The longstanding public health practice of adding fluoride to public drinking water systems in the United States is facing new challenges and bans in some places, and experts have warned that the change would come with significant costs – both to the health of children and the health care system.

A new modeling study , published Friday in JAMA Health Forum, estimates that removing fluoride from public water in the U.S. would lead to 25.4 million excess decayed teeth in children and adolescents within five years, along with $9.8 billion in health care costs. After 10 years, these impacts would more than double to nearly 54 million excess decayed teeth and $19.4 billion in costs.

That translates to one additional decayed tooth for every three children in the U.S. – but the costs wouldn

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