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It basically says you can't add anything to water except for "water quality additives" and has a fuzzy definitely of water quality additive.
And then 403.852(19) has
Bold are the additions. The "primary and secondary drinking water standards" are legally defined terms where the EPA sets limits on maximum allowable amounts of stuff in water.
https://www.epa.gov/sdwa/how-epa-regulates-drinking-water-contaminants-documents
Personally, I would argue that fluoride is added to water for the purpose of "improving water quality" because water that protects people's teeth is higher quality than water that doesn't. If I were someone from a municipality whose job was ensuring water quality, I would read this as still allowing the addition of fluoride. If anyone doesn't like that, let them try to prove in a court that fluoridated water is lower quality.
I don't think that would help these days