Pennsylvania does not currently force water systems to add fluoride, although there are persistent legislative attempts to mandate fluoridation for the whole state.
Although Pennsylvania law describes fluoride as a poison, the government agencies with jurisdiction over public water systems have banned the removal of fluoride from water systems that already have it. The courts have supported these actions, even when recognizing that the agency position is arbitrary.
The Lebanon decisions below created the de facto situation of Pennsylvania being the only state where fluoridation is not mandatory, but where it's illegal to STOP fluoridation.
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