If there is one piece of scientific literacy that I wish the entire world had, it was the concept that toxicity is a function of dose.
Yes, fluoride is toxic. The EPA limit for fluoride is 4ppm, and that is probably too high (something like 2ppm would work better). There are parts of the country where the natural incidence of fluoride in groundwater is in excess of 4ppm, and therefore defluoridation needs to be done.
Fluoridation of drinking water is done to a standard of 0.5-0.75 ppm (US Public Health Service specifically recommends 0.7). Most of the country lives in places where the natural ground water concentration of fluoride is below this level, and thus fluoridation is necessary to reach the recommended level.
the real debate is on whether the toxicity of fluoride outweighs the benefits of using it to prevent tooth decay.
we know that it can cause issues. there are also issues that have not been measured.
a lot of folks forget that unless the outcome of X is death or cancer etc ... it is often not studied. your quality of life can be greatly reduced by something but if it doesn't kill you then no one is looking at it.
I won't argue about that being the best solution, but as someone that did not start to take dental health seriously until their 30's I don't think I'm in any position criticize others for their failure to do so.
It is toxic, it's rat poisoning. Do the lower levels of tooth decay outweigh the risks? So far they have decided yes in many places but that is changing (like lead pipes)
Fluoride in drinking water is a kind of truly marginal level of harm that’s perfectly designed to trigger paranoid libertarians.
A tiny amount of fluoride is helpful for bones and especially teeth. Fluoridated toothpaste covers this need perfectly, but many people don’t use it. Fluoride in drinking water covers this need also but (arguably) brings along small risks of symptoms of slight excess fluoride consumption.
The amounts that are actually put in drinking water do not seem to have any significant negative effects, and it seems reasonably clear that the population positive effects dominate, but being non-consensually subjected to a marginal risk of negative effect in order to achieve a positive outcome for the population is exactly the kind of thing that reliably provokes this kind of reaction from the paranoid libertarian set.
You'll notice one key thing is missing: Side by side comparison with communities that don't have fluoride in their water. That could be other countries. Or better, rural US communities that for the most part use well water. Those controls exist.
Note: Better diet also has an impact on oral health, and diet over the last 75 years has also improved.
I'm not saying not including that comparison is wrong, but as "the science" goes, it does feel odd that something so obvious is not included.
