The water utility in Birmingham, Alabama, has stopped adding fluoride to its drinking water from 2023 and 2024 without informing the public that it had stopped adding it years ago. The utility, Central Alabama Water, confirmed that two of the utility's four water filtration plants had temporarily stopped fluoridating in 2023, and a third had stopped in 2024. The decision was made based on safety, infrastructure, and financial considerations, including the high cost of maintaining and repairing its aging fluoridation systems. Despite warnings from top health officials that fluoride can have harmful effects, the only documented health risks of fluoridation are cosmetic issues such as discolored tooth enamel. However, many public health experts argue that there is an adequate replacement for fluoride for preventing tooth decay.