassandra Arnold, Ed.D., MBA, Deputy Chief of Staff with a tag-team one-two punch aided by Miami-Dade Mayor Daniella Levine Cava. Their combined expertise, and the outstanding panel which spanned both scientific understanding and political advocacy, created a compelling narrative that resonated with the audience. The meticulous presentation of data, coupled with the clear articulation of policy implications, left attendees with a comprehensive grasp of the complex issues surrounding water fluoridation.

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The Unwavering Science

 Behind Fluoride's Benefits

(Continued)

Remineralization: Nature's Repair Mechanism: In the early stages of tooth decay, before a cavity has fully formed, the enamel can lose minerals. Fluoride plays a vital role in remineralization, the process of redepositing these lost minerals back into the enamel. This can effectively reverse the early signs of decay and prevent the progression to a full-blown cavity, saving individuals from more extensive and costly dental treatments.

Reducing Tooth Sensitivity: Comfort and Quality of Life: For many individuals, tooth sensitivity to hot, cold, or sweet stimuli can significantly impact their quality of life. Fluoride can help alleviate this sensitivity by strengthening the enamel and blocking the microscopic tubules in the dentin (the layer beneath the enamel) that transmit these sensations to the nerves.

A Benefit for All Ages: From Infancy to Adulthood: The benefits of fluoride extend across the entire lifespan. For children, fluoride is incorporated into developing teeth, making them stronger and more resistant to decay from the moment they erupt. For adults, fluoride continues to protect against decay, especially as enamel weakens over time or due to other factors like dry mouth or gum recession. The National Institute of Dental and Craniofacial Research (NIDCR), a leading authority in oral health research, unequivocally supports the benefits of fluoride for both children and adults.

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The Equity Imperative: Protecting Our Most Vulnerable

One of the most compelling arguments for community water fluoridation is its inherent equity. It is a public health measure that benefits everyone in the community, regardless of their socioeconomic status, education level, or access to regular dental care. Children and families who may face barriers to accessing dental services, such as financial constraints, lack of transportation, or limited health literacy, receive the protective benefits of fluoride simply by drinking tap water. Eliminating water fluoridation would disproportionately impact these vulnerable populations, potentially widening the existing disparities in oral health outcomes.

Addressing Misconceptions and Ensuring Safety

Despite the overwhelming scientific consensus on its safety and efficacy, water fluoridation has occasionally been the subject of misinformation and unwarranted concerns.

It is crucial to emphasize that the levels of fluoride added to public water supplies are carefully monitored and are well within the safety guidelines established by leading health organizations worldwide, including the American Dental Association (ADA), the American Academy of Pediatrics (AAP), the Centers for Disease Control and Prevention (CDC), and the World Health Organization 1  (WHO). These organizations have rigorously reviewed the scientific evidence and have consistently affirmed the safety and effectiveness of community water fluoridation.   

The concentration of fluoride used in water fluoridation is meticulously controlled to provide optimal benefits for dental health without posing any significant health risks.

The science is clear: community water fluoridation is a safe and effective public health measure.

The Path Forward: Sustaining a Healthy Miami-Dade

Mayor Levine Cava's veto is a crucial step in safeguarding the oral health of our community. It is now imperative that the Miami-Dade Board of County Commissioners upholds this veto, ensuring the continuation of this long-standing and highly successful public health program. Maintaining water fluoridation is an investment in the health and well-being of all Miami-Dade residents, contributing to healthier smiles, reduced healthcare costs associated with dental disease, and a more equitable community.

The united voice of dentists, physicians, researchers, and concerned parents who stood alongside Mayor Levine Cava underscores the importance of evidence-based decision-making in public health. As we move forward, continued dialogue and education are essential to reinforce the scientific understanding of fluoride's benefits and to address any lingering misconceptions.

Let us champion this vital public health initiative and work together to ensure that the residents of Miami-Dade County continue to reap the significant benefits of fluoridated water for generations to come. Protecting our smiles is protecting our health, our well-being, and our future. Reach out to your local (Miami-Dade) commissioners to share your feedback.