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Comment by OedipusRex | Hacker News Reader

There are drugs that help with specific complications that are just simply not made because the market for them is too small, they're call orphan drugs (https://en.wikipedia.org/wiki/Orphan_drug). The drugs that make it to market are not necessarily the best at treating you, they just cover enough of the population (normally more than one ailment per drug) and can be profitable.

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I understand these. And it pains me that they exist.

I'm mostly talking about the availability of certain medication. Like, it makes sense to have a nationwide vaccine program. It doesn't make sense to have fluoridated water due to the relative ease of access to toothpaste.

Especially because we really can't tell with certainty what consuming this does in the long-multigenerational term. Why should we take the risk?

In my youth I lived off a well and did not have access to fluoridated water. My parents still live in that house. There are large swaths of people who live off of a well in the United States. We started adding fluoride to water because our knowledge at the time said it was a good idea (and still probably is). The rates of tooth decay falls when fluoride is introduced in drinking water.

https://www.cdc.gov/fluoridation/pdf/natures_way.pdf

But the only places that have fluoride added to the water are metropolitan areas (at least around me in a Midwestern state).

The weakness of this argument is that there has been no control for a rise in rates of disease over many decades it would take for a bio-accumulating substance.

I understand - fluoridation has been immensely helpful. However, should we re-visit our decisions every once in a while and see if we can do things differently?

Toothpaste production is now more streamlined. We know the immense benefits of fluoride, so getting it to people in a more concentrated and localized matter can be a next step in helping people with this.

Essentially I'm saying it was a potential risk we accepted because the benefits far outweighed the potential risk down the line, but now that we have alternative solutions with smaller potential risk should we discuss them or not?

The effect of fluoride is in addition to the effect of toothpaste and other fluoride delivery modalities (25%). Even if that were not the case, prior to the adoption of other fluoridation modalities, fluoridation reduced cavities by as much as 65%. Additionally, for urban centers it costs less than a tube of toothpaste per person per year. Finally, it works without requiring a behavioral intervention - people naturally drink and eat. It is not considered one of the top ten public health interventions of the 20th century for nothing.

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