A Jefferson County judge ruled Monday that Central Alabama Water immediately resume adding fluoride to its water supply.
Jeffrey Thompson, Central Alabama Water CEO, announced in a press release on March 20 that the utility would immediately cease the inclusion of fluoride in its system.
That triggered a lawsuit from the City of Birmingham, which successfully that the sudden announcement violates an Alabama law requiring that any utility decision in regards to fluoride must be submitted to the state health officer 90 days prior.
“The blatant disregard for the mandates of Alabama Law pertaining to this subject area has certainly harmed and injured the customers and ratepayers of the Defendants,” wrote Jefferson County Judge Fred Bolling. “Further, this harm and injury will likely continue without the issuance of the requested Temporary Restraining Order.”
Birmingham Mayor Randall Woodfin had harshly criticized the utility’s decision on social media following the initial announcement.
“This is the same board that promised transparency,” Woodfin wrote on social media. “The same leadership that said they would run this utility the right way. And now they can’t even follow a basic notification statute before stripping a public health measure from hundreds of thousands of people’s drinking water.”
CAW isn’t the first utility in the state to make the decision to cut fluoride recently. Madison Utilities stopped adding fluoride to its water in June of last year, citing costs and infrastructure damage.
The decisions come as Health Secretary Robert F. Kennedy has made the removal of fluoride from public water systems a goal, calling it “industrial waste.” He has gone so far as to claim it causes lower IQ levels (based on a study of fluoride at levels twice that of what is added to public water systems) and cancer, despite experts saying there is no substantiated evidence that it is carcinogenic.
Alabama dentists have come forward other plead with state water providers to continue fluoridation as a public health benefit.
“Fluoridation of public water supplies is one of the most successful and cost-effective strategies for improving oral health across all age groups and socioeconomic backgrounds,” said Michele Huebner, executive director of the Alabama Dental Association. “For more than 75 years, scientific research has consistently demonstrated that optimal levels of fluoride in drinking water significantly reduce the prevalence of tooth decay by more than 25 percent in children and adults.”
That public health benefit is particularly essential in low-income areas, Huebner said. The CDC has proclaimed community water fluoridation one of the ten great public health achievements of the 20th century because of the role it has played in the reduction of tooth decay.
Huebner also stressed the economic benefit of adding fluoride to the public water supply.
“The economic advantages of community water fluoridation are substantial,” Huebner said. “Compared to the cost of dental treatment, community water fluoridation provides significant cost savings. The average lifetime cost per person to fluoridate a water system is less than the cost of one dental filling. For most cities, every $1 invested in water fluoridation saves $38 in dental treatment costs.
“A 2025 study released by the American Dental Association’s Health Policy Institute estimated Alabama’s 5-year increase in dental care costs due to the removal of fluoride in community water systems to be nearly $758 million.”
The people of Jefferson County will have fluoride in their water once again—for now. But CAW could soon begin the process with the proper notification of the health officer and remove fluoride again in 90 days.
