Baltimore Reduces Fluoride Levels in Water Amid Iran War Disruptions

Supply chain issues force city to lower fluoride content, raising concerns from dental experts.

Apr. 14, 2026 at 1:49am

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A translucent, ghostly X-ray image showing the intricate internal structure of a water treatment component, conceptually representing the disruption to Baltimore's water fluoridation system.An X-ray view of the inner workings of Baltimore's water infrastructure reveals the fragility of the city's fluoride supply amid global supply chain disruptions.Baltimore Today

The Baltimore City Department of Public Works has announced it is reducing fluoride levels in the drinking water this week due to supply chain disruptions caused by the ongoing war in Iran. Fluoride levels will drop from 0.7 milligrams per liter to 0.4 milligrams per liter, impacting residents in Baltimore City and Baltimore and Howard counties. DPW leaders say the decision was made to conserve the limited fluoride supply, as a key supplier in Israel is facing significant operational disruptions.

Why it matters

Fluoride is an essential mineral for dental health, and community water fluoridation has been hailed as one of the most important public health achievements of the past century. Reducing fluoride levels could increase the risk of tooth decay, especially for children and vulnerable populations, and place greater strain on emergency dental services.

The details

DPW leaders said they have been in communication with their fluoride supplier for the past couple of weeks, and the decision to lower levels was made due to supply chain disruptions from the Middle East conflict. A key supplier based in Israel is experiencing significant operational issues, leading to reduced fluoride shipments across the system. While the water supply remains safe and meets all standards, dental experts are encouraging residents to focus on good oral hygiene practices, including using fluoridated toothpaste and mouth rinse, and not skipping fluoride treatments at the dentist.

  • The fluoride reduction went into effect this week in Baltimore City and surrounding counties.

The players

Baltimore City Department of Public Works

The municipal agency responsible for managing the city's water supply and infrastructure.

Matthew Garbark

Director of the Baltimore City Department of Public Works.

Brionna Watson

Director of the Dental Hygiene Program at the Community College of Baltimore County.

Dr. Charles Doring

President of the Maryland State Dental Association.

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What they’re saying

“We've been talking to our vendor, who provides us with the fluoride for the past couple of weeks. Due to disruptions in the supply from the Middle East, due to all of the conflict and issues going on there, the supply that we're receiving is being reduced. A lot of the supply is coming from the same producer, so it's happening across the system.”

— Matthew Garbark, Director of the Baltimore City Department of Public Works

“Fluoride is an essential vitamin for our teeth. It is a great way as a public health initiative to allow everyone to be exposed to fluoride and to help prevent the development of caries as well as the progression of caries. This is a concern. Hopefully things will restore themselves where we are able to get back to the 0.7, but for now, I think it's more about what can we do in the meantime.”

— Brionna Watson, Director of the Dental Hygiene Program at the Community College of Baltimore County

“Community water fluoridation has been hailed as one of the most important public health achievements of the past century. For more than 70 years, the appropriate level of fluoride in drinking water has prevented untold amounts of tooth decay — quietly protecting the health of millions. The stakes of disrupting that protection are real: studies show that children in communities without fluoridated water are three times more likely to require hospital-based dental surgery, placing even greater strain on our already overburdened emergency departments.”

— Dr. Charles Doring, President of the Maryland State Dental Association

What’s next

DPW leaders said they are working to restore fluoride levels to the normal 0.7 milligrams per liter as soon as the supply chain issues are resolved, but it is unclear when that will happen.

The takeaway

This disruption to Baltimore's water fluoridation highlights the public health importance of this essential mineral and the need for resilient supply chains, especially during times of conflict and crisis. Dental experts are urging residents to take extra precautions to maintain their oral health until normal fluoride levels can be restored.