Meanwhile, back here on Earth-1, there's no right thing, and countries all over the world have "by and large solved" the issue by doing completely different things: https://en.wikipedia.org/wiki/Water_fluoridation_by_country
> Water fluoridation is considered very common in the United States, Canada, Ireland, Chile and Australia where over 50% of the population drinks fluoridated water.
> Most European countries including Italy, France, Finland, Germany, Sweden, Netherlands, Austria, Poland, Hungary and Switzerland do not fluoridate water.
Unfortunate that the color scheme is confusing, but not any weird borders.
You can see the uncolored map here: https://en.m.wikipedia.org/wiki/File:BlankMap-World6-Equirec...
These countries largely publicly recognise the benefits of fluoride, but don’t add it because:
- Some countries opt for intake via supplementation.
- Some have a naturally sufficient supply in drinking water via natural processes.
- Some even need to reduce the abundance of fluoride in their water due to over supply.
I think you can pretty easily infer his opinion about toothpaste containing a "dangerous neurotoxin".
The latest report from the National Toxicology Program has found a causal reduction of ~1.63 IQ per additional mg/L concentration of fluoride in their urine [2], which would seem sufficient to also call it a neurotoxin, though the NTP under extensive pressure chose to avoid any particular label after having previously declared it a "presumed neurotoxin."
Notably the study from NTP also mentioned something most people here seem to be missing: "There is a concern, however, that some pregnant women and children may be getting more fluoride than they need because they now get fluoride from many sources including treated public water, water-added foods and beverages, teas, toothpaste, floss, and mouthwash, and the combined total intake of fluoride may exceed safe amounts."
Fluoride being seen as desirable at safe levels, may have drove excessive multi-domain inputs of it, which can combine to drive it to unsafe levels.
[1] - https://en.wikipedia.org/wiki/Fluoride_toxicity
[2] - https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
No it is not. It is sensational and intentionally inflammatory. It is especially damming coming from someone in his position.
Vitamin A, vitamin D, vitamin B, iron, and caffeine are all deadly at that level. The first 4 are mandatory for life, shall we call them dangerous too? Or perhaps we have some nuance and acknowledge the co spirit oriel background (and other beliefs) of the people pushing the anti-fluoride message.
But with fluoride we're talking about extremely low doses, well below the lethal level, being able to potentially permanently damage the mind's of children. Such an extreme risk justifies an abundance of caution, especially when the reason we're doing it is for some relatively modest dental gains, which are likely increasingly obsolete with fluoride being in tooth paste and many other sources besides water. In fact, as per the study I linked to up above, this is precisely the problem!
"Since 1945, the use of fluoride has been a successful public health initiative for reducing dental cavities and improving general oral health of adults and children. There is a concern, however, that some pregnant women and children may be getting more fluoride than they need because they now get fluoride from many sources including treated public water, water-added foods and beverages, teas, toothpaste, floss, and mouthwash, and the combined total intake of fluoride may exceed safe amounts."
See the rest of this thread. If you think the group (at RFK doing so in an official government capacity) using such inflammatory language is going to stop at removing fluoride from just water I don't know what to tell you.
Tooth paste, and other commercial products, are opt-in systems. And indeed there are already numerous unfluoridated options available.
EDIT: I checked. It is possible to buy salt with added fluoride in Germany but it comes with the health note "Zusätzliche fluoridhaltige Präparate sollten nur auf ärztliche Empfehlung eingenommen werden.", which means you should only use it on recommendation by your MD.
I can't find any information on this, do you have a source? According to Wikipedia fluoride toothpaste is recommended by health officials in Germany for children(https://en.m.wikipedia.org/wiki/Water_fluoridation_by_countr...)
Tooth paste with more than one per mille of fluoride has either to be marked as unsuitable for children or has to have a note that children have to be supervised using it and a doctor or dentist has to be consulted in case the child swallows more than a pea-sized amount.
So, not quite prohibited, but far from recommended.
In France, for example, the limit is 1.5 mg/L in tap water. https://www.anses.fr/en/system/files/NUT2007sa0315q.pdf
Supplementation mainly concerns iodine for non-marine salts. Sea salt naturally contains iodine and fluorine. Salt from salt mines contains much less. For this reason, iodine deficiency was relatively common in the Alps until the beginning of the twentieth century.
To my knowledge, there is no debate or controversy on the subject. Endemic goiters are exceedingly rare and are linked to behavioral and eating disorders.
> In England, approximately 10% of the population, or around 6 million people, receive fluoridated water, either naturally or through water fluoridation schemes, mainly in the West Midlands and the North East.
Uh oh. I know it is better now but in 1978 a third of people in the UK didn’t have their natural teeth.
You saw it too in Canada when the Inuit went on food stamps and went from eating mostly meat to mostly plants: their teeth went all over the place and full of holes within a single generation.
We also saw that with the advent of agriculture in general, along with a massive decline in average height.
https://www.yongeeglintondental.com/blog/healthy-primary-tee...
That, of course, is not quite the same thing as perfectly white, perfectly aligned teeth.
No, not really. There are a couple municipalities (Portland, OR, e.g.) that have famously not fluoridated their water forever, but for the most part this is not something most places argue about. UT is an exception.
I think most cities manage their own utilities. So, Portland has to make some decision on this issue. Utah doesn’t, it was an active choice to intervene.
downplayed? you judge.
The British abolished slavery with a vote of parliament. The Russian emperor signed a decree, and freed the serfs. Compromised were made, compensation provided and people were made free. But for some reason, Americans felt the matter is important enough to start a civil war around it.
People complain about America being divided and both sides there being unable to compromise, but if anything, that's been the defining feature of the nation since it's creation. "Y'all should take a chill pill, this ain't that important" is a perfectly valid position to have.
It sure is bizarre for the parts of the world where people are born to do as they're told and shut up.
What's rare is for a nation to have a civil war between sides that agree on almost everything, from the structure of the government to the economic system.
The situation was fundamentally different. Colonies that allowed slavery had no representation in parliament and the slave owners received massive “compensation” that the British people had to spend decades paying off..
Also AFAIK most slaveholders were living in Britain and just viewed their plantations as just another investment. There was very little ideological/“way of life”/racial supremacy stuff involved. So if some Liberals wanted to buyout their not necessarily very liquid “property” with cash they didn’t really have much reason to oppose it.
And then there were 5x more slaves in the US in 1864 while the population was only ~30% higher than that of Britain in 1830 (only if we don’t count the colonies).
Not sure how excited would the inhabitants of New England and other free states would have been if they were forced to buy out all the slaves in the country (if that was even an option).
Slavery for the British was a side note at that point while it was a fundamental component of the US economy.
The idea that no compromise was possible sounds somewhat absurd since America did end the civil war with a compromise. "You can free the slaves, but then we oppress them for 100 or so years." Not that it was a good compromise or anything, but it does show that the civil war was fundamentally pointless.
So it’s hardly applicable to the US (or Britain)
> end the civil war with a compromise
I’m not sure it’s was a compromise per se.
Most people in the north didn’t really actively support country wide abolition before the war (neither did Lincoln) nor were they necessarily particularly concerned about the treatment of the African-American population.
Opposing slavery is a very low bar. Most people in the free states were still deeply racist and segregation was effectively (while not necessarily legally) still a thing there. It only became a major issue in the mid 1900s.
The answer was the same then as it is now: big business. Slave labor cash crops were central to the economy of the South. Great Britain was not dependent on it in the same way.
Even more so the economy of Wall Street.
For one, we’re literally making everyone slightly less intelligent. While it’s a very small factor, I sure as hell wouldn’t want that for my daughters.
For two, IQ is easy to measure. Through that, we know it’s affecting the brain during development. How else is it affecting it? We don’t know.
Weighed against potentially higher risk of cavities pretty much only during childhood and the math seems incredibly clear to me. I feel like the only reason we haven’t banned adding it to water supplies is because people have a knee jerk reaction to anything that sounds even vaguely anti-vax nowadays.
The fact that until 10 years ago the US allowed significantly higher levels should be a really big deal to people.
I’m on reverse osmosis well water so it doesn’t matter to me personally, for what it’s worth.
Almost all fluoride from the drinking water does not have any effect on tooth enamel, because it has contact with it only for a few seconds, except for an infinitesimal fraction that may exit again the body in saliva.
On the other hand, the harmful effects of fluoride in drinking water are certain and it cannot be predicted exactly how much water will be ingested by someone, i.e. which will be the harmful dose of ingested fluoride.
The only argument of those who support water fluoridation is that most people must be morons who cannot be taught to wash their teeth. I do not believe that this theory can be right.
it always surprises me how willing people are to just make something up and be confident in doing so. We've know for almost 75 years that water fluoridation reduces tooth decay[1] and yet here you are straight up denying that.
Do you just not care if you are correct? or do you know you aren't but are driven by the beliefs you already hold?
[1] https://www.cdc.gov/oral-health/data-research/facts-stats/fa...
The contact via toothpaste or mouth wash isn’t all that much longer, so why would they be effective if fluoridated water isn’t? People intentionally wash out toothpaste and mouthwash after this short contact.
I put in a spelling error in the above paragraph of 215 characters, you still understand it but what was your perception of me from this very small error?
Of course it comes down to whether the relationship actually exists. But picking a slightly higher risk of cavities when the other option is potential mental impairment (however mild) seems like a no-brainer..
I don't think it's such a no brainer if every health org is recommending fluoride, and some people think it's scary.
Also you are not supposed to eat toothpaste…
> don't think it's such a no brainer
Well obviously only if the relationship actually exists and there is enough evidence for it. How else could you interpret my comment?
> brainer if every health org is recommending fluoride
Is that true? e.g. throughout entire Europe for instance?
having to resort to childish attempts like this essentially invalidates anything "insightful" you might want to say. if you can't see that manually adding safety-unproven chemicals to water without people's consent is a weird and unethical thing to do, then that's fine, but don't embarrass yourself and everyone else like this
Nobody is doing that, so maybe don't embarrass yourself like that?
> without people's consent
Also not happening. Consent was established when it was voted on, and if people want to change their local policies they are always free to do so. People that object against majority are also free to drink alternative water from the free market instead of relying on socialist handouts
If you want to have an actual, good faith debate about the pros/cons of a specific additive that's wonderful. But you didn't, you reduced the entire thing to "chemicals bad because chemicals". But, more significantly, so too has the US's administration which Utah is following suit on. The US is full on "feels not reals" government mode.
when was it voted on and by who? tell me.
you're also aware that people pay for water, it's not free? quite an odd thing for an adult to not know
"good faith debate". from someone who started making mocking autism noises in the middle of a normal conversation? that's what I suggested was embarrassing, you simply didn't read my comment because you yourself have no interest in having a good faith discussion and you're just blindly throwing terms like that as a way of dismissing an opinion you disagree with.
"chemicals bad because chemicals" I never said anything of the sort, this is a strawman you invented to strengthen your struggling argument. there have quite literally been studies linking increased fluoride to toxicity. it's not "chemicals bad because chemicals" it's "there have been studies suggesting this chemical may be toxic so why are we putting it in drinking water without a public consultation in the last 70 years?"
>The US is full on "feels not reals" government mode.
okay and here we have your real motivation. 90% likely you quite obviously don't give a fuck about fluoridated water or human rights, you are pissed about the current executive branch and you're looking to take it out somewhere. this "debate" is over.
The general idea of the government medicating the people writ large isn't low stakes.
In the US there are a lot of people who are of the opinion the government should just let people be.
I have a feeling it's not about "letting people be". It's about "let me be and screw over those I don't like"
Anyone who thinks this is a straightforward issue is dumb, frankly.
How can the issue people are concerned with be government overreach if they don't care about the government overreaching into others backyards?
If you think all the people advocating for small government must be fools or hypocrites, you don't understand the issues an any depth.
I'm curious, what rights are "granted" by making it illegal for doctors to prescribe puberty blocks when they as a medical professional and a child's parents as their guardian agree they're the best medical course of action for a child?
Saying "it's about granting and taking away" like rights are some zero-sum game feels like it's ignoring the complexity of these issues more than what I'm saying.
So it's not an issue of trampled rights if it's just trans rights, yet you can't come up with a reason that trans rights need to be restricted to ensure freedom of others. And it's being disingenuous to call you out for saying trans rights don't matter when you say this...
You knew the example. You know why society restricts people below 18 from all kinds of things. You are the very definition of disingenuous.
I don't mind being called "the very definition of disingenuous" by you.
Here's some interesting data (2003 I believe, so pretty old) [1]: It reports that most of Europe, Canada, Australia, and South America experiences cavities at rates higher than the United States. However: Many of these countries have public health care; the US does not. Is the US under-reporting? (I didn't dig much deeper into the underlying data; may not be a relevant concern).
Three things I think are likely to be true: (1) Fluoridated toothpaste is widely available and cheap. (2) Cavity rates are significant even in countries with high rates of fluoridation. (3) Fluoridating the water supply carries with it a non-zero monetary cost. I tend to believe that these three realities, at the very least, justify the conversation as being one we should have. It could be the case that water fluoridation made a ton of sense in a world where people didn't have as much access to fluoridated toothpaste, but nowadays the typical person has hit the limit on what it can do for them, and ingesting more is, at best, doing nothing.
Here's another way I like to think about it: Put the science aside for a second (I know, hard, not ideal, but bear with me). You've got two people who are low income. Person A believes, for their own health and in the expression of their own personal liberties, they want access to fluoride; but the Government is not fluoridating their water. They can spend $5 a month to buy fluoridated toothpaste; possibly not even more expensive than the toothpaste they were already buying. Person B is living in the opposite world: They believe that they do not want to ingest fluoride, but the government is fluoridating their water. They would have to spend many dozens to hundreds of dollars a month buying water bottled somewhere more natural. From a personal liberty and economics perspective: Its pretty clear-cut.
[1] https://smile-365.com/what-countries-have-the-lowest-prevale...
Direct monetary cost is entirely insignificant, though. Potential risk of mental impairment (of course there is no conclusive evidence of that) seems like a much bigger issue.
If one out of a hundred people don't want fluoride, can't they can spend slightly more on bottled water? Why require the other 99 to be up-to-date on research to get the best personal medical outcome?
Flouride should be put in the toothpaste. Then people can make a choice on whether they want it, but most importantly, its in the only product that is actually used for brushing teeth
It's basically a waste product and water naturally has fluoride in it at the same levels, or more, that fluoridated water has, and the environment has been just fine in those places.
If it's harmful as you imply, lots of water would need defluoridation.
Sounds like it's not important to address fluorine reduction if a casual relationship can be established.
I do wonder how they compensated properly for fluoride being added in poorer areas. Will dig it out when I get chance.
Meanwhile growing up in Poland in the 90s as kids we had these fluoridation sessions in school, for which everyone had to bring their toothbrush and brush their teeth with some kind of sour tasting fluid that contained fluorine.
We had the same in Sweden up until the early 90s, and it's apparently doing sort of a revival in some schools.
And regardless of whether the water is fluoridated or not, there is no big debate elsewhere about it, nobody cares that much about it, because all the evidence is that in smaller amounts prob it is does not matter much either way, in the presence of people brushing their teeth. A lot of countries stopped it due to logistic purposes. In netherlands they tried fluoride in the water, a court said they should actually pass a law in order to be able to do it, and they did not even bother with that and dropped it. The fact that some countries may not use fluoride in the water is not due to some deeply-held conviction about how destructive fluoride is for the iq of the kids. In terms of risks of fluoride, fluorosis is what is mostly discussed anyway, and to a degree, unless it is too serious, this may just be an aesthetic issue.
From the perspective of one that watches this craziness from outside, the whole debate is non-sense, and whether some european countries use water fluoridation or not is not very important, it does not cause any heated debate in the EU. The debate in the US is not because the US considers some things that others do not consider. There is no actual truthseeking mentality from the current administration or anybody on this to actually find for sure if fluoride decreases iq, or if fluoride in the water is absolutely essential for dental health even if people are brushing their teeth.
We're either bigger, or denser, or less dense, or ... essentially whatever suits the argument.
https://www.airportthai.co.th/en/aot-reiterates-the-guidelin...
edit: But I will say it works both ways. Most countries do not know what it takes to keep hundreds of millions of people of various backgrounds together under a common way of life with a certain risk vs entitlement balance. Americans as a whole are more risk tolerant AND accepting of failure and reinventing yourself. In most cultures it's a great shame to quit your job with benefits, start a business and not succeed. In the states it's not shameful. You tried? Awesome.
I have to assume many, maybe most, people that give reasons like you mention just flat out don't want the policy and reach for a reason to justify it.
I can say I don't want gun control laws. Not because it doesn't work elsewhere or couldn't work here. I just fundamentally disagree with it and don't want to live in a place where the only ones with guns are state officials.
It's baffling how despite numerous other countries outperforming the US in educational outcomes we do not even look at other approaches!
(If we had patriotic songs worth remembering im sure i would have)
The problem is this, hoe do you fix something you are proud of? It seems a contradiction?
Speaking as an American, though, I can both be proud of something and recognize its faults. I'm proud of the core principles that America was based upon, for example, but very much recognize how far we've deviated from them and how much we need to fix.
I think there's never much to gain in being proud of things you have nothing to do with or control over. If you like some principles you would be proud when you uphold them personally. It is when we start feeling proud in the abstract that we start having issues.
"Pride goeth before a fall" is a time-worn saying for good reason.
Hell, in some countries even the national anthem has no lyrics but is purely an instrumental track (Spain being a notable example).
Mexico's Pledge of Allegiance celebrated every Monday in schools.
https://en.wikipedia.org/wiki/Pledge_of_Allegiance_to_the_Me...
But even that was once-in-a-lifetime event to emphasise the importance of the first day at school at age 7, it did not happen every Monday.
Needless to say, it wasn't very effective. As evidenced by history, some of our parents definitely broke that pledge later in their life.
Claiming to be the best (at anything) is just tacky and arrogant. Especially with something as impossible to quantify as "best country". There's no such thing as the best country in the world. Every one has strengths and weaknesses, and you can't really balance and rank them.
[1] https://en.wikipedia.org/wiki/List_of_countries_by_incarcera...
[2] https://www.statista.com/statistics/262962/countries-with-th...
It’s kind of amazing that the left has forgotten that fact.
Poland,
https://georgewbush-whitehouse.archives.gov/national-anthem/...
Netherlands,
https://www.classicfm.com/discover-music/periods-genres/nati...
The difference between America the Beautiful and other anthems is how much it does, for how long, and making sure it gets everything it can possibly cram in there. It's like a bunch of people standing on a stand at a sporting match shouting "America, America, America" unremittingly, whereas most people might be satisfied to shout "Go {my country}" and be done with it.
And oh, that people used to talk about us and that despite they don't anymore we are still a pretty nice place to live.
https://www.tiktok.com/@guinnessworldrecords/video/747057742...
ha-ha f....
The cultural difference is that our rich people are too rich, our media is too centralized, and none of those in power want to enrich and empower the country, when they could enrich and empower themselves.
(For now, at least? How long until that gets cracked down on as dangerous?)
There is no person in the world who cannot have a toothbrush and toothpaste if they want to. And if you find one such person, they won't have access to any centrally treated water.
Considering that the number of such people is very low it would be very cheap to solve this issue.
> really?
Yes, really.
> So why are they poor?
Why is anything the way that it is?
It was referring to the comment where you said “less cynical”.
> Why is anything the way that it is?
America big? America different?
It’s more challenging to find non-cynical reasons for people being poor and suffering.
It's not perfect by any means, but it's definitely much better than nothing. So the US should absolutely be able to at the very least match that, but really most likely it should be able to do much better. That it doesn't is very much a choice.
I think the US would prefer a UHC if we were starting from a blank slate. The difficulty is mapping a path from what we have now to that.
Do you remember when Republicans went on and on about how "Democrats rammed through the ACA without a single Republican vote"? As if that represented a problem on the Democratic Party side, and not the Republican one? Despite the similarities to models proposed by Republicans in the past, and the relative conservative step it represented from "Byzantine kludge of often poor-to-no-coverage" to "something with a higher floor"? That's how hard it would be to find a Republican to "prefer a UHC if we were starting from a blank slate."
It's important not to underestimate the distrust of government services and regulation of any sort of the Republican base. The conservative media - talk-radio, then cable, then social/podcasts - has been intentionally undermining the credibility of government services at every opportunity for 40 years. And the politicians hamstring and sabotage whenever they get a chance to try to make sure that services offered in the US are sub-par compared to elsewhere.
It's a well-oiled machine running a cycle that keeps people focused on anything else but the services they actually use all the time so that cognitive dissonance can't creep in. (Granted, sometimes, when necessary to acknowledge those things, they'll fall back to making it clear that YOU earned/paid for the things you use, but those other gross poor people are just freeloaders.)
It's like with abortion - for decades "overturning Roe V Wade" was what Republicans said they wanted to do. And people kept trying to convince themselves "oh they don't really mean that, they wouldn't do that actually anymore." Take their word on it about wanting to tear down government services.
This is partly what I was getting at when I said the culture of the US is different and the scale is much larger than European countries. It's not just geographically larger, but it's politically and ideologically broader too. If you have a wonderful idea like UHC, you need to make it work with liberals, conservatives, and everyone in between. Like it or not, a universal healthcare or Medicare for all plan is either going to be DoA in Congress, or a considerably watered-down and Americanized version if it has any hope at all of getting enough senators to pass it without first seeing massive electoral college reform in this country first.
That is the scale of the US. You can't assume that an idea that's well-liked and popular in another country is going to be popular and well-liked here.
And the various countries in Europe do have different healthcare systems, sometimes significantly different.
It's difficult, but not as difficult as it's often presented to be, as long as you're okay with giving the finger to a relatively small number of wealthy health industry executives.
And that, is the difficulty. Sure, I agree that it wouldn't be too logistically difficult to implement universal healthcare in the US. But that doesn't matter when more than half the country has been propaganda'd into not even wanting it in the first place.
Hell, I expect that there are a ton of Medicaid and Medicare recipients in the US who would tell you that they think government-provided, single-payer healthcare is a bad idea, when that's essentially what they have, to some degree.
That's what it still has.
The current healthcare system is working perfectly (and by that I mean lucratively) for the 0.01% in control of the political system.
If you want to make that argument, actually make it, because if you try, 99% of the time its not actually true, its simply ignorance.
> US states used to be offered much more independence.
But even in your own example with the EU, the EU still mandates many health policies for its member countries: food safety; air and water quality; tobacco, sugar and alcohol regulations; and so on. That's not at all dissimilar to what the federal government does in the US, except our states don't implement those policies/directives themselves because the feds enforce it all.
The comment I was replying to pointed out that the US isn't several countries put together. As you describe, the EU is several countries put together and yet the US actually pushes more power to the states.
Doesn’t their comment claim the opposite?
Unlike the US Federal government EU has very limited direct means of imposing any if its laws or regulations on member states of they chose not to comply with them.
And are those conditions manmade? If so, would we be better off reversing the proximal issues rather than adding fluoride to try to fix it?
let alone the precautionary principle in a complex system with a gazillion variables... (i.e. things we don't know we don't know)
And this is known by people who do professional advocacy work, on topic I am familiarly with, such as city design and transportation. They take great care to make sure all the examples are from the US, even if those examples aren't nearly as good as others. Because they know, when speaking to American audiences, you lose the audience if you suggest in X town, they should do Y that is done in Europe. In the US selling something as domestic innovation is usually the best, "if people in Indiana can do it, you can do it even better".
To just ignore any explanation that points out that culture matters, and believing that only 'hard' factors matter, is incredibly foolish. Cultural believes, such as exceptionalism absolutely do a play a huge role in determining what happens in the real world. To point that out, is not cynical or lazy.
And this does not just apply to the US, it many countries have different forms of that.
I really don't buy it, at least not as a general statement.
As to rail, both the first-gen and second-gen Acela is based on the French TGV.
The comparison to the Dutch healthcare system is not apt. While the Heritage foundation may used ideas from the Dutch system our system is quite a bit more Byzantine and inefficient. We spend twice as much per capita on healthcare and have worse outcomes and fewer people covered. Our citizens have far more per capita medical debt than the Dutch.
We didn’t really implement the Dutch system and we didn’t really learn from the French how to build and maintain high speed rail. Saying we learned healthcare from the Dutch because we have doctors like they do makes as much sense as your argument.
Why does the US execution not match that of the countries it looks into? I think it's because talented people in the US disproportionately go into the private sector, leading to an incompetent public sector. American distrust of their government is arguably justified.
IMO the most distinct parts of the Swiss health insurance system is that (1) copay is obligatory but limited (i.e. healthcare isn’t free but it’s not expensive either), and (2) it’s individual, companies cannot pay for it, so there’s no US-like extreme benefit of having a good job.
It isn’t really bargaining power of the pool, but the risk assessment of the pool you are in. Being in a hodge lodge personal pool means you are sharing risk with people who will have more expenses. That’s why Switzerland throws everyone into the same pool, so no crème low risk can be siphoned away.
Due to the regulations it is not a big run to the bottom
> The average Obamacare plan costs $483 monthly for a 30-year-old, $544 for a 40-year-old and $760 for a 50-year-old.
> The bronze plan covers 60% of the costs associated with care.
I feel like they missed the most important parts of the Dutch health insurance system…
I'm skeptical of results showing IQ loss but I also think fluoridation should be phased out as fluoride toothpaste and mouthwash are now widely available. Banning it seems like the wrong move to me...states should simply decide to continue adding it or not.
Isn't that exactly what's happening here? A state deciding to not continue adding it?
Did OP mean that municipalities should simply decide to keep adding or not? If so, how do we decide (from our various armchairs in most cases far away from Utah) what the appropriate level of government for making this call is?
I think the bigger complication though is going to be - depending on the state - how water districts are apportioned. I think even many counties (let alone municipalities) will share water infrastructure so it’s not really clear who has the jurisdiction to make that decision other than the state.
By having official country-level guidelines by the health ministries or similar for people to brush their teeth with toothpaste containing fluoride, and specific guidelines around it for kids, as trivial as it may sound. Along with experts' reviews providing more details on these decisions, and explaining tradeoffs properly.
Fluoride containing toothpaste is the main recommendation, even in places that fluoridate the water (which are the minority). There is not much to add to this apart from refining these guidelines. Eg in the EU where some countries fluoridate water, most don't, there is no huge debate about it overall. Most eu countries that fluoridated the water stopped doing it some point mostly because it was no longer needed in preventing cavities, and prob largely due to logistics/costs than possible risks.
Your second paragraph reflects my personal views on it, too. The "banning" is weird, esp since, according to the article, it comes from people that seem to advocate against use of fluoride in general in toothpastes etc. The discussion should be around best policies to prevent cavities etc, but it does not seem to be around that. I see nothing wrong with local communities deciding if they want to put fluoride or not in their water, based on their own opinions but also general situation. Maybe in some much poorer areas fluoridation of water could be beneficial until some other measures take place, for example.
> While more than 90 per cent of Australians have access to fluoridated water, that figure is significantly lagging in the sunshine state, where local councils have ultimate authority over whether it is adopted.
> A decade after the Newman government handed responsibility for fluoridated drinking water to local governments, 51 out of 77 have opted out. That means about 28 per cent of Queenslanders do not have fluoridated drinking water
https://www.abc.net.au/news/2023-11-24/fluoride-dental-care-...
This is not obvious. Some water has high levels of fluoride, which can cause harm (fluoride added for public health reasons is not the highest level of fluoride you will find [in the UK]).
Fluoridation could be done by mixing of naturally high fluoride water sources into other water.
There’s evidence that despite widespread availability of fluoride toothpaste and mouthwash, fluoridated drinking water improves dental outcomes at the population level.
There’s also evidence that at high levels (not the normal levels it is added at, but at higher levels which can happen on accident) fluoride may reduce IQ.
I’m ok with either trade off but the “solved” phrasing makes it sound like there is an obviously superior choice.
But beyond Europe there’s still no global consensus.
I do agree that the US is an outlier with fluoride being nearly universal.
Some countries no longer add it (but their water still has naturally occurring fluoride that they don't remove).
(To be fair, though, many [most?] Western countries do not fluoridate their water. The US is actually not doing the common thing here.)
It's honestly not clear if water fluoridation in the US is necessary or all that useful here anymore, as we started doing it when fluoride toothpaste wasn't really a thing. Now pretty much all(?) toothpaste in the US has fluoride in it. If someone can't afford toothpaste, then they probably can't afford regular dental care either, and fluoridated water isn't going to make much of an impact anyway.
How have other countries solved it?
Adding fluoride into tap water always sounds borderline insane to me. The only benefit is to protect your teeth, which, to me, strongly suggests that the correct approach is to put it into toothpaste or other oral hygiene products instead of water.
https://www.uk-water-filters.co.uk/pages/areas-with-fluoride...
> Maybe the US should look into how other countries have solved it?
I mean Utah is trying, sorry it took a while. I know Germany and Sweden don't fluoridate its water, I assume you mean Western Europe by the "world" (sorry if I am interpreting too much here, but that's usually what's popular to compare US to and bash US on how bad it is), so US is getting "with the program", finally I suppose. States having individual laws here is a benefit, one state doesn't have to wait for the Federal Government to act.
> This is one of these US-specific polarised debates I find really bizarre,
I don't think it's that polarizing? Unless 1) you're listening to US media more and 2) you're not getting many non-polarizing issues in the news, because those are well are just boring and don't sell ads.
Suddenly everything was up for debate.
Some place do it. Others partially, many not at all.
For context... some people think statins should be put in the water. Maybe they should. But were does mass medication of the people stop?
There's absolutely no need to resort to a slippery slope here. We have plenty of examples around the world for things that work without anyone invoking a boogeyman.
There are examples of the boogeyman existing in real life - just 80 years ago we had one of the worst. Right now we have some boogeymen although not Hitler level. Get a little historical perspective.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/...
This isn't a sensible way to think about it. Every contentious conversation I've ever had has gone this way:
Me: why do people want to ban fluoride
Them: [anti government paranoia]
Me: um...but how about tooth decay
Them: pineal gland calcification
Me: idk sounds pretty far-fetched
Them: THAT'S WHAT THEY WANT YOU TO THINK
They are experts in this field, and, unlike “random person on the internet who spent 2 minutes on google”, have informed opinions on this topic.
If you want a serious discussion on why fluoride is good or bad, that’s where you need to go.
Random person on the internet is very easy to disagree with, because we’re all idiots right? It’s a very easy lazy way of self confirmation.
…but if you are serious about critically considering the issue and facing your own biases, talk to an actual topic expert.
My dentist told me he had carefully reviewed the literature and determined to his satisfaction that public fluoridated water was in the best interests of public health, currently. He offered to share some reading that he was convinced by.
You can’t really ask for more that that.
Discussing this here is a bit like protesting by posting on social media; yes, I suppose it’s better than doing nothing and not engaging with the topic at all… but only barely, and not in any meaningful way.
Why do almost no other countries fluoridate drinking water?
Even if it does turn out to be unambiguously good, people have a basic right to make their own medical decisions.
Recent systematic reviews suggest an association between higher fluoride exposure and lower IQ in children. - https://en.wikipedia.org/wiki/Water_fluoridation
At some point, you have to accept that your random wikipedia page and 5 minutes on google is not a convincing argument.
This is right up there in the conspiracy theory territory.
Rational discussion means listening to experts and admitting that you are not an expert.
What do you want me to say?
You aren't a qualified expert on this topic. If you want an expert opinion, talk to an expert, not some dubious fucking provenance wikipedia page.
Who do you think conducted those peer-reviewed systematic reviews? I'm sorry if I don't take the word of some random guy's dentist over multiple meta analyses in major medical journals.
And I don't need an expert to tell me people should have the right to make their own medical decisions.
And finally, I live in a country where public health experts have decided against water fluoridation. This is represents the vast majority of countries. What now? Should I pick some other experts to listen to?
> Should I pick some other experts to listen to?
I think it's reasonably clear that you haven't spoken to an expert in this field.
> I'm sorry if I don't take the word of some random guy's dentist over multiple meta analyses in major medical journals.
Are you certain you're competent to review and understand the literature on the topic? It takes a lot of time and effort; that's what dentists do as a job. That's why they have to go to school. That's why random people on the internet do not do dentistry.
If you don't trust my dentist, then talk to your dentist.
This is literally my point: I'm not telling you how it is; I'm telling you, talk to someone who knows what they're talking about; and, don't believe that you are an expert because you put some trivial amount of effort into investigating it yourself.
You can't be an expert at everything. No one can.
As some point, you have to trust other people.
My previous dentist pushed these $80 (not covered by insurance) fluoride treatments on every cleaning visit. There's no research that shows much of anything about their effectiveness (good or bad). Yet they push them anyway, because it (their words) might help and probably won't harm. That doesn't give me a good feeling about their competence to have an expert opinion on this sort of thing.
I would, however, trust the opinion of someone who is doing medical/dental research, and holds a doctorate in a relevant field.
I don’t understand what you mean here. Are you just wholly rejecting the concept of expert knowledge, trials, meta analyses, basically the foundations of science, just because in order to participate in it you have to have tainted yourself by rigorously studying it?
I am embracing expert knowledge in trusting meta-analyses and the decisions of EU health experts.
If you’re this deep on the appeal to authority train, the NIH released a report in the last year linking fluoride exposure to moderate drops in IQ with moderate confidence.
It’s probably not the worst thing in the world, but is definitely not inert.
I’d say that’s a reasonable sign of someone qualified to have an opinion.
I think you’re getting confused with a dental technician.
Your dentist is well qualified to have an opinion on the effects of fluoride on your teeth.
They are poorly qualified to have an opinion on whether it should be added to the water supply at source.
Chemists who work in fluorine chemistry on the other hand have to become experts on the biological effects of fluorine exposure. Small and seemingly innocuous exposures can do a lot of damage and kill you, though not in a way that lends any support to the idea that municipal fluoridation will harm you. If you do understand how it kills you (basically by being exceptionally narrowly focused on making free calcium ions and to a lesser extent magnesium ions biologically unavailable), it is hard to describe a chemically plausible scenario that somehow avoids this basic fact of chemistry. Fluoride behaves the same way outside the body.
Municipal water exposure is far below the noise floor for fluoride. Food has far higher levels of fluoride than municipal water and the body has ample excess calcium and magnesium to absorb the loss of bioavailability of a microscopic amount of those minerals. Humans consume calcium measured in grams per day, multiple orders of magnitude more than can be lost via municipal fluoridation. Natural dietary variation will have a far larger effect.
There is a very serious mechanism of action problem. Fluorine poisoning is a thing that happens. The observed effects and empirical evidence, as well as the mechanisms of action that cause them, are incompatible with any mechanism of action that supports the hypothesis that it causes brain damage. Basically, it would invalidate the entire history of actual fluoride exposure.
The other serious problem is that people are exposed to far more fluorine through what they eat than through water. What is special about trace levels in municipal water? And many parts of the world have far higher natural fluoride levels in their water than any municipal water supply with no evidence of adverse consequences. This has been studied many times in many countries! In fact, the only consistent correlation with naturally high fluoride levels is better cardiovascular health (for which there is a known mechanism of action).
This notion that trace levels of fluoride in some municipal water is adversely impacting IQ based on thin evidence from the developing world is just the public health version of “faster than light neutrinos”. Someone thinks they measured it but it contradicts everything we know about the subject. The rational approach isn’t to discard everything we know without a hell of a lot more evidence.
I don’t think adding fluoride to municipal water does much these days but it also isn’t harming anyone.
That debate is framed around being vaccinated vs the scare of "vaccine caused autism" (or myocarditis), but that frame is missing the risk of things like measles.
Likewise tooth decay is not only expensive, but it can have dreadful health consequences if left unaddressed. Missing teeth is also socially costly. Being poor or "ugly" or poor looking is a serious adverse health consequence. Imagine parents barely making ends meet or working multiple jobs. It's easy to imagine disadvantaged kids missing out on dental care.
I also explicitly remember reading multiple reports of poor tooth health correlating with dementia development. I've also read that serious infections of any sort can harm IQ.
The bigger issue is that we have vast amounts of scientific data and empirical evidence around fluoride toxicity. People are injured and die due to fluorine exposure, we understand how it interacts with biology. Any mechanism of action that can support the hypothesis that fluorine causes brain damage necessarily invalidates all of this evidence and is difficult to explain as a matter of basic chemistry.
And then we have to explain why fluoride in water has this effect but the much higher levels of fluoride in food does not.
Fluoridating municipal water may not offer much benefit but there is no credible science that it is actually harmful. Large regions of the world have water that naturally has far higher fluorine content than municipal water and there is no evidence of IQ reduction in these regions either.
The vast majority of dentists are not public health experts, and will have little to offer other than “exposing your teeth to fluoride regularly is good”.
No they are not. The are experts are filling cavities and treatment. They have no additional knowledge of fluoride in water vs any other interested person.
For that you need to talk to someone in research, which is not someone seeing patients.
It's not a debate everywhere else because adding fluoride to the water is objectively an unusual thing to do that they just... don't. Presumably they get fluoride other ways.