Fluoride in our drinking water may not be as useful as it used to be
gizmodo.com
gizmodo.com
With that said, the author commits the two cardinal sins of public health journalism: they allow dangerous levels of a substance to be conflated with recognized safe levels, and they confuse value for a sub-sample of the population (those who can/do use fluoride toothpaste and go to the dentist regularly) with value for the entire population.
The latter in particular is why water fluoridation in areas with low natural fluoride levels is sound public health policy: it helps the population as a whole, even when not all segments can or will obtain appropriate dental care.
For fluorine it's the same: some drink tap water, some drink only bottled water, so some get potentially too much some potentially nearly none.
That's why "universal" is essentially wrong.
Any argument made that's trying to take a position on a scientific point, yet has grammatical mistakes, significantly detracts from the point being made. If there is a lack of attention to trivially simple "to" vs "too"...what's the chance of sufficient attention being made to the vastly more complex points of debate?!
Well, in debate terms: let's say you could decide to add element to tap water because locally you state "there are not enough of this element", how can you dose it? Some do not drink tap water, will get nearly none, some drink much, some came here for a bit of time coming from other places, ...
Teaching people a good diet it's a thing, "imposing" adding stuff to common goods is a dangerous choice, which could be well abused to do very nasty things.
Funny because many countries choose to NOT add fluoride to their water sources. Despite all the "safety" data available.
Western Europe and Latin America are examples of (1), Central Europe is an example of (2), and much of Asia is (2) or (3).
And this is the point: if you have naturally occurring fluoride at safe levels, you shouldn’t add it. If you have it at unsafe levels (which much of the world does!), you should defluoridate your water. But the body of evidence is overwhelming that 0.7mg/L for fluoridation is not a significant public health risk, especially in contrast with its tangible benefits.
> 121. Plaintiffs have proven, by a preponderance of the evidence, that water fluoridation at the level of 0.7 mg/L – the prescribed optimal level of fluoridation in the United States – presents an “unreasonable risk of injury to health or the environment, without consideration of costs or other non-risk factors, including an unreasonable risk to a potentially exposed or susceptible subpopulation under the conditions of use.” 15 U.S.C. § 2620(b)(4)(B)(ii).
Full ruling: https://fluoridealert.org/wp-content/uploads/2024/09/Court-R...
The law mentioned: https://www.law.cornell.edu/uscode/text/15/2620
The people with 1.5 mg/L fluoride (or higher--the EPA limit is 2.0mg/L) are because the groundwater is percolating through rock that is high in fluorides, and people don't want to spend the money on defluoridating the water down to acceptable standards. Defluoridation is of course much harder than fluoridation because fluorides are highly soluble.
The limits are set such that if you _only_ drank tap water you won't consume more than the safe limit. If you then reduce how much tap water you consume because you get hydration from other sources, your well under the limit.
Not accounting for someone eating tubes of fluorinated toothpaste, which is out of specified usage.
The CDC sets the recommend fluorination levels are 0.7 mg/L, more than 4x lower than the amount considered safe to consume.
So you would need to consume over 20L of water (think 10 2L soda bottle worth).
I couldn't personally physically do that.
The coffee, soda, beer, or kombucha you drink was made with fluoridated water. Your salad was grown with fluoridated fruit was washed in fluoridated water.
Fluoride permeates modern supply chains because it’s literally in the water which is an input to countless things.
Fluoride proponents have utterly failed to control dosage and harmed public health in doing so.
> The coffee, soda, beer, or kombucha you drink was made with fluoridated water. Your salad was grown with fluoridated fruit was washed in fluoridated water. >
How much flouride? And from what sources?
Typically farms need wells because of how much water infrastructure they need can't generally be supported by municipal water. There are exceptions particularly in dense areas with vertical farms or urban farms but this doesn't align with your claim, that effectively everything we consume has some detectable level of flouride.
I bet you've already read this though
https://ods.od.nih.gov/factsheets/Fluoride-HealthProfessiona....
The only thing studied that contained more flouride than municipal water but still 3x less than the safe limit, is tea. And that was measured with distilled water to eliminate the water source as a variable.
Most tea isn't grown in the USA.
So your claims fall flat on their face here, but I'm not done.
> Fluoride permeates modern supply chains because it’s literally in the water which is an input to countless things. >
How much? Making such a claim is fine if we want hand waved values. But when you want to be an Internet advocate for a specific policy, show up with receipts or don't show up at all.
See previous link for current source of information on food supply.
> Fluoride proponents have utterly failed to control dosage and harmed public health in doing so.
Based on what evidence?
You have utterly failed to show you have a solid grasp on the scientific method, public policy, and critical thinking.
"On any given day, more than one half of the American population drinks tea. On a regional basis, the South and Northeast have the greatest concentration of tea drinkers."
Source: https://www.teausa.com/teausa/images/Tea_Fact_2021.pdf
Tea may easily contain 5 to 10 times as much fluoride as fluoridated water.
2. TOTAL intake is what determines fluoride toxicity. This has been established since the 1930s when fluoride was discovered to be the source of "mottled enamel" - dental fluorosis.
In 1991, total intake among adults in fluoridated areas in the US was estimated to be up to 6.6 mg/day. (US PHS, 1991)
"The daily intake of most adults is about equally divided among food, drinking water, beverages, and mouthrinses." (U.S. Dept. Health & Human Services, Report on fluoride benefits and risks. MMWR Recomm Rep. 1991 Jun 14;40(RR-7):1-8. PMID: 2051975.)
The NTP monograph doesn't conclude that fluoridation at levels of 0.7mg/L are safe or unsafe, but it is better to be safe than sorry. With some populations receiving fluoridated water at concentrations of 1.2mg/L and an estimated 2% to 7% of the population receiving water fluoridated above this concentration, I think it's reasonable to be concerned in light of the NTP's monograph on fluoride (even if this just means to increase focus on de-fluoridation of water).
As per the NTP: > The moderate confidence conclusions may also be relevant to people living in optimally fluoridated areas of the United States depending on the extent of their additional exposures to fluoride from sources other than drinking water.
Also just to note, the EPA's secondary maximum contaminant limit (SMCL) is 2.0mg/L. This isn't the federal limit as set forth by the MCL of 4.0mg/L, but notice is still required by the EPA here.
Taking the recent Cochrane report in mind, which shows a small reduction of 0.24 decayed tooth per child in places practicing fluoridation, and fails to find high quality studies on the effects of fluoridation for adults, it is reasonable to question the EPA's limits and the US's policy of fluoridation.
I can't find any strong evidence for the benefits of systemic ingestion of fluoride which makes me ultimately conclude that the policy is an ineffective one of forced medication (in the name of those who can't brush their teeth).
With no evidence of it being a safe policy, I don't know why the CDC and EPA still advocate nowadays for water fluoridation. Although perhaps costly to change, neither do I know why the EPA sets their limits to levels above where known harms (such as dental fluorosis and neurodevelopmental effects) occur. As Judge Edward Chen says:
> In all, there is substantial and scientifically credible evidence establishing that fluoride poses a risk to human health; it is associated with a reduction in the IQ of children and is hazardous at dosages that are far too close to fluoride levels in the drinking water of the United States.
A big issue in this discourse is that for the strong claims to be true, it would essentially require existing science around fluoride toxicity and the related mechanisms of action to be materially incorrect, contrary to all historical evidence. Fluoride poisoning is a thing that happens and has straightforward interventions. Are we supposed to pretend this science doesn't exist? I actually worked in fluoride chemistry, it is difficult to square this circle.
In addition to the "plausible mechanism of action" question, there is the inconvenient observation that exposure to fluoride from natural dietary sources is far higher today than from municipal water. Why the obsession with municipal water augmentation in historically low-fluoride environs? Most people eat far more fluoride than what their water exposes them to.
I find this particular social contagion deeply weird. You see the same persistent misrepresentation on social media as climate science, but in the case of climate science the effects on people is obviously consequential so the motivated reasoning is more understandable. The fluoride thing is trying to invent an issue around a topic that is inconsequential by all evidence and science.
Who benefits by encouraging people to tilt at this windmill?
An EPA review on fluoride exposure that I found (https://www.epa.gov/sites/default/files/2019-03/documents/fl...) puts most estimates of the "natural" dietary fluoride intake at 0.9mg per day. This is in contrast to the estimated 0.7 * 2 = 1.4mg of fluoride a person will ingest from consuming fluoridated water (with a fair number of water systems fluoridated at levels greater than 0.7mg/L).
Another study I found from the EFSA estimates fluoride intake from non-supplemented food at 0.120mg per day for adults compared to 0.500mg per day from water fluoridated at (1.0mg/L) (https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa...). Admittedly, in countries where salt is fluoridated, this will constitute the majority of fluoride ingested (especially given most of them don't fluoridate their water :P). But I don't think anti-fluoride advocates would support this either.
I also don't understand what you mean by the "strong claim" and "weak claim" of the NTP monograph. You seem to have doubts that the claims of the NTP monograph are true, based off of the known mechanisms of fluoride toxicity?
My best guess for why the rational anti-fluoride advocates are so stirred up over water fluoridation is that it is a policy proposed without currently a rigorous scientific backing. Per the recent Cochrane review, there is evidence that fluoridation mildly benefits children's teeth, and a lack of high-quality evidence that fluoridation presently benefits adults teeth. There also isn't good evidence that fluoride consumption isn't harmful at present levels (fluorosis is known to occur, and studies evaluated by the NTP point to neurodevelopmental harms, albeit with the conclusion for higher concentrations of fluoride); nor is there strong evidence that systemic fluoride ingestion has any benefits. They might therefore be angry at a somewhat political policy of forced medication that isn't well backed.
https://poisonfluoride.com/phpBB3/viewtopic.php?f=11&t=5677
The NTP monograph is a very flawed document, as the review failed to consider a crucial confounder/modifier - iodine/thyroid status. Fluoride toxicity is directly dependent on the individual's thyroid/iodine status. If iodine-deficient, even miniscule amounts of fluoride may affect you. If iodine intake is excessive, then iodine toxicity may be pre-dominant - this has been known since the 1930s.
See https://pfpc.substack.com/p/pfpc-letter-to-richard-woychik-d...
For the second article, this is interesting information and I can see causes for concern in the study (there were multiple hick-ups in the peer review process), and ideally high-quality randomised control trials would form the basis for a conclusion. But what is your opinion on policies of water fluoridation in light of this (I know you are a different commenter than who I was replying to, and don't expect your opinion to be the same)? Is it that people should be focussing on studying its (potentially harmful) effects in light of iodine exposure within regions? The link you posted, written by members of Parents of Fluoride-Poisoned Children, states that:
> As fluoride toxicity is directly related to iodine status - and iodine toxicity to fluoride status -, both mass-supplementation programs require urgent reassessment on a global scale.
and also asks:
> Furthermore, we call for the proper evaluation of the toxicity of fluoride on neurodevelopment based on the extensive body of evidence that addresses the impact on iodine and thyroid hormone metabolism.
They (Andreas Schuld) also state in a later article (https://substack.com/home/post/p-139843513) that: > We also learned that most of the research linking fluoride to thyroid dysfunction had been actively suppressed by public health agencies worldwide, including the World Health Organization (WHO), the European Scientific Committee on Health and Environmental Risks (SCHER), as well as the U.S. CDC, the Agency for Toxic Substances and Disease Registry (ATSDR), the NTP, and the EPA.
https://www.theguardian.com/us-news/2024/oct/04/fluoridation...
When it doesn’t, say they courts and the regulators are captured and crooked.
The Police can’t regulate themselves - they need court oversight. Courts are allowed to define what is acceptable policing and what is not, despite not being police.
The EPA can regulate itself and understands science. Courts aren’t allowed to weigh in because they aren’t scientists. The EPA is a morally upright actor, all other government agencies aren’t.
A perfectly rational position. (I say that with extreme sarcasm - it’s malarkey.)
The cops are theoretically subject to it, but in practice... nah, mostly not. They receive at least Chevron-levels of deference for things like "I feared for my life!" or "he was coming right at me!" or "I thought it was a gun!" or "based on my experience and training the suspect was acting suspiciously" sort of expert claims.
A similar case might be iodine in table salt. A lot of salt available in America is iodized on purpose. We don't do that where I live, where the usual diet is already rich in iodine. There is no single right answer, only a cost-benefit analysis for each location.
Foreign sources of rice have to pass tests for fluoride while California rice is exempt, from my understanding.
Plus, drinking tea or eating California rice are completely optional. While you have to go through a filtering process to get ride of fluoride.
Plus, the strongest effects of fluoride are on kids and kids might drink 0 to half a cup of tea a day.
So fluoride toothpaste, or even better fluoride rinse's are much more effective.
I'm not going to put myself in danger to avoid it. But when the evidence is marginal, social factors are something I'll take into account.
Even if there is indeed a problem with fluoridated water, it only shows up in a small effect that requires a large sample to see. The conspiracy theorists were guessing, even if they guessed right. And they ignored the data that had been gathered.
Science changes its mind, but conspiracy theorists never do. They accumulate, and it looks to me as if we're about to drown in them.
https://www.theguardian.com/us-news/2024/oct/04/fluoridation...
Of course, the EPA would never live it down if the anti-fluoridation people actually had something to their claims. However, I’m not the EPA. If they were wrong, screw them.
(It’s also not a ruling “against” the EPA. It’s entirely consistent with the statute, and the EPA will presumably act in accordance with it and produce yet another study demonstrating marginal-to-zero harm associated with fluoridation below 1.5mg/L.)
What's stopping them from coming back with the same or higher acceptable levels of that's where the evidence leads?
You've decided to weigh social factors over evidence because you believe the other side isn't behaving rationally.
So kids have to take tablets if they want the impact. But this is far less effective.
Ask a dentist here. Locals have more tooth decay.
What about genetic predisposition to cavities?
Kind of depends how you track things I'd think. New Jersey, the state with the highest population density in the US, largely doesn't put fluoride in the water outside of a few municipalities.
There's no fluoride in the water in almost the entirety of Hudson, Essex, and Bergen counties, which are located near NYC and include the cities of Newark and Jersey City. Combined population of those three counties is over 2.5 million people.
By comparison Portland’s is 3%. Probably why dentists see high level of tooth decay here.