Water fluoridation is back in the debate spotlight as President-elect Donald Trump prepares to take office with an administration skeptical of the practice. The U.S. first began adding fluoride to water in the 1940s after studies showed it reduced cavities and tooth decay. However, Robert F. Kennedy Jr., Trump's nominee to lead the Department of Health and Human Services, has vocally opposed fluoridation, questioning its health benefits and safety.  

How did fluoride get added to water?
Fluoride is a naturally occurring mineral in soil, water, plants and food. It has been known to help oral health by preventing tooth decay and cavities, especially in children. Some countries "add fluoride to water," like the U.S., and others "add fluoride to milk or salt," said CNN.

As of 2022, approximately 72% of the U.S. population receives fluoridated water. The decision to fluoridate water is made at the local level and is only recommended, not mandated, by the Centers for Disease Control and Prevention. 

The Trump White House will "advise all U.S​. water systems to remove fluoride from public water," Kennedy said on X. "It remains unclear whether the incoming Trump administration could effectively ban water fluoridation," said Scientific American. "But at the federal level, fluoridation opponents could deploy the Safe Drinking Water Act, which regulates water contaminants nationally." 

Is it safe?
"Several credible studies estimate that fluoridated water now reduces child and adult tooth decay by about 25%," said Scientific American. But fluoride also "comes with potential risks, as many public health interventions do," said The New York Times. Too much can cause bone disease and tooth staining. 

The biggest source of controversy is its potential to cause cognitive problems. In August, the National Toxicology Program, part of the Department of Health and Human Services, released a report summarizing studies conducted in several countries and concluded that "drinking water containing more than 1.5 milligrams of fluoride per liter is consistently associated with lower IQs in kids," said The Guardian. The CDC's recommended limit is 0.7 milligrams per liter. 

Other recently conducted studies have not shown a link between fluoride and cognition. "The contradictory results, along with the limitations of the existing studies, have fueled a contentious, and still ongoing, debate among experts about the potential risks," said the Times.

Before he was appointed Crypto and AI Czar, a newly created position, by President-elect Donald Trump, David Sacks was a venture capital firm co-founder and chief operating officer of Silicon Valley giant PayPal. And he has been a prominent conservative voice who backed Trump's 2024 presidential bid. 

Charter member of the 'PayPal mafia'
Sacks' first job out of law school was a brief stint as a management consultant at McKinsey & Company, which he left in 1999 to join Confinity, a start-up founded by his Stanford friend Peter Thiel. There, Sacks worked alongside Elon Musk and several other future Silicon Valley heavyweights.

The group's marquee product was banking and payment site PayPal, which became such a huge success that it was acquired by eBay in a $1.5 billion deal in 2002. Sacks and the company's early developers became known as the PayPal mafia because so many of them went on to found other successful ventures. For Sacks, that was Yammer, a social networking site for business, which was acquired for $1.2 billion by Microsoft in 2012. Sacks established Craft Ventures in 2017, a venture capital firm that has invested in a variety of companies, including Uber and Airbnb.

Alliance with Trumpism
Sacks has become a "leading practitioner of a new right-wing sensibility that has emerged in the political realignments provoked by Trumpism and the pandemic," said Jacob Silverman at The New Republic. In his new position, Sacks will "work on a legal framework so the crypto industry has the clarity it has been asking for," said Trump. Sacks' appointment puts an "advocate for looser regulation of digital assets inside the White House," said David Hollerith and Ben Werschkul at Yahoo Finance. 

Critics expressed concern about the closeness of these industries to the Trump White House. Sacks' appointment means that the Trump administration intends to "disregard the very real dangers around crypto AI's energy use and pollution and environmental plunder and copyright infringement," said Nitish Pahwa at Slate, to further enrich the "guys whose riches are fueling this dystopia."