Cookies help us run our site more efficiently.

By clicking “Accept”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. View our Privacy Policy for more information or to customize your cookie preferences.

Everything you need to know to keep your teeth healthy

News Feed
Monday, March 17, 2025

Consumer Reports has no financial relationship with any advertisers on this site.With age comes a greater risk that things will go wrong with your teeth. Among adults, procedures such as filling cavities tend to peak in your early to mid-50s, according to the Health Policy Institute. By the time you reach your 60s, you’re almost certain to need treatment for tooth decay. Figuring out exactly what dental care you need and when can be challenging. Yet there’s one key step that’s simple and inexpensive: taking care of your teeth at home.Though certain dental problems may require extra attention, the basics of brushing twice daily and cleaning between your teeth by flossing haven’t changed. And while plenty of companies would like to sell you pricey gadgets and special products for your oral health, you don’t need to shell out big bucks to keep your mouth in great shape.How often for dental cleaning?Even with great home hygiene habits, you still need to see your dentist regularly for checkups and cleanings. Some people will need to visit more often than the standard twice a year, while others may be fine with less frequent visits. A 2020 review by Cochrane, an independent group of expert researchers, found that adults who visited the dentist every six months and those who visited on a schedule customized to their individual dental risk had comparable oral health.People who are being treated for periodontal disease or who have dental implants — which can fail more quickly than a natural tooth — may need to see their provider every three months or so, says Martha McComas, a clinical associate professor of dentistry at the University of Michigan School of Dentistry in Ann Arbor.Your dentist can help you figure out the right cadence for checkups, as well as your optimal at-home dental care strategy. “We can customize it based on what we see in your mouth,” says Karin Arsenault, program director of geriatric dentistry at the Tufts University School of Dental Medicine in Boston.Between visits, here’s what you need to know about the vital tools for keeping your teeth and your whole mouth as healthy as they can be.Your toothpaste mattersFluoride is important. Fluoride is crucial because of the power it has to help fight cavities and tooth decay — something proved by decades of research. While some ingredients, notably a chemical called hydroxyapatite, have shown promise as viable alternatives, fluoride is still your best choice right now, according to the American Dental Association.Cavities occur when the bacteria in our mouths consume the traces of food left on our teeth, particularly anything sugary. As the bacteria gobble up these sugars, they release acid, which can remove minerals from our teeth’s enamel, eventually creating cavities. Fluoride can help replace some of these lost minerals, strengthening the surface of our teeth and repairing some damage.When you’re shopping for toothpaste, look for one with the ADA Seal of Acceptance. To earn that seal, manufacturers need to not only include fluoride in their toothpaste but also meet other safety and efficacy standards, including one meant to ensure toothpastes aren’t too abrasive. (Very abrasive toothpastes can damage enamel.)Watch out for this ingredient: If you’re prone to canker sores inside your mouth, you may want to look for a toothpaste that doesn’t contain sodium lauryl sulfate (SLS). A 2019 research review found that using an SLS-free toothpaste might help reduce canker sores in people who get a lot of them (about 25 percent of adults).Skip charcoal toothpaste. Activated charcoal is often touted as a superior ingredient for a variety of products, including toothpaste. But it can be highly abrasive, which research has shown can damage your enamel and cause increased sensitivity.How much toothpaste to use: Generally, adults need only a pea-size amount of toothpaste — that will create enough foam to cover all the surfaces in your mouth, Arsenault says.Also, “one of the big myths about toothbrushing is that you should rinse your mouth out after you brush,” says McComas. Studies show that the fluoride in your toothpaste provides the biggest benefit if you don’t do this, instead allowing the fluoride to work its magic on your enamel for more time.What about prescription pastes? You may want to ask your dentist whether a prescription toothpaste, which generally contains a higher dose of fluoride, might be right for you. Severe dry mouth, which can be more common as you age (particularly if you’re taking certain medications for various chronic conditions, including for high blood pressure and depression), can raise your risk of cavities. So can periodontal disease, especially if the surfaces of the roots of your teeth, which lack protective enamel, are exposed.How to brush wellThe right bristles: Use a toothbrush with soft or extra-soft bristles. There are so many toothbrush options, but in the midst of considering the shape of the brush head, the brand name and other fancy features, don’t lose sight of bristle stiffness. Seek out a toothbrush with “soft” or “extra soft” on the packaging. Stiffer bristles are more likely to damage your gums or your teeth’s enamel, according to the American Dental Association.The advantages of an electric toothbrush: You can keep your mouth perfectly healthy with a manual toothbrush, but a 2014 Cochrane review found that three months of using an electric toothbrush resulted in 21 percent less plaque and 11 percent less gum inflammation (also called gingivitis).There are not significant performance differences between oscillating (or rotating) electric toothbrushes, which typically have round heads, and sonic toothbrushes, which usually have rectangular heads. So get the kind you like and will use.How much to brush: Do it twice a day for at least two minutes. Some research suggests that people may brush for a lot less time than this on average, possibly around a minute or less. But common sense and a 2009 Journal of Dental Hygiene study suggest that brushing longer will remove more plaque — though the added benefit of extra time beyond two minutes is probably marginal, and brushing too hard can exacerbate problems, including receding gums, which can expose the roots of your teeth to a greater risk of cavities and tooth decay.How to flossWhy flossing matters: Use any standard string floss (waxed or unwaxed), floss pick or interdental cleaning brush. The scientific evidence for flossing is not as strong as it is for brushing: A 2019 Cochrane review found that flossing in addition to brushing may reduce plaque and gingivitis more than brushing alone, but the authors cautioned that the evidence supporting this conclusion was weak. Still, dentists say the biological justification for flossing is sound: Without it, the bacteria that cause decay can build up between your teeth even if you’re brushing regularly.Do water flossers work? While not quite as effective as string floss, water flossers can be a great option if you have a hard time using string floss, have mouth hardware like braces or a permanent retainer, or have other kinds of dental work like implants, bridges, or crowns. Dentist Sally Cram, a spokeswoman for the American Dental Association, says the evidence on the benefits of a water flosser is encouraging, but it’s not enough for her to recommend it as a replacement for flossing just yet. Still, if you know you won’t use string floss every day, a water flosser is better than nothing.Avoid floss with PFAS. Skip floss that’s coated with these environmental contaminants, which are associated with a variety of health problems. You can look for flosses that use non-PFAS coatings such as beeswax or plant waxes like carnauba or candelilla.CR partnered with Made Safe, an independent organization that certifies products as safer and more sustainable, to find flosses made without PFAS. Read our special report, “How to Choose Dental Floss Without PFAS and Other Harmful Chemicals,” for the details, including three good floss options made from silk instead of plastic.How often should you floss? Do it once a day. Whether you floss or brush first doesn’t matter, as long as you do both.What if you have implants or gum disease? If you have an implant, you may want to opt for an interdental brush instead of regular string floss, particularly if your implant doesn’t touch the teeth next to it on either side.These are tiny round brushes designed specifically to clean in between teeth, and they work well with teeth that have gaps in between them. They come in different sizes, so Jennifer Harmon, a registered dental hygienist and clinical associate professor at the University of North Carolina Adams School of Dentistry in Chapel Hill, recommends working with your dentist to figure out which size you need for your teeth.If you’re dealing with bleeding gums, Arsenault says, you can consider using prescription chlorhexidine mouthwash after you floss. Just be sure to follow your dentist’s instructions, because chlorhexidine can also cause some tooth staining and changes in taste.Do you need these dental tools?Tongue scrapers: The experts we spoke with say this is a great tool. The bacteria that cause tooth decay don’t just live on your teeth; they can collect on your tongue, too. That means you should clean your tongue daily. You can do this with your toothbrush bristles or the ridged back of some brushes, but a tongue scraper can be a little more effective, Cram says.Plus, scraping your tongue is a great habit if you struggle with halitosis (bad breath), says Roxanne Dsouza-Norwood, a registered dental hygienist and clinical assistant professor of dental hygiene at the University of North Carolina at Chapel Hill. But be gentle; otherwise you could accidentally lacerate your tongue. And you may need to experiment with different types of tongue scrapers to find one that doesn’t activate your gag reflex.Whitening strips: Over-the-counter whitening strips can help your teeth look whiter, but it can sometimes be difficult to spot the change, McComas says. You can try using them only on the upper teeth first so that the difference is more visible. (Then apply them to the lower teeth.) Keep in mind that the older you get, the more you can see the yellowish dentin underneath your enamel, which — along with crowns and implants — is not affected by strips. So you might end up with uneven colors.Strips can also cause sensitivity, particularly if you already have sensitive areas from gum recession, Cram says. So leave them on only as long as instructed on the package.Mouthwash: Because swishing it around can coat parts of your teeth’s surface that are harder to reach with other tools, mouthwash can be a nice adjunct to your dental care routine, particularly if you choose one that has fluoride. Prescription washes that contain chlorhexidine can also be helpful for people with bleeding gums or other severe gum problems.Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer and healthier world. CR does not endorse products or services and does not accept advertising. Read more at ConsumerReports.org.

From brushing to whitening to the timing for dental cleanings, and everything in between.

Consumer Reports has no financial relationship with any advertisers on this site.

With age comes a greater risk that things will go wrong with your teeth. Among adults, procedures such as filling cavities tend to peak in your early to mid-50s, according to the Health Policy Institute. By the time you reach your 60s, you’re almost certain to need treatment for tooth decay. Figuring out exactly what dental care you need and when can be challenging. Yet there’s one key step that’s simple and inexpensive: taking care of your teeth at home.

Though certain dental problems may require extra attention, the basics of brushing twice daily and cleaning between your teeth by flossing haven’t changed. And while plenty of companies would like to sell you pricey gadgets and special products for your oral health, you don’t need to shell out big bucks to keep your mouth in great shape.

How often for dental cleaning?

Even with great home hygiene habits, you still need to see your dentist regularly for checkups and cleanings. Some people will need to visit more often than the standard twice a year, while others may be fine with less frequent visits. A 2020 review by Cochrane, an independent group of expert researchers, found that adults who visited the dentist every six months and those who visited on a schedule customized to their individual dental risk had comparable oral health.

People who are being treated for periodontal disease or who have dental implants — which can fail more quickly than a natural tooth — may need to see their provider every three months or so, says Martha McComas, a clinical associate professor of dentistry at the University of Michigan School of Dentistry in Ann Arbor.

Your dentist can help you figure out the right cadence for checkups, as well as your optimal at-home dental care strategy. “We can customize it based on what we see in your mouth,” says Karin Arsenault, program director of geriatric dentistry at the Tufts University School of Dental Medicine in Boston.

Between visits, here’s what you need to know about the vital tools for keeping your teeth and your whole mouth as healthy as they can be.

Your toothpaste matters

Fluoride is important. Fluoride is crucial because of the power it has to help fight cavities and tooth decay — something proved by decades of research. While some ingredients, notably a chemical called hydroxyapatite, have shown promise as viable alternatives, fluoride is still your best choice right now, according to the American Dental Association.

Cavities occur when the bacteria in our mouths consume the traces of food left on our teeth, particularly anything sugary. As the bacteria gobble up these sugars, they release acid, which can remove minerals from our teeth’s enamel, eventually creating cavities. Fluoride can help replace some of these lost minerals, strengthening the surface of our teeth and repairing some damage.

When you’re shopping for toothpaste, look for one with the ADA Seal of Acceptance. To earn that seal, manufacturers need to not only include fluoride in their toothpaste but also meet other safety and efficacy standards, including one meant to ensure toothpastes aren’t too abrasive. (Very abrasive toothpastes can damage enamel.)

Watch out for this ingredient: If you’re prone to canker sores inside your mouth, you may want to look for a toothpaste that doesn’t contain sodium lauryl sulfate (SLS). A 2019 research review found that using an SLS-free toothpaste might help reduce canker sores in people who get a lot of them (about 25 percent of adults).

Skip charcoal toothpaste. Activated charcoal is often touted as a superior ingredient for a variety of products, including toothpaste. But it can be highly abrasive, which research has shown can damage your enamel and cause increased sensitivity.

How much toothpaste to use: Generally, adults need only a pea-size amount of toothpaste — that will create enough foam to cover all the surfaces in your mouth, Arsenault says.

Also, “one of the big myths about toothbrushing is that you should rinse your mouth out after you brush,” says McComas. Studies show that the fluoride in your toothpaste provides the biggest benefit if you don’t do this, instead allowing the fluoride to work its magic on your enamel for more time.

What about prescription pastes? You may want to ask your dentist whether a prescription toothpaste, which generally contains a higher dose of fluoride, might be right for you. Severe dry mouth, which can be more common as you age (particularly if you’re taking certain medications for various chronic conditions, including for high blood pressure and depression), can raise your risk of cavities. So can periodontal disease, especially if the surfaces of the roots of your teeth, which lack protective enamel, are exposed.

How to brush well

The right bristles: Use a toothbrush with soft or extra-soft bristles. There are so many toothbrush options, but in the midst of considering the shape of the brush head, the brand name and other fancy features, don’t lose sight of bristle stiffness. Seek out a toothbrush with “soft” or “extra soft” on the packaging. Stiffer bristles are more likely to damage your gums or your teeth’s enamel, according to the American Dental Association.

The advantages of an electric toothbrush: You can keep your mouth perfectly healthy with a manual toothbrush, but a 2014 Cochrane review found that three months of using an electric toothbrush resulted in 21 percent less plaque and 11 percent less gum inflammation (also called gingivitis).

There are not significant performance differences between oscillating (or rotating) electric toothbrushes, which typically have round heads, and sonic toothbrushes, which usually have rectangular heads. So get the kind you like and will use.

How much to brush: Do it twice a day for at least two minutes. Some research suggests that people may brush for a lot less time than this on average, possibly around a minute or less. But common sense and a 2009 Journal of Dental Hygiene study suggest that brushing longer will remove more plaque — though the added benefit of extra time beyond two minutes is probably marginal, and brushing too hard can exacerbate problems, including receding gums, which can expose the roots of your teeth to a greater risk of cavities and tooth decay.

How to floss

Why flossing matters: Use any standard string floss (waxed or unwaxed), floss pick or interdental cleaning brush. The scientific evidence for flossing is not as strong as it is for brushing: A 2019 Cochrane review found that flossing in addition to brushing may reduce plaque and gingivitis more than brushing alone, but the authors cautioned that the evidence supporting this conclusion was weak. Still, dentists say the biological justification for flossing is sound: Without it, the bacteria that cause decay can build up between your teeth even if you’re brushing regularly.

Do water flossers work? While not quite as effective as string floss, water flossers can be a great option if you have a hard time using string floss, have mouth hardware like braces or a permanent retainer, or have other kinds of dental work like implants, bridges, or crowns. Dentist Sally Cram, a spokeswoman for the American Dental Association, says the evidence on the benefits of a water flosser is encouraging, but it’s not enough for her to recommend it as a replacement for flossing just yet. Still, if you know you won’t use string floss every day, a water flosser is better than nothing.

Avoid floss with PFAS. Skip floss that’s coated with these environmental contaminants, which are associated with a variety of health problems. You can look for flosses that use non-PFAS coatings such as beeswax or plant waxes like carnauba or candelilla.

CR partnered with Made Safe, an independent organization that certifies products as safer and more sustainable, to find flosses made without PFAS. Read our special report, “How to Choose Dental Floss Without PFAS and Other Harmful Chemicals,” for the details, including three good floss options made from silk instead of plastic.

How often should you floss? Do it once a day. Whether you floss or brush first doesn’t matter, as long as you do both.

What if you have implants or gum disease? If you have an implant, you may want to opt for an interdental brush instead of regular string floss, particularly if your implant doesn’t touch the teeth next to it on either side.

These are tiny round brushes designed specifically to clean in between teeth, and they work well with teeth that have gaps in between them. They come in different sizes, so Jennifer Harmon, a registered dental hygienist and clinical associate professor at the University of North Carolina Adams School of Dentistry in Chapel Hill, recommends working with your dentist to figure out which size you need for your teeth.

If you’re dealing with bleeding gums, Arsenault says, you can consider using prescription chlorhexidine mouthwash after you floss. Just be sure to follow your dentist’s instructions, because chlorhexidine can also cause some tooth staining and changes in taste.

Do you need these dental tools?

Tongue scrapers: The experts we spoke with say this is a great tool. The bacteria that cause tooth decay don’t just live on your teeth; they can collect on your tongue, too. That means you should clean your tongue daily. You can do this with your toothbrush bristles or the ridged back of some brushes, but a tongue scraper can be a little more effective, Cram says.

Plus, scraping your tongue is a great habit if you struggle with halitosis (bad breath), says Roxanne Dsouza-Norwood, a registered dental hygienist and clinical assistant professor of dental hygiene at the University of North Carolina at Chapel Hill. But be gentle; otherwise you could accidentally lacerate your tongue. And you may need to experiment with different types of tongue scrapers to find one that doesn’t activate your gag reflex.

Whitening strips: Over-the-counter whitening strips can help your teeth look whiter, but it can sometimes be difficult to spot the change, McComas says. You can try using them only on the upper teeth first so that the difference is more visible. (Then apply them to the lower teeth.) Keep in mind that the older you get, the more you can see the yellowish dentin underneath your enamel, which — along with crowns and implants — is not affected by strips. So you might end up with uneven colors.

Strips can also cause sensitivity, particularly if you already have sensitive areas from gum recession, Cram says. So leave them on only as long as instructed on the package.

Mouthwash: Because swishing it around can coat parts of your teeth’s surface that are harder to reach with other tools, mouthwash can be a nice adjunct to your dental care routine, particularly if you choose one that has fluoride. Prescription washes that contain chlorhexidine can also be helpful for people with bleeding gums or other severe gum problems.

Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer and healthier world. CR does not endorse products or services and does not accept advertising. Read more at ConsumerReports.org.

Read the full story here.
Photos courtesy of

New Flu Variant Could Bring Another Severe U.S. Season

By I. Edwards HealthDay ReporterTHURSDAY, Nov. 20, 2025 (HealthDay News) — A new flu variant spreading overseas may set the stage for another tough...

THURSDAY, Nov. 20, 2025 (HealthDay News) — A new flu variant spreading overseas may set the stage for another tough winter in the United States, experts warn.The strain, called subclade K, has caused a rise in flu cases in the United Kingdom, Canada and Japan. And now signs suggest it is beginning to take hold across the United States as flu activity rises.According to the latest U.S. Centers for Disease Control and Prevention (CDC) FluView report, reported flu activity in the United States remains low but is climbing quickly.Last year’s flu season was the worst the United States had seen in nearly 15 years and led to at least 280 child deaths, according to the CDC.Most cases this year are from the H3N2 virus and about half of those belong to the subclade K variant, the same strain that fueled a difficult flu season in the Southern Hemisphere.Because it wasn’t circulating widely when strains were selected for the vaccine update, this year’s flu shot targets close strains of the virus."It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case," Richard Webby, a researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee, told CNN.Early findings from the UK Health Security Agency suggest the variant carries seven genetic changes on a major part of the virus, making it a bit harder for the body's immune system to recognize.Even so, they found that the flu shot has reduced the risk of hospitalization or emergency care by about 75% in children and 30% to 40% in adults so far this season.What worries experts even more is that fewer Americans appear to be getting the flu shot.Data from IQVIA shows that pharmacies gave 26.5 million flu vaccinations from August through October, down from 28.7 million during the same period last year."I’m not surprised," Jennifer Nuzzo, professor of epidemiology and director of the Pandemic Center at Brown University in Providence, Rhode Island, said.She said recent debates about vaccine safety have "left people confused but possibly at the worst have left people worried about getting vaccinated."Australia’s flu shot rates also fell this year and the country went on to record more than 443,000 cases."What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming," Dr. Earl Rubin, division director of infectious disease at Montreal Children’s Hospital, told CNN.Several early indicators already show flu levels rising in the U.S.The WastewaterSCAN network found type A flu in 40% of samples in November, up from 18% in October, according to Marlene Wolfe, an assistant professor in the department of environmental health at Emory University in Atlanta.Only four U.S. monitoring sites in Maine, Vermont, Iowa and Hawaii have officially crossed the threshold for declaring flu activity high, but experts say the trend is clear.While it’s not yet clear whether subclade K could cause more severe illness, a rise in infections alone could cause hospitalizations to skyrocket, Rubin noted."It’s not too late. Go and get your flu shot," Dr. Adam Lauring, chief of the division of infectious diseases at the University of Michigan Medical School, in Ann Arbor, said.These results are preliminary and have not yet been peer-reviewed.The Texas Department of State Health Services (DSHS) has more on the flu vaccine.SOURCE: CNN, Nov. 18, 2025Copyright © 2025 HealthDay. All rights reserved.

Thousands of US Hazardous Sites Are at Risk of Flooding Because of Sea Level Rise, Study Finds

A new study finds that thousands of hazardous sites across the U.S. are at risk of flooding due to sea level rise that could pose public health threats to neighboring communities

If heat-trapping pollution from burning coal, oil and gas continues unchecked, thousands of hazardous sites across the United States risk being flooded from sea level rise by the turn of the century, posing serious health risks to nearby communities, according to a new study.Researchers identified 5,500 sites that store, emit or handle sewage, trash, oil, gas and other hazards that could face coastal flooding by 2100, with much of the risk already locked in due to past emissions. But more than half the sites are projected to face flood risk much sooner — as soon as 2050. Low-income, communities of color and other marginalized groups are the most at risk.With even moderate reductions to planet-warming emissions, researchers also determined that roughly 300 fewer sites would be at risk by the end of the century. “Our goal with this analysis was to try to get ahead of the problem by looking far out into the future," said Lara J. Cushing, associate professor in the Department of Environmental Health Sciences at the University of California, Los Angeles who co-authored the paper published in the science journal Nature Communications.“We do have time to respond and try to mitigate the risks and also increase resilience," she added, speaking at a media briefing Wednesday ahead of the study's release. The study was funded by the Environmental Protection Agency and builds on previous research from California. Climate change is driving and accelerating sea level rise. Glaciers and ice sheets are melting, and the sea's waters are expanding as they warm. In many places along the coastal U.S., sea level rise is accelerating faster than the global average because of things like erosion and land sinking from groundwater pumping, according to the National Oceanic and Atmospheric Administration. Thomas Chandler, managing director at the National Center for Disaster Preparedness at Columbia University who was not involved in the research, said it’s “a really important study” that the public, policy makers and government agencies “need to make note of.” Derek Van Berkel, an associate professor in the school for environment and sustainability at University of Michigan who was also not involved in the study, wasn't surprised to learn about the disproportionate risks. What was “alarming” was considering the magnitude of “feedback effects” from flooding, he said. How researchers approached the data The study's researchers started by identifying and classifying tens of thousands of hazardous sites near the coasts of Puerto Rico and the 23 states with coastline. Next, they wanted to know each site's projected future flood risk. They did this by calculating how likely each year coastal flooding could inundate a site using historical sea level measurements and projected sea level rise in 2050 and 2100 under low and high emissions scenarios. Lastly, they identified and classified communities as being at-risk if homes are located within 1 kilometer (0.62 miles) of a hazardous site with a high threat of future flooding, and compared those communities' characteristics with other coastal neighborhoods with no at-risk sites nearby. But researchers did not include all types of hazardous facilities, such as oil and gas pipelines, nor did they account for groundwater upwelling or more intense and frequent storms in the future, which could lead to underestimates. On the other end, the flood-risk model they used could have overestimated the number of threatened sites. “It is important to note that previous disasters, such as hurricanes Katrina, Rita and Harvey, did result in a lot of toxic contamination from oil and gas pipelines,” Chandler said. The 5,500 at-risk sites includes 44% that are fossil fuel ports and terminals, 30% power plants, 24% refineries and 22% coastal sewage treatment facilities. Most of the sites — nearly 80% — are in Louisiana, Florida, New Jersey, Texas, California, New York and Massachusetts. Potential health impacts from exposure to hazards People exposed to flood waters near industrial animal farms or sewage treatment plants could be exposed to bacteria like E. coli, said Sacoby Wilson, professor of global, environmental and occupational health at the University of Maryland during the briefing. Symptoms can include bloody or watery diarrhea, severe stomach cramps or vomiting and fever. Those living near industrial sites like refineries could be exposed to heavy metals and chemicals that can cause rashes, burning of the eyes, nose and throat, headaches or fatigue, added Wilson, who was not involved in the study. “For folks who are vulnerable, maybe have an underlying health condition, those health conditions could be exacerbated during those flood events.” Longer term, some of these exposures could contribute to cancer, liver, kidney or other organ damage, or have reproductive effects, he said. For Chandler, the Columbia University director, the study highlights the need to heavily invest in hazard mitigation. “It's really important for federal, state and local governments in the United States to address these factors through multi-stakeholder resilience planning and encouraging local governments to integrate climate risk assessments into their mitigation strategies.”The Associated Press receives support from the Walton Family Foundation for coverage of water and environmental policy. The AP is solely responsible for all content. For all of AP’s environmental coverage, visit https://apnews.com/hub/climate-and-environment.Copyright 2025 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Photos You Should See – Nov. 2025

RFK Jr.’s Miasma Theory of Health Is Spreading

The agency is picking up Robert F. Kennedy Jr.’s argument that a healthy immune system can keep even pandemic germs at bay.

Last week, the two top officials at the National Institutes of Health—the world’s largest public funder of biomedical research—debuted a new plan to help Americans weather the next pandemic: getting everyone to eat better and exercise.The standard pandemic-preparedness playbook “has failed catastrophically,” NIH Director Jay Bhattacharya and NIH Principal Deputy Director Matthew J. Memoli wrote in City Journal, a magazine and website published by the Manhattan Institute for Policy Research, a conservative think tank. The pair argue that finding and studying pathogens that could cause outbreaks, then stockpiling vaccines against them, is a waste of money. Instead, they say, the United States should encourage people to improve their baseline health—“whether simply by stopping smoking, controlling hypertension or diabetes, or getting up and walking more.”On its own, Bhattacharya and Memoli’s apparently serious suggestion that just being in better shape will carry the U.S. through an infectious crisis is reckless, experts told me—especially if it’s executed at the expense of other public-health responses. In an email, Andrew Nixon, the director of communications at the Department of Health and Human Services—which oversees the NIH—wrote that the agency “supports a comprehensive approach to pandemic preparedness that recognizes the importance of both biomedical tools and the factors individuals can control.” But more broadly, Bhattacharya and Memoli’s proposal reflects the spread of a dangerous philosophy that Robert F. Kennedy Jr., the secretary of HHS, has been pushing for years: a dismissal of germ theory, or the notion that infectious microbes are responsible for many of the diseases that plague humankind.In his 2021 book, The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health, Kennedy, a longtime anti-vaccine activist, argues that modern scientists have blamed too much of infectious disease on pathogens, which he suggests are rarely problematic, unless the immune system has been compromised by poor nutrition, toxins, and other environmental stressors. He credits sanitation and nutrition for driving declines in infectious-disease deaths during the 20th century; vaccination, he has baselessly claimed, was largely ineffective and unnecessary. In his view, germs don’t pose a substantial threat to people who have done the work of “fortifying the immune system”—essentially, those who have taken their health into their own hands.In terms of general health, most Americans would benefit from improvements in diet and exercise. A strong emphasis on both has been core to the Make America Healthy Again movement, and in one important aspect, Kennedy and his allies are correct: The immune system, like other bodily systems, is sensitive to nutritional status, and when people are dealing with chronic health issues, they often fare less well against infectious threats, Melinda Beck, a nutrition and infectious-disease researcher who recently retired from the University of North Carolina, told me. Conditions such as obesity and diabetes, for instance, raise the risk of severe COVID and flu; malnutrition exacerbates the course of diseases such as tuberculosis and measles.But applied to widespread infectious outbreaks, the MAHA prescription is still deeply flawed. Being generally healthy doesn’t guarantee survival, or even better outcomes against infectious diseases—especially when an entire population encounters a pathogen against which it has no immunity. Although some evidence suggests that the 1918 flu pandemic strongly affected certain groups of people who were less healthy at baseline—including undernourished World War I soldiers—“relatively healthy people, as far as we could understand, were the main victims,” Naomi Rogers, a historian of medicine at Yale, told me. Smallpox, too, infected and killed indiscriminately. HIV has devastated many communities of young, healthy people.In his book, Kennedy relies heavily on the term miasma theory as a shorthand for preventing disease “through nutrition and by reducing exposures to environmental toxins and stresses.” He’s employing that phrase incorrectly: Historically, at least, miasma theory referred to the notion that epidemics are caused by bad air—such as toxic emanations from corpses and trash—and was the predominant way of describing disease transmission until scientists found definitive proof of infectious microbes in the late 19th century. But his choice of words is also revealing. In pitting his ideas against germ theory, he plays on a centuries-old tension between lifestyle and microbes as roots of illness.In its early days, germ theory struggled to gain traction even among physicians, many of whom dismissed the idea as simplistic, Nancy Tomes, a historian at Stony Brook University, told me. After the idea became foundational to medicine, scientists still had to work to convince some members of the public that microbes could fell healthy people, too. In the early days of polio vaccination, when the virus still ran rampant in the U.S., some vaccine-skeptical Americans insisted that children were falling seriously ill primarily because their parents weren’t managing their kids’ nutrition well and “had disrupted the child’s internal health,” Rogers told me.Over time, as pharmaceutical companies made global businesses out of selling antibiotics, vaccines, and antivirals, the products became a symbol, for some people, of how germ theory had taken over medicine. Accepting vaccines came to represent trust in scientific expertise, Rogers said; misgivings about the industry, in contrast, might translate into rejecting those offerings. In that skeptical slice of the American public and amid the rise of alternative-wellness practitioners, Kennedy has found purchase for his ideas about nutrition as a cure-all.Since taking over as health secretary, he has on occasion made that distrust in germ theory national policy. In his book, he wrote that “when a starving African child succumbs to measles, the miasmist attributes the death to malnutrition; germ theory proponents (a.k.a. virologists) blame the virus.” Earlier this year, when measles raged through undervaccinated regions of West Texas, the secretary acted out his own miasmist theory of the outbreak, urging Americans to rely on vitamin-A supplementation as a first-line defense, even though deficiency of that vitamin is rare here.But germ theory is key to understanding why outbreaks become pandemics—not because people’s general health is wanting, but because a pathogen is so unfamiliar to so many people’s immune systems at once that it is able to spread unchecked. Pandemics then end because enough people acquire sufficient immunity to that pathogen. Vaccination, when available, remains the safest way to gain that immunity—and, unlike lifestyle choices, it can represent a near-universal strategy to shore up defenses against disease. Not all of the risk factors that worsen disease severity are tunable by simply eating better or working out more. For COVID and many other respiratory diseases, for instance, old age and pregnancy remain some of the biggest risk factors. Genetic predispositions to certain medical conditions, or structural barriers to changing health habits—not just lack of willpower—can make people vulnerable to disease, too.In their article, Bhattacharya and Memoli purport to be arguing against specific strategies of pandemic preparedness, most prominently the controversial type of gain-of-function research that can involve altering the disease-causing traits of pathogens, and has been restricted by the Trump administration. But the pair also mischaracterize the country’s current approach to pandemics, which, in addition to calling for virus research and vaccine development, prioritizes measures such as surveillance, international partnerships, and improved health-care capacity, Nahid Bhadelia, the director of the Center on Emerging Infectious Diseases at Boston University, told me. And Bhattacharya and Memoli’s alternative approach cuts against the most basic logic of public health—that the clearest way to help keep a whole population healthy is to offer protections that work on a societal level and that will reach as many people as possible. Fixating on personal nutrition and exercise regimens as pandemic preparedness would leave many people entirely unprotected. At the same time, “we’re basically setting up society to blame someone” in the event that they fall ill, Jennifer Nuzzo, the director of the pandemic center at the Brown University School of Public Health, told me.Kennedy’s book bemoans that the “warring philosophies” of miasma and germ theory have become a zero-sum game. And yet, at HHS, he and his officials are presenting outbreak preparedness—and the rest of public health—as exactly that: The country should worry about environment or pathogens; it should be either pushing people to eat better or stockpiling vaccines. Over email, Nixon told me that “encouraging healthier habits is one way to strengthen resilience alongside vaccines, treatments, and diagnostics developed through NIH-funded research.” But this year, under pressure from the Trump administration, the NIH has cut funding to hundreds of vaccine- and infectious-disease focused research projects; elsewhere at HHS, officials canceled nearly half a billion dollars’ worth of contracts geared toward developing mRNA vaccines.The reality is that both environment and pathogens often influence the outcome of disease, and both should be addressed. Today’s public-health establishment might not subscribe to the 19th-century version of miasma theory, but the idea that environmental and social factors shape people’s health is still core to the field. “They’re saying you can only do one thing at a time,” Bhadelia told me. “I don’t think we have to.”

Clinicians can help address environmental toxics in reproductive health, international experts say

In a recent opinion paper published in the International Journal of Gynecology & Obstetrics, the International Federation of Obstetrics and Gynecology (FIGO) addresses how exposures to environmental toxics — including endocrine disrupting chemicals — have a wide range of impacts on reproductive health, and how clinicians can play a role in addressing this issue.In short: Extensive research has linked exposure to environmental toxics with an increased risk of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, hormonally mediated cancers, menopause, and both female and male infertility. The key mechanisms behind these impacts include hormone disruption, oxidative stress, inflammation, and epigenetic changes that can affect multiple generations.FIGO emphasizes that harm from environmental toxics can be addressed, and that clinicians play a crucial role in ensuring environmental factors are meaningfully considered as a part of patient care. Key quote: “As trusted health advisors, obstetricians and gynecologists (OBGYNs) have an essential role in integrating environmental health into routine gynecologic and fertility care.” Why this matters: In this opinion paper, FIGO argues that clinicians should incorporate environmental health into routine care, and provides practical strategies to do so. Some of these strategies include taking environmental histories, counseling patients on risk reduction and healthy lifestyles, recognizing high-risk settings (e.g., occupational exposures), and advising patients on simple steps to reduce exposure — particularly during sensitive windows like preconception, pregnancy, puberty, and menopause. Clinicians should be aware of regional environmental health alerts, such as air quality advisories or contamination events. In addition, clinicians can advocate for policy change.Related EHN coverage: Chemical mixtures may impact fertility and IVF success, new study findsUnderstanding how the environment affects pregnant people’s healthMore resources: Additional International Federation of Obstetrics and Gynecology (FIGO) statements and opinions relating to the environment:FIGO opinion on reproductive health impacts of exposure to toxic environmental chemicalsFIGO calls for removal of PFAS from global useRemoval of glyphosate from global usageClimate Crisis and HealthStatement on Draft Strategy on health, environment and climate changeToxic chemicals and environmental contaminants in prenatal vitaminsDeNicola, Nathaniel et al. for International Journal of Gynecology & Obstetrics. Sept. 26, 2025

In a recent opinion paper published in the International Journal of Gynecology & Obstetrics, the International Federation of Obstetrics and Gynecology (FIGO) addresses how exposures to environmental toxics — including endocrine disrupting chemicals — have a wide range of impacts on reproductive health, and how clinicians can play a role in addressing this issue.In short: Extensive research has linked exposure to environmental toxics with an increased risk of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, hormonally mediated cancers, menopause, and both female and male infertility. The key mechanisms behind these impacts include hormone disruption, oxidative stress, inflammation, and epigenetic changes that can affect multiple generations.FIGO emphasizes that harm from environmental toxics can be addressed, and that clinicians play a crucial role in ensuring environmental factors are meaningfully considered as a part of patient care. Key quote: “As trusted health advisors, obstetricians and gynecologists (OBGYNs) have an essential role in integrating environmental health into routine gynecologic and fertility care.” Why this matters: In this opinion paper, FIGO argues that clinicians should incorporate environmental health into routine care, and provides practical strategies to do so. Some of these strategies include taking environmental histories, counseling patients on risk reduction and healthy lifestyles, recognizing high-risk settings (e.g., occupational exposures), and advising patients on simple steps to reduce exposure — particularly during sensitive windows like preconception, pregnancy, puberty, and menopause. Clinicians should be aware of regional environmental health alerts, such as air quality advisories or contamination events. In addition, clinicians can advocate for policy change.Related EHN coverage: Chemical mixtures may impact fertility and IVF success, new study findsUnderstanding how the environment affects pregnant people’s healthMore resources: Additional International Federation of Obstetrics and Gynecology (FIGO) statements and opinions relating to the environment:FIGO opinion on reproductive health impacts of exposure to toxic environmental chemicalsFIGO calls for removal of PFAS from global useRemoval of glyphosate from global usageClimate Crisis and HealthStatement on Draft Strategy on health, environment and climate changeToxic chemicals and environmental contaminants in prenatal vitaminsDeNicola, Nathaniel et al. for International Journal of Gynecology & Obstetrics. Sept. 26, 2025

Suggested Viewing

Join us to forge
a sustainable future

Our team is always growing.
Become a partner, volunteer, sponsor, or intern today.
Let us know how you would like to get involved!

CONTACT US

sign up for our mailing list to stay informed on the latest films and environmental headlines.

Subscribers receive a free day pass for streaming Cinema Verde.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.