BIRMINGHAM, ALABAMA — Central Alabama Water announced last week that it will stop adding fluoride to Birmingham's drinking water. The utility revealed that fluoride addition had already ceased at most of its facilities, with two of four water filtration plants stopping in 2023 and a third in March 2024, according to a spokesperson.

The water utility had stopped adding fluoride to Birmingham's drinking water years earlier without notifying the public. Central Alabama Water has found no record of the public being notified about the stoppage of fluoride addition, a spokesperson said. The changes were made under prior leadership when the utility had a different name, according to a spokesperson.

The decision to stop adding fluoride was based on a comprehensive evaluation of safety, infrastructure, and financial considerations, according to a press release. Maintaining and repairing the aging fluoridation systems would require more than $3.7 million, the press release stated. The state's departments of health and environmental management were immediately informed when fluoride addition first stopped, a spokesperson said.

Birmingham Mayor Randall Woodfin criticized the lack of transparency in a Facebook post. "Y'all can get the same energy I gave the prior board when you are not transparent and honest with the customers," Woodfin wrote. He added, "You are not just a public entity. This is our water we are talking about. Stop playing with us."

The removal of fluoride in 2023 and 2024 occurred when the Birmingham Water Works Board was the area's water utility, a spokesperson said. The Birmingham Water Works Board became Central Alabama Water last year, according to a spokesperson. Woodfin wrote in his Facebook post that some of the top leaders at Central Alabama Water worked for the previous board. In a court filing in Jefferson County, Alabama, a former attorney for the Birmingham Water Works Board alleged that the individuals most responsible for allowing the fluoride systems to fall into disrepair are now running Central Alabama Water.

Dr. Scott Tomar, Head of the Department of Population Oral Health at the University of Illinois Chicago, said the decision has health implications for residents. "It certainly is true that fluoride-containing toothpaste is effective at preventing decay, but it's not true that that alone justifies removing fluoride from our drinking water," Tomar said. He added, "It has probably put youngest children at the greatest risk, because that's usually where we see it show up first when fluoridation stops."

Removing fluoride from drinking water allows customers and their health care providers to make more individualized decisions about fluoride use, according to a press release. Many customers now receive fluoride from toothpaste and other topical products like mouthwash, the press release stated.

The American Academy of Pediatrics and the American Dental Association recommend adding fluoride to drinking water to help prevent cavities. Around 72% of people served by community water systems in the U.S. receive fluoridated water, according to the latest available data from the CDC.