- A federal appeals court overturned a 2024 ruling that water fluoridation poses an unreasonable risk to children's IQ, citing procedural errors by the judge.
- Consumer advocacy groups filed a petition Nov. 12, 2026, asking the 9th Circuit to reconsider its May 21 decision, arguing it misapplied legal principles.
- The lower court had ordered the EPA to regulate fluoride under the Toxic Substances Control Act after finding neurotoxic harm to children.
- The appeals panel did not challenge the science but ruled the judge improperly delayed proceedings to await a key government study.
- More than 80 communities and two states have voted to end fluoridation since the original ruling, driven by the "Make America Healthy Again" movement.
Consumer advocacy groups are pressing a federal appeals court to revisit its decision to overturn a landmark ruling that fluoride in U.S. drinking water poses an unreasonable risk to children’s intelligence, arguing the panel relied on flawed procedural reasoning. The petition for rehearing, filed Nov. 12, 2026, by Food & Water Watch, Fluoride Action Network (FAN), and Moms Against Fluoridation, targets the May 21, 2026, ruling by the 9th U.S. Circuit Court of Appeals. That ruling vacated a 2024 decision by U.S. District Judge Edward Chen, which had found current fluoridation levels—0.7 mg/L, endorsed by the Environmental Protection Agency (EPA)—harmful to fetal and child brain development. The rehearing request asks the full court or original three-judge panel to restore Chen’s directive that the EPA initiate rulemaking under the Toxic Substances Control Act (TSCA).
The fight began in 2016 with a citizen petition to the EPA to ban water fluoridation due to neurotoxicity evidence. After the EPA denied the petition, the groups sued the agency under TSCA’s citizen suit provision, a process granting “de novo” judicial review—meaning the court weighs scientific evidence independently without deferring to agency judgment. A two-phase trial in San Francisco federal court culminated in Chen’s 2024 ruling, which cited the National Toxicology Program’s (NTP) seven-year review linking fluoride exposure to reduced IQ in children. That NTP report, released under court order in March 2023 after government officials allegedly blocked its release, formed the core of the scientific case.
The procedural dispute at the heart of the case
The 9th Circuit panel did not dispute the science. Instead, it found that Judge Chen violated the “party-presentation principle” by pausing the first trial phase in 2020 to await the NTP review, essentially “commandeering” the evidentiary record. In the unsigned May memorandum, Judges Sidney Thomas and Ronald Gould, Clinton appointees, and Brian Morris, an Obama appointee, argued that Chen abused his discretion by broadening the record beyond what the parties had originally presented. They directed Chen to decide based only on evidence from the first phase, which predated the NTP report.
The plaintiffs counter that the EPA itself deemed the NTP review “indisputably central” to the case and never objected to the pause during the second trial. Their petition argues the panel misapplied the principle, which prevents courts from introducing new legal issues, not from managing complex proceedings. They warn the ruling “could chill ordinary, well-accepted case-management practices” in toxic chemical litigation, undermining judges’ authority to stay cases for developing science.
The untold story of a suppressed report
This case exposes a pattern of regulatory resistance to emerging fluoride research. For decades, the CDC hailed water fluoridation as a top 20th-century public health achievement, while the American Dental Association and EPA defended its safety. Yet internal emails, obtained through Freedom of Information Act requests, revealed that top HHS and CDC officials blocked the NTP report’s release for years, even as evidence of neurotoxicity accumulated. The plaintiffs argue this suppression mirrors broader industry capture of health agencies, where financial and institutional interests override scientific caution. The NTP review, when finally published, found consistent associations between maternal fluoride exposure and child IQ deficits—a finding Chen’s 2024 ruling described as a preponderance of evidence.
Communities and states move as court battle continues
Despite the appeals setback, the lower court ruling has already catalyzed action. More than 80 communities, along with Utah and Florida, have voted to end water fluoridation since September 2024, driven by Health and Human Services Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” push. These votes cross political lines, reflecting a shift as cities reconsider decades-old practices. FAN board member Rick North noted, “This isn’t blue vs. red. It’s health versus harm.”
The science remains unrefuted
The case returns to Judge Chen, who must now rule on a narrowed record excluding recent studies and the NTP report that supported his original decision. Yet the plaintiffs emphasize that neither the EPA nor the appeals court refuted the underlying finding: fluoridation at 0.7 mg/L poses an unreasonable risk of lowered child IQ. As the legal process unfolds, communities continue to abandon the practice, signaling that public opinion—and science—may outpace the courts in this seven-year fight over one of the nation’s most entrenched chemical policies.
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