Birmingham, Alabama Residents Discover Water Supply Lacked Fluoride for Years Without Public Notice

Central Alabama Water revealed that Birmingham's drinking water has lacked fluoride since 2023, when previous leadership stopped fluoridation at three of four treatment plants without notifying the public, only informing state health agencies. The utility announced on March 27, 2026 that it would permanently cease fluoridation, citing over $3.7 million in needed infrastructure repairs and arguing that customers can obtain fluoride from toothpaste and make individualized healthcare decisions. The decision contradicts recommendations from the American Academy of Pediatrics and American Dental Association, with University of Illinois Chicago expert Dr. Scott Tomar warning that Birmingham residents, especially young children, now face unnecessarily greater cavity risk. The controversy unfolds amid a broader national movement against fluoridation, with Utah and Florida banning the practice and at least 21 states introducing similar legislation in 2025, despite CDC findings that fluoridation's only documented health risks are cosmetic.

Undisclosed cessation of water fluoridation in Birmingham

• ▪Central Alabama Water stopped adding fluoride at a third water filtration plant in March 2024.
• ▪Birmingham residents were informed on March 27, 2026 that their drinking water would no longer contain fluoride.
• ▪The Birmingham Water Works Board was the area's water utility before becoming Central Alabama Water in 2025.
• ▪Central Alabama Water stopped adding fluoride at two of its four water filtration plants in 2023 without public notification.
• ▪Central Alabama Water has found no record of the public being notified about the cessation of fluoridation.

Utility's justification and policy decision on fluoride removal

• ▪Central Alabama Water announced as a new policy that it would not add fluoride to Birmingham's drinking water moving forward.
• ▪Central Alabama Water's decision to remove fluoride was based on a comprehensive evaluation of safety, infrastructure and financial considerations.
• ▪Central Alabama Water stated that removing fluoride from drinking water allows customers and their health care providers to make more individualized decisions about fluoride use.
• ▪Central Alabama Water's aging fluoridation systems would require more than $3.7 million to maintain and repair.
• ▪Birmingham Mayor Randall Woodfin stated that some of the top leaders at Central Alabama Water worked for the previous board.

Public health implications and expert concerns about fluoride removal

• ▪Robert F. Kennedy Jr. became the United States health secretary after 2024.
• ▪Around 72% of people served by community water systems in the U.S. receive fluoridated water according to the Centers for Disease Control and Prevention.
• ▪Dr. Scott Tomar is head of the department of population oral health at the University of Illinois Chicago.
• ▪Robert F. Kennedy Jr. said in 2024 that fluoridation was associated with bone cancer, thyroid disease, IQ loss and neurodevelopmental disorders.
• ▪At least 21 U.S. states introduced bills in 2025 legislative sessions to ban fluoride from being added to community water systems.
• ▪Utah became the first U.S. state to ban fluoride in public water systems one year before March 2026.

Perspective of Central Alabama Water

• ▪Central Alabama Water's aging fluoridation systems requiring more than $3.7 million in repairs made continued fluoridation financially impractical.

Perspective of Public health advocates and dental professionals

• ▪The American Academy of Pediatrics and American Dental Association endorse water fluoridation as an effective cavity prevention measure.

Perspective of Anti-fluoridation advocates

• ▪Utah and Florida enacted statewide bans on fluoride in public water systems by March 2026.
• ▪At least 21 U.S. states introduced legislation in 2025 to prohibit fluoride addition to community water systems.

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