As the debate about the value of adding fluoride to public drinking water permeates communities across the United States, a new nationally representative survey conducted by the Annenberg Public Policy Center (APPC) at the University of Pennsylvania finds that Americans are deeply divided on the use of fluoride in public drinking water.
The new findings come amid renewed attention to fluoridation following critical comments from Secretary of Health and Human Services Robert F. Kennedy Jr., legislative developments, and new scientific debate about the health effects of varying levels of fluoride exposure.
Fluoride is a mineral that occurs naturally in water and food and is commonly added to dental products such as toothpaste and mouthwash. Most major cities in the United States add fluoride to their drinking water. However, concerns have been raised that the total fluoride intake may exceed safe levels for some pregnant women and children.
For decades, the U.S. Centers for Disease Control and Prevention (CDC) has promoted community water fluoridation as a safe and cost-effective method to reduce tooth decay, claiming it was the main reason for the decline in tooth decay rates in the 20th century. The agency announced that fluoridated water can save billions of dollars a year in dental costs.
However, on April 6, 2025, the U.S. Environmental Protection Agency (EPA) announced that it would review “new science on fluoride in drinking water.” That same day, RFK Jr. announced that he planned to “tell the Centers for Disease Control and Prevention (CDC) to stop recommending fluoridation in communities across the country,” and said he was “forming a task force of health experts to study this issue and make new recommendations.” “President Kennedy cannot order communities to stop fluoridation, but he can direct the CDC to stop recommending fluoridation and work with the EPA to change allowable amounts,” the Associated Press said in a news article.. ”
highlights
The APPC Annenberg Survey of Scientific Public Health (ASAPH), conducted April 14-28, 2026 among 1,639 U.S. adults, found:
- Forty-three percent of U.S. adults support the use of fluoride in public drinking water, while 26% oppose it and 30% neither support nor oppose it.
- When asked if their community supported or opposed drinking water fluoridation, 43% said they supported or opposed fluoridation if the community decided to fluoridate, 23% said they were against fluoridation, and 34% said they were neither for nor against fluoridation.
- Those who identify as supporters of the MAHA movement are more likely to oppose than support adding fluoride to local drinking water (41% vs. 26%). Most people who do not support MAHA say they are in favor of fluoridation rather than against it (63% vs. 11%).
- Americans are far more confident than HHS Secretary Robert F. Kennedy Jr. that the American Dental Association (ADA) provides reliable information about the health effects of fluoride in drinking water (74% vs. 34%). Among MAHA supporters, trust in Kennedy is higher (74%) and trust in the ADA is higher (68%).
About a quarter (26%) of respondents in a nationally representative survey sample identified themselves as supporters of the MAHA movement, or Make America Healthy Again, the political slogan and health initiative first associated with RFK Jr.’s 2024 presidential campaign. A further 40% do not consider themselves MAHA supporters and 33% are unsure. This analysis examines responses from the entire population, self-identified MAHA supporters, and self-identified MAHA non-supporters.
“Americans are divided on fluoridation, but what stands out is that supporters of the ‘Make America Healthy Again’ movement are especially skeptical,” said Patrick E. Jamison, director of the APPC Annenberg Institute for Health Risk Communication, which oversees the study. “Yet, the American Dental Association, widely trusted, reports that 80 years of research shows that community water fluoridation is safe and is ‘the single most effective public health measure to prevent tooth decay.'”
Knowledge of the use of fluoride in U.S. water supplies
Fluoride has been part of the nation’s water supply for decades, but many Americans say they don’t know much about it. Nearly half of U.S. adults (46%) say they are not familiar with the use of fluoride in U.S. water supplies, while 54% say they are somewhat (45%) or very familiar with fluoride (9%). Four in 10 (41%) people are unsure whether the public water supply in their area is fluoridated, while around half (48%) say the public water supply in their area is fluoridated.
The impact of water fluoridation on public health is recognized.
By a more than 2-to-1 margin, Americans say the use of fluoride in public water supplies has an overall positive effect on public health (42%) rather than a negative effect (17%), while 6% say it has no impact. However, more than a third (35%) were unsure, which may reflect a lack of knowledge about the use of fluoride in water supplies.
MAHA supporters are four times more likely than non-supporters to say that fluoride in water supplies has a negative impact on public health (30% vs. 7%). Non-MAHA supporters are twice as likely as MAHA supporters to say water fluoridation has a positive effect on public health (61% vs. 30%).
Although MAHA supporters are less supportive of public water fluoridation than other groups, surprisingly, MAHA supporters are about equally likely to say that fluoride has a positive or negative impact on public health, 30% in both cases, reflecting uncertainty about its impact. ”
Laura A. Gibson, APPC Research Analyst
Views on fluoridation of public water supplies
When asked to choose which of the various opinions on fluoridation of public water supplies most closely matches their own, the population as a whole is more likely to support local fluoridation (43%) than to oppose it (22%), and a third (34%) have no opinion.
- Supporters of fluoridation are split sharply between those who support fluoridation as a community decision (23%) and those who believe communities should be required to fluoridate public water (20%).
- Opponents of fluoridation are evenly divided between those who believe fluoridation should be banned in all communities (11%) and those who oppose fluoridation but think the decision should be left to each community (11%).
MAHA supporters are more likely to oppose fluoridation, while non-supporters clearly support fluoridation.
- 21% of MAHA supporters oppose fluoridation and think local communities should ban fluoridation, and 18% oppose but agree that the decision should be left to local communities.
- Among MAHA non-supporters, 33% expressed support for mandatory fluoridation, and 28% said they supported fluoridation but believed the decision should be left to each community.
Policy position on cessation of fluoride use in public water supplies
A plurality of respondents oppose policies that would eliminate the use of fluoride in public drinking water (40% vs. 28% in favor). A third (32%) say they neither agree nor disagree. MAHA supporters are more than three times as likely as non-MAHA supporters to say they support ending the use of fluoride in drinking water (50% vs. 15%).
When it comes to water fluoridation, which is more reliable: RFK Jr. or ADA?
Overall, Americans have far more confidence in the American Dental Association (ADA) to provide the public with reliable information about the health effects of fluoride in drinking water than do Secretary of Health and Human Services Robert F. Kennedy Jr.
The survey found that two-thirds (65%) of U.S. adults are not confident that President Kennedy is providing reliable information about fluoride in drinking water, with 42% not at all confident and 23% not very confident. Only a third (34%) of adults have confidence in Mr Kennedy, with 8% saying they are “very confident” and 27% saying they are “somewhat confident”.
In contrast, three-quarters (74%) of U.S. adults say they are confident in the ADA, with 28% saying they are very confident and 45% saying they are somewhat confident. A quarter (26%) of those surveyed have no confidence in the ADA, 9% have no confidence at all, and 17% feel not very confident.
Among the subgroup of MAHA supporters, trust in Kennedy is much higher. Three in four (74%) MAHA supporters say they trust him very much (23%) or somewhat (51%) as a reliable source of information about the health effects of fluoride, while only 9% of non-MAHA supporters say they trust the health secretary.
The public and non-supporters of MAHA express higher levels of trust in the ADA than in Kennedy in providing reliable information about the health effects of fluoride in drinking water. Most MAHA supporters also express confidence in the ADA (68%), but confidence in Kennedy is higher (74%), and non-MAHA supporters have even greater confidence in the ADA (83%).
“When it comes to fluoride, Americans trust the American Dental Association significantly more than they trust Secretary of Health Robert F. Kennedy Jr.,” said Ken Winneg, managing director of research at APPC. “These overall numbers obscure the fact that many MAHA supporters express trust in both sources, reflecting how differently Americans evaluate health information depending on their broader views.”
APPC’s ASAPH Survey
The findings are from the 29th wave of the Annenberg Scientific Public Health Survey (ASAPH), which was conducted among 1,639 U.S. adults from April 14 to 28, 2026. The survey was conducted for the Center for Policy Studies by SSRS, an independent research firm. The nationally representative probability-based panel, first introduced in April 2021, has a margin of sampling error of ± 3.5 percentage points at the 95% confidence level. All numbers are rounded to the nearest whole number and may not add up to 100%. Due to rounding, combined subcategories may not add to the topline and text total.
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Annenberg Public Policy Center, University of Pennsylvania
