A military’s readiness level typically reflects its training, equipment and the capacity of its leaders across the ranks.

But what about a healthy set of chompers?

Sen. Elizabeth Warren, D-Mass., believes there is a link between quality dental health in the troops and military readiness — and that link could possibly be weakened by politically charged fluoridated water decisions.

In 2011, defense officials mandated all installations in the United States and territories that own or operate a potable water treatment facility serving 3,300 people or more fluoridate their drinking water by 2016, according to a Military Times report.

Providing fluoridated water for junior-enlisted personnel living in on-base housing was especially critical since that population was at the highest risk of dental issues, officials stated at the time.

But Warren, who serves on the Senate Committee on Armed Services, notes that since the majority of service members and their families live outside of military bases — as well as National Guard members and reservists — all communities, civilian and military, should have fluoridated water.

Earlier this year, Warren sent a letter to Department of Defense Secretary Pete Hegseth raising flags about the potential risk to troops if fluoride is no longer being added to drinking water in communities nationwide.

Health and Human Services Secretary Robert F. Kennedy Jr. has signaled his intent to direct the Centers for Disease Control and Prevention to stop recommending fluoride be added to America’s drinking water supplies.

“Our military is already falling short on delivering high quality dental care for our service members, and Secretary Kennedy’s fluoride crusade is threatening to worsen this crisis and hurt our military’s ability to deploy where they’re needed,” said Warren in a statement.

“Our government should be focused on improving dental health access for our service members, not pushing anti-science conspiracies. I’m going to continue holding Secretary Kennedy accountable for his disastrous policies.”

According to Warren, the Pentagon’s response to her letter to Hegseth included several findings:

• Dental emergencies account for 20%-30% of all disease non-battle injuries among deployed service members.
• Dental issues leave nearly 10% of service members “not medically ready to deploy.”
• The military was not consulted by HHS or Kennedy on the plan to direct the CDC to stop recommending water fluoridation.
• Fluoridation has contributed to improved dental readiness across the military.
• Removing fluoridation would likely lead to increased rates of dental decay.

The senator’s news release also included a comment attributed to Air Force Chief of Staff Gen. Kenneth Wilsbach:

“(B)enefits of optimally fluoridated drinking water have been proven repeatedly. … The Air Force Surgeon General supports maintaining fluoridated water systems in accordance with the 2013 DOD policy and the AF dental community strongly advocates to continue the policy of optimally fluoridated water on (DOD) installations.”

But any discussion of fluoridated water is, of course, usually divisive.

HHS press secretary Emily Hilliard dismissed Warren’s claims as “false and politically motivated,” according to The Defender.

“(Kennedy) is focused on restoring public trust in health policy by following current science, not outdated narratives or bureaucratic talking points.”

What are the challenges of assessing ‘dental readiness’ in the ranks?

The DOD’s recent memo in response to Warren’s letter was reviewed by Military Times.

It reported that while U.S. troops’ “dental readiness” has improved some over the past decade, there’s also been a decline in the percentage of troops with the best dental health.

From 2014 to 2024, the percentage of troops with the worst levels of dental health decreased from 8.3% to 6.3%, while the percentage of troops with the best dental health dropped from 48.9% to 44.8%, Military Times reported.

Specifically, Military Times reported, Warren requested details on whether troops’ dental readiness had improved since the implementation of the 2013 DOD requirement to fluoridate water on military installations that serve more than 3,300 people.

According to DOD, 14 of those installations haven’t implemented the policy, mostly due to varying concentrations of naturally occurring fluoride in their water supply.

Currently, there aren’t any service members who are reported as being “nondeployable” due to dental problems, according to responses provided by Anthony J. Tata, undersecretary of defense for personnel and readiness, to Warren.

In 2018, however, officials modified how that status is reported: Troops assessed as having the higher level of dental problems are categorized as “not medically ready to deploy,” but they aren’t reported in the “nondeployable population,” Military Times reported.

Dental emergencies account for 20%-30% of all “disease non-battle injuries” — or injuries not directly related to combat — during deployments, DOD officials said in their memo to Warren. The officials cited a 2024 study outlining 264 dental emergencies per 1,000 deployed personnel per year, based on an analysis of multiple long-term studies, according to the Military Times report.

There’s no clear evidence that fluoridation of drinking water alone is responsible for improved military dental readiness, defense officials told Warren.

“It is likely that a combination of factors, including fluoridation and other preventive interventions, have contributed positively to improved dental readiness across the force,” they said.

But there are complicating factors. Some installations purchase water from non-DOD drinking water providers, while many military members live off base.

Officials also noted that access to care, disease patterns, diet, oral hygiene practices and regular dental preventive care also impact an individual’s dental health and readiness, according to Military Times.

Utah’s history-making role in the fluoride argument

The Beehive State holds a historic place in the ongoing “fluoride in the water” debate.

Last May, Utah became the first state in the nation to ban the introduction of fluoride in public drinking systems. Florida soon followed.

The American Dental Association and the Centers for Disease Control and Prevention say fluoride has been one of the most dramatic public health accomplishments to help prevent dental decay, according to Deseret News reports.

Health experts cite numerous studies that extoll the benefits, but there is also other scientific information that calls that conclusion into question.

During an April visit to Utah, Kennedy cited a couple of 2024 studies, including one by the National Toxicology Program that said moderately higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children.

The report also concluded that more research is needed to better understand if there are health risks associated with exposure to lower fluoride concentrations.

Kennedy said it was those recent studies that helped solidify his opposition to fluoride.

“It has no business in our drinking water,” he said.

Meanwhile, the Utah Dental Association has challenged Kennedy, saying community water fluoridation is effective and safe.

“We welcome public discourse on health policy,” said Dr. Rodney Thornell, president of the Utah Dental Association, at the time of Kennedy’s April visit.

“But it’s important that these discussions are rooted in sound science and public health evidence. Fluoridation is one of the most studied and beneficial public health interventions of the last century.”