What is the best evidence in favor of this?
There's a subset of researchers that argue that now that fluoride toothpaste is widespread, the benefit of fluoridating water is much much smaller than it first was and the (small) risk of fluorosis is now comparatively more significant
The CDC tracks some key indicators like mean decayed, missing or filled teeth (DMFT) and in critical age groups like 12-15 there has been no progress made in the past 20 years and the US continue lagging behind European countries: https://www.cdc.gov/oral-health/media/pdfs/Oral-Health-Surve...
And none of that has anything to do with fluoride in the water or not.
Sorry but this reddit consensus is out of step with actual researchers. The #1 paediatric journal has published quite a bit on this recently. Basically the evidence isn’t of high quality but what we have doesn’t look great.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/...
2023 – NTP Monograph on Fluoride Neurotoxicity – National Toxicology Program (USA)
2020 – Till et al. – Infant Formula Fluoride Exposure & IQ – Till C, Green R, Lanphear B, Hornung R, Martinez-Mier EA (Canada)
2019 – Green et al. – Maternal Fluoride Exposure & IQ – Green R, Lanphear B, Hornung R, Flora D, Martinez-Mier EA, et al. (Canada)
2017 – Bashash et al. – Prenatal Fluoride Exposure & Offspring IQ – Bashash M, Thomas D, Hu H, et al. (Mexico/USA)
2012 – Choi et al. – Meta-analysis on Fluoride & Neurodevelopment – Choi AL, Sun G, Zhang Y, Grandjean P (Harvard/China)
2006 – NRC Report – Fluoride in Drinking Water – National Research Council (USA)
[1] https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
[2] https://pubmed.ncbi.nlm.nih.gov/31743803/
[3] https://jamanetwork.com/journals/jamapediatrics/fullarticle/...
[4] https://ehp.niehs.nih.gov/doi/10.1289/EHP655
[5] https://ehp.niehs.nih.gov/doi/10.1289/ehp.1104912
[6] https://www.nap.edu/catalog/11571/fluoride-in-drinking-water...
From the first link:
> It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ
It doesn't seem in favor of this?
> the first link [...] doesn't seem in favor of this?
To me that falls under "the best evidence [available] in favor of this." It's not great, but it's not nothing; it's certainly something in favor. After all.. I guess I don't know about you, but I feel like if someone told me dose X of something is toxic, I would not feel comfortable feeding myself and the entire country 50% of that dose, on that basis alone.
Granted, 35% < 50%, but not really that much less.
I don't know if what you are repeating is slop, etc. I can't trust the source.
A single recent systematic review is more trustworthy than that.
Also, nothing in that list of papers supports your initial claim? I know you'll say you didn't claim anything, so I will say also, that nothing in those links provides for what the prior commenter asked for evidence for.
Other than, fluoride consumption at high concentrations is bad (which is something that was already agreed upon, and is not being questioned in this thread)?
Put simply, it's a wall of links. No quotes. No claims. Its valid to ask if the person posting the links has actually read those articles, or if there is a primary source recommending them. (Or no source if it's LLM copypasta.)
I am the OP and someone asked for evidence and the only answer after an hour, falsely stated there was no evidence. I didn't want to challenge anyone directly so I posted what I thought were the top few more convincing links I have compiled out of 30+.
I am disappointed that I am getting downvoted and this is somehow being made into something political when people deserve to see the evidence for and against supplementing fluoride the drinking water of every living thing because the government wants to improve the health of our teeth. It is a fair question to ask.
The very famous meta studies with all the negative correlations get all the bad associations with flouride from regions where water naturally has extremely high (relative to most other parts of the world) levels of fluoride in addition to high levels of many other uncommon concentrations.
Some of these regions also have additional problems with industry waste.
Put simply, negative correlations about unattended children in swimming pools cannot be extrapolated to infer negative correlations about young children and sippy cups of water.
No? What is a coping response? I asked the commenter to provide context to their links that supposedly show evidence for what the initial question was (does fluoride at the concentrations in drinking water cause harm), which they definitely do not show evidence for.
Nah. I pretty much agree with what Utah is doing here (though I’d prefer just not mandating it and making the decision as local as it needs to be). OP’s link list looks AI generated. That’s just not a good-faith comment.
I suppose you want a summary, well read the abstracts of the papers. It's not that challenging, is it?
They first went defensive when asked about it up thread [1].
I didn’t downvote. (I don’t think.) But as a non-expert, I also didn’t see value in a wall of links. (Particularly when you wouldn’t confirm it wasn’t AI generated.)
A better presentation would pull quotes or make an argument, in your voice, with the citations as scaffolding for your arguments.
To illustrate the issue, I believe I could construct a context-free wall of links justifying just about anything.
If you could explain the process that led to the production of the list & what led you to the belief that those are the best studies/evidence so far, that would probably help people view it more favorably.
Perhaps I should note that I had indeed (believe it or not) already Googled this before asking the question. I asked not because I was too lazy to search but because I didn't know if my search was turning up the best studies from anyone's perspective.
So, no, this wasn't equivalent to saying "I don’t want to google this, so google this for me."
Agreed
Are you asking if there's room to believe it's just a sincere "everything you eat or drink should stay untouched, like it's found in nature" belief? OK sure, let's go with that. So why aren't they working to dismantle water treatment plants altogether and e.g. fighting against modern industrial farming practices in that case?
I'm happy to believe it if I can understand what is leading them to that belief, which is exactly what I'm asking. Is it a general aversion to unnatural stuff (hence my previous comment) or based on some evidence (hence my initial question) or something else (what?)?
Again, we go back to my initial question [1]: what is the best evidence in favor of this?
[1:20] "I do believe that autism comes from vaccines" [https://www.foxnews.com/video/6330950198112]
Does it matter what he actually believes? If it's different from the Trump's policy he'll keep it to himself.
The burden of proof should be on the people who want to add it. Because that is extra cost, extra chemical. If they can't prove it, then we don't do it.
> However, in 1973, the Dutch Supreme Court ruled that there was no legal basis for fluoridation…. The debate hasn’t been meaningfully revived since then, Hofman told Euronews Health. "People started to say, ‘Well, the government should not give us some medicine [when] we cannot choose where to buy our drinking water from," she said.
That’s the “little c” conservative viewpoint. You don’t need to prove it’s harmful. The default should be not putting chemicals in everyone’s drinking water.
there is definitely an argument for an optimal amount of minerals in water being non zero (not only because having it that clean would be practically expensive) but also because we benefit from natural minerals. now if some natural water source isnt as good as another one, why not correct it? we have the technology.
especially at the community level. the little c stance should be to let communities decide, not ban it from the top down.
> and lots of water has natural flouride?
Fluoridated water seems not to have major effects.
I wouldn't want to drink, touch, or be near fluorinated water.
Could it have something to do with the increasing use of fluoridated toothpaste?
If the benefit is great enough then the risk makes sense. That is the case in a lot of areas. Is it worth taking a risk of an unknown effect somewhere in the body in exchange for… a marked but not even drastic reduction in cavities…? Not sure…
Let’s say that hypothetically there is a 3rd order effect on the excretion pattern of some neurotransmitter. Can we detect that? Could it negatively affect mood regulation? There are a million things like that.
Where do you get this from? If you ingest a random chemical (or imagine licking random objects...), do you really expect the chances of it being beneficial vs. detrimental to your health to be remotely close to 50/50?
This is only true if you assume that all effects are too small to notice. If you run an experiment on adding fluoride to water, declare an interest in enamel thickness, and then observe that 30% of the experimental group died within six months, you just made a finding that you didn't know you should have been looking for.
https://www.ncbi.nlm.nih.gov/books/NBK109832/=
> .9 Radiographic detection of teeth and skeletal changes and microscopic examination of affected bone are helpful adjunct procedures for diagnosis.
> Histopathologic and radiographic examination of bones detects bone lesions and tentatively confirms osteofluorosis.14,26 Biopsy or rib or coccygeal vertebrae is used to obtain samples for skeletal fluoride analysis.23
https://www.sciencedirect.com/science/article/abs/pii/B03230...
https://en.wikipedia.org/wiki/Skeletal_fluorosis
> We have developed a localized noninvasive nuclear magnetic resonance (NMR) method for determining the accumulated bone fluoride content in human index fingers
https://pubmed.ncbi.nlm.nih.gov/2339643/
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It sounds like people who have time to pay attention to this have a better chance of discerning a methodology of assay.
I grew up in the PNW of the USA and lots of small hippie towns have been removing fluoride for decades. It comes up on city ballots every year in Oregon.
When it comes to things like radioactivity we assume a linear no threshhold model (e.g. that lower concentrations still have effects, just our measuring tools aren't good enough to detect it) and spend billions as a result. Why wouldn't we do the same for flouride?
Highly recommend visiting the link for details about each point an references (it is not that long), here is a summary, don't comment if you haven't visited the link:
1) Fluoride is the only chemical added to water for the purpose of medical treatment. 2) Fluoridation is unethical. 3) The dose cannot be controlled. 4) The fluoride goes to everyone regardless of age, health or vulnerability. 5) People now receive fluoride from many other sources besides water. 6) Fluoride is not an essential nutrient. 7) The level in mothers’ milk is very low. 9) No health agency in fluoridated countries is monitoring fluoride exposure or side effects. 10) There has never been a single randomized controlled trial to demonstrate fluoridation’s effectiveness or safety. 11) Benefit is topical not systemic. 12) Fluoridation is not necessary. 13) Fluoridation’s role in the decline of tooth decay is in serious doubt. 14) NIH-funded study on individual fluoride ingestion and tooth decay found no significant correlation. 15) Tooth decay is high in low-income communities that have been fluoridated for years. 16) Tooth decay does not go up when fluoridation is stopped. 17) Tooth decay was coming down before fluoridation started. 18) The studies that launched fluoridation were methodologically flawed. 19) Children are being over-exposed to fluoride. 20) The highest doses of fluoride are going to bottle-fed babies. 21) Dental fluorosis may be an indicator of wider systemic damage. 22) Fluoride may damage the brain. 23) Fluoride may lower IQ. 24) Fluoride may cause non-IQ neurotoxic effects. 25) Fluoride affects the pineal gland. 26) Fluoride affects thyroid function. 27) Fluoride causes arthritic symptoms. 28) Fluoride damages bone. 29) Fluoride may increase hip fractures in the elderly. 30) People with impaired kidney function are particularly vulnerable to bone damage. 31) Fluoride may cause bone cancer (osteosarcoma). 32) Proponents have failed to refute the Bassin-Osteosarcoma study. 33) Fluoride may cause reproductive problems. 34) Some individuals are highly sensitive to low levels of fluoride as shown by case studies and double blind studies. 35) Other subsets of population are more vulnerable to fluoride’s toxicity. 36) There is no margin of safety for several health effects. 37) Low-income families penalized by fluoridation. 38) Black and Hispanic children are more vulnerable to fluoride’s toxicity. 39) Minorities are not being warned about their vulnerabilities to fluoride. 40) Tooth decay reflects low-income not low-fluoride intake. 41) The chemicals used to fluoridate water are not pharmaceutical grade. 42) The silicon fluorides have not been tested comprehensively. 43) The silicon fluorides may increase lead uptake into children’s blood. 44) Fluoride may leach lead from pipes, brass fittings and soldered joints. 45) Key health studies have not been done. 46) Endorsements do not represent scientific evidence. 47) Review panels hand-picked to deliver a pro-fluoridation result. 48) Many scientists oppose fluoridation. 49) Proponents usually refuse to defend fluoridation in open debate. 50) Proponents use very dubious tactics to promote fluoridation.