In April, Robert Kenedy Jr ordered the CDC to stop recommending fluoridation of the public water supply, contrary to the recommendation of the American Dental Association and most public health experts.
Why the controversy? Is fluoridation a Communist plot to weaken our society as General Jack D Ripper thundered in Dr. Strangelove?
The science behind fluoridation is solid. Fluoride helps remineralize tooth enamel and it prevents cavities. An experiment was done in Michigan beginning in 1945. Fluoride was added to the public water supply in Grand Rapids, and its citizens were carefully followed and compared to those in nearby Muskegon whose water was left alone.
The experiment was to run for 15 years, but the results were so obvious within six years, with cavities plummeting in Grand Rapids, that the residents of Muskegon demanded their water be fluoridated. The American Dental Association endorsed fluoridation in 1950 and still does.
In Utah, where Salt Lake City has fluoridated water while the rest of the state does not, dentists report about half the dental caries rate in children living in Salt Lake City. Despite this, the Utah state government recently banned fluoridation.
Those opposed to fluoridation point to the dangers of high fluoride levels, which can result in discoloration of the developing teeth, brittle bones, and, at very high levels, neurologic defects in children. All of these occur at levels of fluoride much higher than that in public water. Almost anything that is safe in usual amounts can be dangerous in excess.
Another argument revolves around choice. When the public water supply is fluoridated, parents who wish to avoid fluoride must buy bottled water.
Finally, there are now other ways to get fluoride into children’s teeth. You can buy toothpaste with fluoride or have the dentist apply it. Use of toothpaste with fluoride is not as effective. Fluoride from toothpaste is applied topically and only a few times a day. It’s also often rinsed off, limiting its exposure time.
The benefit of having the public water fluoridated is that this proven effective therapy is available to all, without regard to their income or ability to get regular dental care. It saves a lot of money. Estimates are that $1 spent on fluoridation saves $38 in dental expenses.
The science is clear. Fluoridation at recommended levels of 0.7 mg/liter is safe and it dramatically reduces dental cavities. Do not let conspiracy theories or disinformation sway you.
Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.
What Does The Doctor Say?
By Dr. Edward Hoffer