Some Alabama residents have been learning that their water has been free of fluoride for years

Last week, residents of Birmingham, Alabama, were notified that their drinking water would no longer contain fluoride. Then came the twist: It turned out that their water utility, without telling the public, actually stopped adding it years ago.

John Matson, a spokesman for Central Alabama Water, which serves Birmingham and the surrounding area, confirmed to NBC News that two of the service’s water treatment plants temporarily stopped discriminating in 2023, and the third was stopped in March 2024. The changes were made under previous leadership, he said, when the service had a different name.

Matson said Central Alabama Water found “no record” that the public was notified.

WBRC 6 News first reported that fluoridation in Birmingham had been quietly phased out by 2023.

The revelation came just days after the utility announced that as a new policy, it will not be adding fluoride to Birmingham’s drinking water going forward. The decision was made based on “a comprehensive assessment of safety, infrastructure and financial considerations,” Central Alabama Water said in a press release. It cited the high cost of maintaining and repairing its aging fluoridation systems, which it said would require more than $3.7 million.

Matson said the state’s health and environmental management departments were immediately notified when fluoride began to stop being added to the water supply. The Department of Health did not respond to a request for comment and the Department of Environmental Management was not available for comment.

The American Academy of Pediatrics and the American Dental Association recommend adding fluoride to drinking water because it helps prevent cavities. About 72% of people served by public water systems in the US receive fluoridated water, according to the most recent data available from the Centers for Disease Control and Prevention.

But a growing number of public water systems have begun to consider removing fluoride from drinking water.

Top health officials in the Trump administration have warned, without solid evidence, that fluoride can have harmful effects. Robert F. Kennedy Jr. he said in 2024, before he became the state’s health secretary, that fluoridation is associated with bone cancer, thyroid disease, IQ loss and neurodevelopmental disorders. Scientists, however, say there isn’t enough data to show a link. According to the CDC, which Kennedy now chairs, the only documented health risks of fluoridation are cosmetic issues such as discolored tooth enamel.

Last year, Utah became the first US state to ban fluoride from public water systems. Florida followed suit. At least 21 states introduced bills in last year’s legislative session to ban fluoride from being added to public water systems, according to the National Conference of Two Joint Legislatures.

Central Alabama Water said last week that removing fluoride from drinking water “allows customers and their health care providers to make more individualized decisions about fluoride use.” The agency added that “many consumers now find essential fluoride in toothpaste and other topical products such as mouthwash.”

Matson said the removal of fluoride in 2023 and 2024 took place while the Birmingham Water Works Board was the source of water for the area. It became Central Alabama Water last year and is “committed to being transparent with its customers,” he said.

However, in court Wednesday in Jefferson County, Alabama, a former attorney for the Birmingham Water Works Board alleged that “the people most responsible for allowing fluoride systems to fail are now using the CAW.”

Birmingham Mayor Randall Woodfin posted on Facebook Tuesday that some of the top leaders at Central Alabama Water worked for the previous board.

“Y’all can get the same power that the front board gave you if you weren’t successful and loyal to the customers,” Woodfin said. “You are not just a public organization, this is our water we are talking about, stop playing with us.”

Many public health experts say there is not enough replacement of fluoride in drinking water.

“It is certainly true that fluoride toothpaste is effective in preventing tooth decay, but it is not true that that alone provides a reason to remove fluoride from our drinking water,” said Dr. Scott Tomar, head of the department of oral health at the University of Illinois Chicago.

Tomar said removing fluoride from Birmingham’s water puts residents at greater risk of cavities.

“It’s possible that it puts young children at great risk, because that’s usually where we first see when fluoridation stops,” she said.