The EPA has filed an appeal in the landmark fluoride case in which Judge Edward Chen ruled last September that the EPA recommendation for water fluoridation levels in the United States is an “unreasonable risk to human health.” Attorney Michael Connett, Partner at Siri & Glimstad, called out the Department of Justice and the EPA for filing the “time-wasting appeal.”

“EPA filed its appeal in the fluoride case yesterday,” Connett wrote. “In its brief, EPA does not challenge the merits of the Court’s determination that fluoridation poses an unreasonable risk. Instead, EPA challenges various legal aspects of the case. EPA, Lee Zeldin, and Pam Bondi have the authority to withdraw this time-wasting appeal any time they choose. If they do, EPA would have the authority, under the court’s order, to implement a nationwide ban on fluoridation.”

HHS Secretary Robert F. Kennedy Jr. said while campaigning for President Donald Trump that the Trump administration, if elected, would advise all U.S. water systems to remove fluoride from the public water supply on day one. “Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease,” Kennedy wrote. “President Trump and First Lady, Melania Trump, want to Make America Healthy Again.​”

On February 13, 2025, President Trump signed an executive order establishing the MAHA Commission, which comprises the heads of multiple federal agencies, including HHS and the EPA. At the end of March, Utah became the first state to ban water fluoridation. Shortly after, on April 7, EPA Administrator Lee Zeldin and HHS Secretary Kennedy held a joint press conference in Salt Lake City. They announced an “expeditious review” of the scientific information regarding potential health effects of fluoride consumption via the public water supply.

The April press release acknowledged the court ruling that levels above 1.5mg of fluoride are associated with lower IQ in children. This ruling was made with moderate confidence. While the EPA recommends a concentration of 0.7mg of fluoride, the actionable level is 4.0mg. “Secretary Kennedy has long been at the forefront of this issue,” Administrator Zeldin said during the press conference. “His advocacy was instrumental in our decision to review fluoride exposure risks, and we are committed to working alongside him, utilizing sound science as we advance our mission of protecting human health and the environment.”

“The decision to appeal the court’s order was not made by the HHS or Secretary Kennedy,” Connett wrote on X. “It was made by the Solicitor General of the Department of Justice, who reports to Pam Bondi and the White House. For his part, Secretary Kennedy has been clear that states should end their water fluoridation programs (as Florida and Utah have recently done), and that CDC will be revising its anachronistic recommendations, which would be a major development. The HHS does not, however, have the authority to ban fluoridation. Only the EPA has this power, and it has decided, for now, to forego its historic opportunity (as provided by the court’s decision) to exercise it.”

Administrator Zeldin has not directly commented on the EPA’s appeal of the court decision, but did write about the “expeditious” fluoride review less than a week after Connett announced the appeal process was moving forward. “At the Trump EPA, an urgent and expeditious review is underway of new science on fluoride in drinking water in response to Secretary Kennedy’s tremendous advocacy and leadership,” Administrator Zeldin wrote. “His bold efforts with President Trump to Make America Healthy Again are already historic!”

Secretary Kennedy shared the message and said he is proud to work with Administrator Zeldin and President Trump to ensure the drinking water is safe.

“It’s not good enough that the EPA is going to conduct another ‘review’ of the science,” Connett said on X. “EPA needs to take *action.* And action means protecting people from the fluoridation chemicals that are still added to the tap water of over 200 million Americans. EPA can do this by dropping its appeal and banning fluoridation (just like most of Europe has already done).”

Connett said in another post that he had hoped the appeal process wouldn’t be necessary, but he and the legal team are prepared to take on the EPA’s challenge.

The EPA filed a notice of appeal on January 17, just days before the deadline and in the final days of the Biden administration. The EPA has filed and been granted four extensions since then. The latest reasoning is that the defendant’s counsel and the EPA-retained expert had planned vacations and other business to tend to.

In May, Florida became the second state to ban the practice of community water fluoridation. Also in May, the FDA began the process of removing fluoride tablets for children from the market. The FDA announcement said ingesting fluoride alters the gut microbiome, which is a “magnified concern” for developing children.

Commissioner Marty Makary said, “The best way to prevent cavities in children is by avoiding excessive sugar intake and good dental hygiene, not by altering a child’s microbiome. For the same reason that fluoride may kill bacteria on teeth, it may also kill intestinal bacteria important for a child’s health.”

A three-judge panel at the United States Court of Appeals for the Ninth Circuit will make the ruling. The Fluoride Action Network stated that this process typically takes 6-12 months but could potentially take longer.

Other states and local governments continue to advance bills to reverse the practice of community water fluoridation, but nothing has been introduced at the federal level.