Miami-Dade mayor issues veto on fluoride. Will commissioners override it?

Douglas Hanks, Miami Herald on Apr 11, 2025

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MIAMI — Miami-Dade’s mayor on Friday vetoed legislation that would strip fluoride from county drinking water, setting up a showdown override vote by county commissioners over a public health practice that began in the 1950s.

Citing recommendations from doctors, dentists and national medical groups, Mayor Daniella Levine Cava said fluoridated water is needed to protect residents from dental conditions that can come from too little fluoride use.

“The science is very clear,” Levine Cava said at a Friday morning press conference. “No major study has shown harm at the levels of fluoride being used in Miami-Dade. ... Ending fluoridation could have real and lasting harm, especially for children and families who cannot afford regular dental care.”

While a mainstream position for decades, that view has come under fire from the top health officials in Tallahassee and Washington, D.C., under Gov. Ron DeSantis and President Donald Trump. Florida Surgeon General Joseph Ladapo spoke before commissioners twice in support of the Miami-Dade legislation, which orders the county’s Water and Sewer Department to stop adding fluoride to tap water within 30 days.

The veto pits Levine Cava, a Democrat, against both the DeSantis administration and the bipartisan coalition of county commissioners who voted for the legislation on April 1.

“No to forced medication!” DeSantis said on social media Thursday night on a Ladapo post predicting a Levine Cava veto.

The legislation passed on an 8-2 vote, and a maximum of nine votes is needed to override a mayor’s veto. Three commissioners missed the April 1 vote — Marleine Bastien, Keon Hardemon and Micky Steinberg — so their votes could be decisive in the override tally. A two-thirds vote is enough to override a mayor’s veto.

Fluoridation’s long-term future in Miami-Dade may not rest with the fate of Levine Cava’s veto. Robert F. Kennedy Jr., the Health and Human Services secretary under Trump, said recently he would ask federal regulators to stop recommending that local governments add fluoride as a way to lower the risk of cavities across a population.

A federal judge in California last fall ordered the Environmental Protection Agency to take some sort of regulatory action against fluoridation after deciding that studies suggested enough of a health risk to merit that step. While the EPA fought the ruling under President Joe Biden, it’s not clear the agency will continue its appeal under Trump.

On the state level, legislation under consideration in Tallahassee would ban Florida’s local governments from adding fluoride to tap water.

At issue are scattered studies linking fluoride consumption to developmental issues in children, with critics of water fluoridation pointing out that brushing with standard fluoride toothpaste protects teeth without having to consume the mineral, too.

Medical groups, including the American Academy of Pediatrics, say the bulk of the research still points to fluoridation as both safe and a net positive for dental health.

Vetoes are rare in Miami-Dade government, and this is the first for Levine Cava’s second term after her reelection last August.

It’s likely Miami-Dade will only have 12 commissioners when the May 6 meeting begins. Commissioner Kevin Cabrera was confirmed this week as Trump’s ambassador to Panama, and he’s expected to resign his seat well before May 6. He voted with the majority to end fluoridation, but his absence may not matter mathematically. If 12 commissioners attend the May 6 meeting, it only takes eight votes to hit the two-thirds threshold. That would still leave the override camp needing an additional vote beyond what would be seven sitting commissioners who voted for the original legislation. The no votes on April 1 came from a Democrat, Commissioner Eileen Higgins, and a Republican, Commissioner Raquel Regalado.

Commissioner Roberto Gonzalez is the Republican sponsor of the legislation. He’s been warning supporters of a potential Levine Cava veto this week.

“As more and more evidence is mounting against fluoridation, Miami-Dade County took a bold step forward to protect public health,” Gonzalez posted on social media Thursday. “A veto would be a very disappointing step backward.”