4 ms·

>Many dentists, having seen what life was like before fluoridation, have no interest in returning to the pre-fluoridation era of widespread cavities, abscesses,

>Many dentists, having seen what life was like before fluoridation, have no interest in returning to the pre-fluoridation era of widespread cavities, abscesses, dentures and people in pain. Is that really true? I live in a country without drinking water medication (thank god) and it's not such a horror story as this article makes it sound. I know that dental health was worse in the past and has improved since, but it doesn't seem to be due to water fluoridation but rather other advances in dentistry and personal dental care.

DantesKite 5y ago
Right? We even have electric toothbrushes now which are way better than manual toothbrushes. Maybe if it was the 18th century and we somehow had access to fluoride it would be justified.
- ssully 5y ago
  Electric toothbrushes have become more affordable, but they are still pretty expensive, especially for people who are low income.
  - gnabgib 5y ago
    I don't think this is fair? Perhaps you haven't seen the $4 electric brushes.. perhaps they're not as good as the $80+ devices, but it's still an improvement over manual brushing. I've even seen them used in "buy N grocery products get a free electric toothbrush" promotions (I want to say it was a cereal company)
browningstreet 5y ago
I asked my pediatric dentist (our city was flirting with de-flouridating), and he produced a number of studies where cities with unfluoridated water had significantly higher rates of those tooth issues mentioned. It also impacts lower income communities more, possibly because the supplies of and access to dental care aren't what middle class and higher communities are accustomed to.
- nyscof 5y ago
  Many studies show ceasing fluoridation doesn't increase tooth decay https://www.prnewswire.com/news-releases/nyscof-report-fluoride-dentists-magic-bullet-is-shooting-blanks-137713193.html https://www.prnewswire.com/news-releases/nyscof-report-fluor...
  - efirman 5y ago
    many studies who the impact of not providing community water fluoridation: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-018-0684-2 https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12... https://ucalgary.ca/news/study-shows-tooth-decay-worsened-calgary-children-after-fluoride-removal https://ucalgary.ca/news/study-shows-tooth-decay-worsened-ca... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925000/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925000/
    - nyscof 5y ago
      In Chile where water and milk is fluoridated, "both public measures have no direct or remarkable effect on dental health" https://pubmed.ncbi.nlm.nih.gov/28453591/ https://pubmed.ncbi.nlm.nih.gov/28453591/
      - efirman 5y ago
        Thanks for sharing that article. In reading it I noticed a few things: 1) the primary author is a well published structural engineer. The article was billed as review of the medical literature, so this is an odd match in regards to expertise and content. Their first co-author does have MD, MPH credentials, but they were fairly green having published only one other article. The journal itself seems legit and has been around for 100+ years. In looking at the content 1) The methodology was essentially one paragraph and in execution it appears they cherry picked the literature and did not clearly indicate concentration of fluoride as they discussed certain postulated effects. 2) Often they reached conclusions based on single studies that do not seem to reflect the current body of evidence. For example, the reference to a Utah study on bone fracture in the elderly population. Many other studies have found opposite results and have been published prior to the publication of this study. 3) Their graphs that show a lack of association of water and salt fluoridation are used as evidence to make the declaration that there is no effect without discussion of causation for that difference. In essence, this piece seems like a regurgitation of soundbites from US advocates opposed to fluoridation. Chile continues its fluoridation program (70% of its population) and milk fluoridation for rural areas https://www.borrowfoundation.org/chile https://www.borrowfoundation.org/chile. The question over how to address cavities rates at the population level in rural areas where water fluoridation is not practical is a good one. And in looking at the evidence on milk fluoridation programs as I considered this article, there is room for further consideration and study there. However; this particular study is not enough to base such a policy discussion/ decision. The US does not currently offer or consider milk fluoridation in rural areas.
Spooky23 5y ago
Many people in the US don’t have access to dental care. Dentists managed to stay at arms length from insurance in general and many employers don’t offer it. For poor people, access is difficult. Dentistry is optional in Medicaid and many states opt out. My state Medicaid funds dental, but in my county (pop 350k), there are 4 dentists that accept Medicaid dental.
jws 5y ago
When added, fluoride is generally adjusted to 0.5-1.5ppm, a bit less than ocean water. Depending where you live, your water supply probably has plenty of fluoride. (Perhaps you can consider it "pre-medicated"). Natural water sources vary widely. Above 2ppm it starts to become a problem. In Africa and China 60% of the population have these levels or higher in their drinking water. Some of the initial studies in the early 1900s which identified fluoride as a factor in dental health were of children in Colorado with discolored, but very strong, teeth. Their water sources were up to 13ppm fluoride.

DantesKite 5y ago

Right? We even have electric toothbrushes now which are way better than manual toothbrushes. Maybe if it was the 18th century and we somehow had access to fluoride it would be justified.

ssully 5y ago
Electric toothbrushes have become more affordable, but they are still pretty expensive, especially for people who are low income.
- gnabgib 5y ago
  I don't think this is fair? Perhaps you haven't seen the $4 electric brushes.. perhaps they're not as good as the $80+ devices, but it's still an improvement over manual brushing. I've even seen them used in "buy N grocery products get a free electric toothbrush" promotions (I want to say it was a cereal company)

browningstreet 5y ago

I asked my pediatric dentist (our city was flirting with de-flouridating), and he produced a number of studies where cities with unfluoridated water had significantly higher rates of those tooth issues mentioned. It also impacts lower income communities more, possibly because the supplies of and access to dental care aren't what middle class and higher communities are accustomed to.

nyscof 5y ago
Many studies show ceasing fluoridation doesn't increase tooth decay https://www.prnewswire.com/news-releases/nyscof-report-fluoride-dentists-magic-bullet-is-shooting-blanks-137713193.html https://www.prnewswire.com/news-releases/nyscof-report-fluor...
- efirman 5y ago
  many studies who the impact of not providing community water fluoridation: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-018-0684-2 https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12... https://ucalgary.ca/news/study-shows-tooth-decay-worsened-calgary-children-after-fluoride-removal https://ucalgary.ca/news/study-shows-tooth-decay-worsened-ca... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925000/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925000/
  - nyscof 5y ago
    In Chile where water and milk is fluoridated, "both public measures have no direct or remarkable effect on dental health" https://pubmed.ncbi.nlm.nih.gov/28453591/ https://pubmed.ncbi.nlm.nih.gov/28453591/
    - efirman 5y ago
      Thanks for sharing that article. In reading it I noticed a few things: 1) the primary author is a well published structural engineer. The article was billed as review of the medical literature, so this is an odd match in regards to expertise and content. Their first co-author does have MD, MPH credentials, but they were fairly green having published only one other article. The journal itself seems legit and has been around for 100+ years. In looking at the content 1) The methodology was essentially one paragraph and in execution it appears they cherry picked the literature and did not clearly indicate concentration of fluoride as they discussed certain postulated effects. 2) Often they reached conclusions based on single studies that do not seem to reflect the current body of evidence. For example, the reference to a Utah study on bone fracture in the elderly population. Many other studies have found opposite results and have been published prior to the publication of this study. 3) Their graphs that show a lack of association of water and salt fluoridation are used as evidence to make the declaration that there is no effect without discussion of causation for that difference. In essence, this piece seems like a regurgitation of soundbites from US advocates opposed to fluoridation. Chile continues its fluoridation program (70% of its population) and milk fluoridation for rural areas https://www.borrowfoundation.org/chile https://www.borrowfoundation.org/chile. The question over how to address cavities rates at the population level in rural areas where water fluoridation is not practical is a good one. And in looking at the evidence on milk fluoridation programs as I considered this article, there is room for further consideration and study there. However; this particular study is not enough to base such a policy discussion/ decision. The US does not currently offer or consider milk fluoridation in rural areas.

Spooky23 5y ago

Many people in the US don’t have access to dental care. Dentists managed to stay at arms length from insurance in general and many employers don’t offer it. For poor people, access is difficult. Dentistry is optional in Medicaid and many states opt out. My state Medicaid funds dental, but in my county (pop 350k), there are 4 dentists that accept Medicaid dental.

jws 5y ago

When added, fluoride is generally adjusted to 0.5-1.5ppm, a bit less than ocean water. Depending where you live, your water supply probably has plenty of fluoride. (Perhaps you can consider it "pre-medicated"). Natural water sources vary widely. Above 2ppm it starts to become a problem. In Africa and China 60% of the population have these levels or higher in their drinking water. Some of the initial studies in the early 1900s which identified fluoride as a factor in dental health were of children in Colorado with discolored, but very strong, teeth. Their water sources were up to 13ppm fluoride.