I think one thing you're not considering (especially when you say we should vote with our feet) is poverty. It’s true that fluoride toothpaste is widely available, but for people in poverty, of which there are millions in our country, basic hygiene items like toothpaste and a toothbrush aren’t guaranteed. Neither is it guaranteed that everyone has a perfect daily brushing habit like the dentist tells us; there are people who don't brush every day, or even every week.

You talked about dental care not being covered by public insurance — is it not worth considering that some basic level of dental care is already being applied to the country via fluoridation? It's a minimal, cost-effective way to prevent tooth decay at scale. Fluoridated water is one of the few dental protections available to everyone regardless of their income.