It is a scenario playing out nationwide. From Oregon to Pennsylvania, hundreds of communities have in recent years either stopped adding fluoride to their water supplies or voted to prevent its addition. Supporters of such bans argue that people should be given the freedom of choice. The broad availability of over-the-counter dental products containing the mineral makes it no longer necessary to add to public water supplies, they say. The Centers for Disease Control and Prevention says that while store-bought products reduce tooth decay, the greatest protection comes when they are used in combination with water fluoridation.

The outcome of an ongoing federal case in California could force the Environmental Protection Agency to create a rule regulating or banning the use of fluoride in drinking water nationwide. In the meantime, the trend is raising alarm bells for public health researchers who worry that, much like vaccines, fluoride may have become a victim of its own success.

The CDC maintains that community water fluoridation is not only safe and effective but also yields significant cost savings in dental treatment. Public health officials say removing fluoride could be particularly harmful to low-income families — for whom drinking water may be the only source of preventive dental care.

“If you have to go out and get care on your own, it’s a whole different ballgame,” said Myron Allukian Jr., a dentist and past president of the American Public Health Association. Millions of people have lived with fluoridated water for years, “and we’ve had no major health problems,” he said. “It’s much easier to prevent a disease than to treat it.”

According to the anti-fluoride group Fluoride Action Network, since 2010, over 240 communities around the world have removed fluoride from their drinking water or decided not to add it.

  • MossyHabitat@lemmy.world
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    7 months ago

    Please do your own research, as this is a very controversial subject which has been fought since its inception, with entrenched opinions. Here’s a primer:

    • Too much fluoride is bad for humans, and the threshold can achieved with a standard diet and recommended intake of water, assuming fluoridated water is used for both consumption and food prep. This excludes fluoride toothpaste.
    • Fluoride can not be removed from tap water using standard water filters, or even R/O filters. Removal requires highly specialized filters which utilize aluminum to chemically un-bind the fluoride, which then require a separate filtration statge to remove the aluminum.
    • This is because fluoride creates some of the strongest chemical bonds, and is the reason it is the primary component in PFAS, or “forever chemicals”
    • Very little of our tap water actually touches human teeth.
    • Fluoride is a problematic byproduct of the production of aluminum and fertilizer industry.
    • Buildup of fluoride in urban/suburban soils is becoming a crop & gardening concern for which there is no viable solution.
    • Fluoride tablets were administered as a remedy for hyper-thyroidism, as it decreased thyroid function. Fluoride is believed to be a factor in the increase of modern hypo-thyroid ailments
    • Fluoride is a known carcinogen.
    • Fluoride is a known neurotoxin, shown to reduce IQ - particularly for children. Many pediatricians advise against fluoride toothpaste at young ages.

    Most of the research done on fluoridating tap water was done in the early 1940s & 50s, well in advance of modern dental hygiene and fluoridated toothpaste use. Studies do definitively show applying fluoride directly to teeth does strengthen tooth enamel, but modern studies are mixed, at best, regarding efficacy of fluoridated tap water between equivalent socioeconomic communities. No studies have been conducted regarding dermal absorption of fluoride , believed to further elevate intake.

    I think the simplest solution is to let people choose for themselves, and add fluoride to their personal drinking water if that’s what they choose.

    We don’t need to fluoridate water in our toilets, showers, or irrigation.

    • state_electrician@discuss.tchncs.de
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      7 months ago

      I just want to point out that too much of anything is bad, because that’s what “too much” means. Saying “but too much of x is bad” is such a dumb argument, that I always bring this up.

      • MossyHabitat@lemmy.world
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        7 months ago

        The delta between fluoride levels considered “theraputic” and “harmful” (per the WHO) is quite small. The most effective use of fluoride is topical (applying to teeth) rather than oral.

    • affiliate@lemmy.world
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      7 months ago

      can you provide sources for these claims?

      i have not been able to find any conclusive evidence on fluoride being a carcinogen. in fact, im finding many reputable sources saying that’s still an open question.

      i also can’t find a reliable source on the IQ claims.

      the other claims are also fairly dubious as well.

    • TheHarpyEagle@lemmy.world
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      7 months ago

      I’m all for continued study on fluoride’s effects, but I’m not totally convinced on all these points.

      It seems like most studies showing negative IQ effects are attributed to naturally high concentrations of fluoride in drinking water, or elevated levels due to nearby coal burning. It’s certainly significant to know that there are toxic levels of fluoride, but recommended levels have been adjusted to be about half of that (though the exact threshold of toxicity is fuzzy).

      So yes, we need to be careful about the amount of fluoride in our water, but removing it completely (excepting natural presence) may be throwing the baby out with the fluoridated bath water, as it were.

      The main reason I’m against removing it completely is because it’s not clear that it isn’t helping prevent tooth decay, especially for those who don’t have the means to get directly applied fluoride (i.e. Toothpaste and dentist applied coatings) and wouldn’t have the means to add fluoride to their water on an individual basis.

      • AA5B@lemmy.world
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        7 months ago

        The best available scientific information is that it does help, and it’s the most cost effective way of doing so

      • MossyHabitat@lemmy.world
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        7 months ago

        “The authors conclude that available evidence suggests that fluoride has a potential to cause major adverse human health problems, while having only a modest dental caries prevention effect”: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956646/

        I’m against removing it completely is because it’s not clear that it isn’t helping prevent tooth decay

        ^ I think this logic needs to be reversed - the burden of proof must be abundantly clear with few to no risks before it should be considered. The paper above also highlights interesting aspects about the initial test which spurred water fluoridation in the US. This was also a time in which broad public awareness of dental hygiene was first entering mainstream - was the causality due to amended tap water, or more tooth-brushing?

        There’s a reason most of Europe (and most of the world) doesn’t fluoridate their water, and their teeth are statistically healthier than the USA & Australia, where most tap water is fluoridated.

        In my opinion the water fluoridation debate has become associated with nut-job conspiracy theorists and the “don’t tread on me” crowd. There are legitimate concerns, and the debate has been ongoing prior to Roswell, etc. There are literal conspiracies diluted in public perception/sentiment by wacky theoretical conspiracies and the types who espouse them.

        • TheHarpyEagle@lemmy.world
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          7 months ago

          That’s the thing, the proof has been that fluoridated water helps teeth. The data is old, yes, but that doesn’t necessarily mean it’s incorrect. As for European countries, at least according to Wikipedia, not many of them artificially fluoridate their water, but some of them have naturally high levels of fluoride in their water and some others provide fluoride via salt or milk.

          Here’s a study that compares oral health and cognitive decline across varying levels of water fluoridation (natural or artificial) in Sweden. The data finds positive oral health outcomes and no significant impairment associated with higher fluoride levels. Obviously this directly contradicts your linked study, so what are we to believe? I think the only conclusion we can really come to is that more research needs to be done.

          It’s also not surprising that tooth health has generally improved with the rising availability of toothpaste and other dental care, but I think what remains to be seen is, are we at the point where we no longer need fluoridated water, or would our tooth health overall decline without it, particularly among vulnerable populations? Particularly in countries like the US where oral healthcare is often prohibitively expensive and not usually covered by general health insurance, is it wise to cut off the small amount of freely available dental help we have before finding a suitable alternative?

    • Flying Squid@lemmy.world
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      7 months ago

      Very little of our tap water actually touches human teeth.

      Very little of our tap water actually touches human stomachs too, but we still make sure it isn’t filled with amoebas.

      • MossyHabitat@lemmy.world
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        7 months ago

        Without chlorination people would get sick and possibly die. Amoebas & bacteria can enter our bodies when showering or even flushing a toilet - via aerosolization. Chlorination is also important for the water infrastructure itself, and to prevent buildup within home pipes and appliances.

        Should we put multi-vitamin compounds in our drinking water too? It is strange that this one thing is added to water vs the host of other compounds which are shown to benefit human health.

        • Flying Squid@lemmy.world
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          7 months ago

          Should we put multi-vitamin compounds in our drinking water too?

          Sure, why not? If they can be absorbed by the body that way and do some good, what’s the problem?

          • MossyHabitat@lemmy.world
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            7 months ago

            Do you consider water to be medicine, or a resource? Why don’t we add caloric value to our tap water too, for the sake of malnutrition in impoverished communities?

            • Flying Squid@lemmy.world
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              7 months ago

              Because not everyone benefits from extra calories, but as long as you don’t include vitamins that you can’t take too much of as long as it is in small quantities, what’s the harm?

              • MossyHabitat@lemmy.world
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                7 months ago

                I was being facetious and think your argument is completely preposterous, but continuing for fun. Let’s say you are dictator of your loyal subjects, and decide to medicate their water with… vitamins, including copper. What if someone is sensitive to added copper, either because of damage to their copper plumbing, copper cookware, or a metabolic issue? What if someone is working outdoors in the summer heat and consumes 2 gallons of water per day, but begins to experience symptoms of copper toxicity due to the volume of water intake? The water is excreted, but our bodies do not excrete most excess vitamins, such as copper. This copper intake then causes an imbalance/deficiency of zinc and subsequently magnesium.

                Should we add prozac/SSRIs to our water to thwart depression and make the populous happier?

                Most of the world doesn’t medicate their water, and their citizens are surprisingly healthier than us in the US & Australia where we “medicate” our water. How about we give people access to clean, pure water and let them supplement as they & their doctors see fit?

                • Flying Squid@lemmy.world
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                  7 months ago

                  I like how you ignored the “as long as you don’t include vitamins that you can’t take too much of as long as it is in small quantities” and moved on to “what if someone takes too much?”

                  • MossyHabitat@lemmy.world
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                    7 months ago

                    You’re ignoring the overarching debate, but fine I’ll address your nit-picky distraction.

                    “Small” is a relative term, and to the amounts that would be harmless in all situations would have negligible health benefits, to the point of questioning “why bother”. Also even small quantities add up, such as the example of 2-gallon consumption on a hot day. What isn’t controversial or subjective, though, is pure water.

                    The simplest solution is usually best - instead of a one-size-fits-all “medicated” water approach, just take a multivitamin that works best for your individual biology and preferences… assuming you can’t consume foods which contain the variety of compounds our bodies need, being the ideal solution. Even the USDA recommendations for vitamins & minerals are mere guesstimated guidelines which varies per individual & lifestyle.