The Fluoride Wars Rage On

https://www.nature.com/articles/d41586-021-02924-6

by Wildgoose • 5 years ago

37 79 5 years ago

bondarchuk• 5 years ago

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.

DantesKite8• 5 years 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• 5 years ago

Electric toothbrushes have become more affordable, but they are still pretty expensive, especially for people who are low income.

browningstreet• 5 years 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.

nyscof4• 5 years ago

Many studies show ceasing fluoridation doesn't increase tooth decay https://www.prnewswire.com/news-releases/nyscof-report-fluor...

Spooky232• 5 years 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• 5 years 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.

DantesKite8• 5 years ago

I mean fluoride is one of the most interactive elements on the periodic table. It’s pretty clear it interacts with the body in pathogenic ways. That’s part of the reason why it bonds to the enamel of the teeth so well.

I don’t think we need to supplement tapwater with fluoride now that toothbrushes and toothpaste are so widely available.

You can’t control the dosage since people can drink as much tapwater as they want and still do not know how much they actually are receiving.

That being said I highly recommend everybody get a reverse osmosis water filter. Add in some electrolytes and you’re good to go.

Edit: Never mind, I was wrong. Fluoride isn't an element. It's somewhat reactive, but not nearly as much as Fluorine.

latchkey7• 5 years ago

I just bought an RO system of Amazon and it is great. There is a relatively newer design that doesn't require the external pressurization tank and uses a single easily-replaceable filter.

The faucet even has a realtime TDS measurement (inlet water is over 400 and the filter brings it down to about 17-18). I put a higher flow filter (doesn't lower the TDS) in front of the RO system so that my regular faucet water is filtered and it extends the life of the RO filter. Takes like 30 minutes to get everything installed. Totally worth it!

yumraj• 5 years ago

Could you share which one?

DantesKite8• 5 years ago

I'm really fond of the Brondell H2O+ Circle RO filter. It's the best system I've ever used and the filters are so easy to replace it boggles my mind why every other filter isn't like it.

It comes with a reverse flush system that makes the RO filter last for years. Takes our water from 250ppm to 12ppm.

Used to be around 850ppm but luckily, the city improved its water filtration practices.

JumpCrisscross• 5 years ago

pretty clear it interacts with the body in pathogenic ways

Shouldn't we have mountains of decisive evidence to support this point by now?

veemjeem2• 5 years ago

With such a small amount in tap water, it seems like it would be hard to conduct a controlled study.

DantesKite8• 5 years ago

Yep.

Here's one, low-level example.

https://en.wikipedia.org/wiki/Dental_fluorosis

vizzier• 5 years ago

Just note that Flouride and Flourine are very different things. Chlorine is also very highly reactive and dangerous but you think nothing of eating table salt.

RC_ITR• 5 years ago

As with almost all controversial health discussions, everyone loves to talk about elemental chemistry and hates to talk about ionization.

jjoonathan3• 5 years ago

Just look at this video of sodium exploding in water! Now buy my all-natural alternative!

lend0003• 5 years ago

You'll find fluorine atoms in a disproportionate number of poisons, while other halogens are much weaker. It really is an anomalous atom and the comparison to Chlorine is not accurate (which is less electronegative than oxygen).

I wondered why we don't use something that can also promote crystallization of hydroxyapatite (primary mineral in surface tooth enamel), and apparently it's because carbonate also promotes plaque crystallization. However, if you go to the dentist regularly, it seems an objectively better personal option.

The argument for water fluoridation is a macro-argument that looks good from 10,000 feet, but when you apply nuance, such a policy does not benefit (and probably subtly harms) the vast majority of readership on HN, and is more likely to affect the most impoverished who do not brush their teeth regularly and cannot afford or do not prioritize going to the dentist (which is a surprisingly high percentage of the general public).

That isn't to say it's a bad policy, but it certainly isn't black and white.

Gravityloss• 5 years ago

What kind of fluoride? Fluoride salts can be extremely stable even at very high temperatures. They were used in prototype molten salt nuclear reactors and uranium hexafluoride gas is used in uranium enrichment.

Spooky232• 5 years ago

Given that NYC has been fluoridating since 1965, and how insane people are on the topic, I’m sure we would be aware of actual problems long ago.

DantesKite8• 5 years ago

Well, I don't think that's a good heuristic for determining whether something is bad. There are plenty historical examples of doctors not washing their hands even when there was substantial evidence suggesting it decreased deaths.

DantesKite8• 5 years ago

Yes. We are.

https://en.wikipedia.org/wiki/Dental_fluorosis

nyscof4• 5 years ago

70th human study links fluoride to neurological damage https://fluoridedangers.blogspot.com/2021/09/70th-human-stud...

Prominent scientists proclaim “It is time to protect kids’ developing brains from fluoride” https://www.ehn.org/fluoride-and-childrens-health-2648120286...

Fluoridation Fails New York City https://fluoridenews.blogspot.com/search?q=New+York+City

A 2012 book by Kozol regarding poor children in the South Bronix (fluoridated since 1965) reports ""Many of the children who attend these schools also suffer the emotional and physical attrition that results from chronic illnesses like asthma and anxiety, as well as the steady and low-level misery of rotting teeth, infected gums, and festering, untreated sores. " https://thirdworldtraveler.com/Third_World_US/AmazingGrace_K...

Based on NYS Department of health data researchers found " For every age/race group, there was a consistently significant association of SiF [silicofluoridated] treated community water and elevated blood lead" https://pubmed.ncbi.nlm.nih.gov/11233755/

Politic$, not science, supports fluoridation

mizzack• 5 years ago

Been on RO for a decade. Add a few drops of trace minerals (Concentrace) and it's the best tasting water out there.

jandrewrogers• 5 years ago

I've worked with fluoride chemistry in the lab, which entails some specific safety protocols due to its effects on the human body if you make a mistake. Your characterization of the health risks to humans is misinformation, particularly at the exposure levels in water regardless of how much you drink.

Fluoride aggressively and preferentially binds to calcium in the human body. That's how it protects teeth, the chemicals that cause tooth decay have a weaker affinity for calcium than fluorine, and therefore can't displace it.

The mechanism of action for its lethality is the same. Calcium ions are used throughout the human body, notably in the heart for critical signaling functions. If you are exposed to sufficient quantities of fluoride, it will circulate until it finds some calcium in your body, including readily depleting your calcium ion channels which causes your heart to stop working.

Human bodies have significant excess calcium floating around. There is simply not enough fluoride in water, no matter how much you drink, to tax those calcium reserves. People have been drinking naturally fluoridated water, some at much higher concentrations than municipal water, for millennia.

DantesKite8• 5 years ago

We can argue about the relative safety of fluoride to the human body. Maybe there's a middle ground somewhere, but saying that it is hazardous to your health in excess amounts and that those excess amounts can be found in tap-water isn't controversial nor is it misinformation.

For example, as a very basic, low-level example, exposing children to fluoride early on when teeth are forming causes dental fluorosis. This is well-known, well-studied, and not at all controversial. And in fact, tap water is the most common source of dental fluorosis.[1]

Now there are clear benefits to fluoride: It can be used in a variety of circumstances and probably has done humanity a net good, especially in areas where dental hygiene (for whatever reason) isn't well understood or well-practiced.

But there's clearly a level where it's not safe to expose to human beings.

[1] https://en.wikipedia.org/wiki/Dental_fluorosis

UI_at_80x24• 5 years ago

My town (~500,000) stopped putting fluoride in the drinking water in Jan 2013.

  According to the Oral Health 2018 [0] report released by the health unit, the percentage of children with tooth decay or requiring urgent care has increased by 51 per cent in 2016-17 compared to 2011-12.

[0] https://www.wechu.org/reports/oral-health-2018-report

DantesKite8• 5 years ago

I wonder how they know whether it’s specifically from a lack of fluoride or because of diet.

Permit• 5 years ago

What suggests to you that between 2011 and 2016 there was a large shift in children's diets?

SkittyDog• 5 years ago

They don't know that... it's an anecdote, not an epidemiological study.

But you also have no evidence that diets changed drastically for the whole city of 500k people around the same time... Probably because we don't even know what city this is actually referring to.

Maybe all 500,000 people all stopped brushing their teeth... Maybe all the dentists left town... Maybe aliens are dosing the town from orbit with radiation weapons.

It's not a useful counter-point for you to just assert some alternative causation... Of course there could be other causes, that's literally always true about any causative assertion.

Analemma_• 5 years ago

Be serious. You’re suggesting that at the exact same time that this town, and only this town, stopped using fluoride, it is also the same case that this town, and only this town, had a rapid change in children’s diets?

anonporridge• 5 years ago

As someone with a naturophile mother who grew up drinking nothing but filtered water as a child, I was riddled with tooth decay. So many cavities and fillings that I lost count. Two crowns and one root canal all before my 13th birthday.

I believe we also used some kind of natural toothpaste that was probably fluoride free.

It's only recently that I connected the dots and realized that never drinking tap water is probably why my teeth are a mess. I'm almost certainly going to have to get implants much earlier in life than I should have.

It might be possible to avoid this with proper fluoride toothpaste or mouth wash, but you simply can't rely on most people knowing enough to care or understand the importance of it. For most people, if an issue hasn't personally affected them, they tend to not consider a risk that needs to be mitigated.

gnabgib2• 5 years ago

Two similarly sized cities, one stopped fluoridation, the other didn't, the study shows a 17.6% increase in cavities in grade 2 students[0]. So yes, there seems a benefit of fluoride to children's teeth. Although, better dental hygiene can also do this, and on average cavities have trended down around the world (fluoride in water or not).

But that's not what the article is about.. is fluoride dangerous for humans to ingest? (also yes) So given there are more direct ways to get fluoride to teeth (toothpaste - somewhat, varnishes, lacquers or rinses - good), should we continue to cause damage to all in the name of helping young children's teeth?

https://cumming.ucalgary.ca/news/calgary-childrens-dental-he...

adolph• 5 years ago

https://www.wechu.org/reports/oral-health-2018-report

In the 2016/2017 school year, 18,179 children from 119 schools were screened for oral health issues. Between 2011/2012 to 2016/2017, the percentage of children with decay or requiring urgent care has increased by 51%.

This is a terrible statistic. Out of such an exact number of children and schools there is no numerator or denominator for the increase of 51%. I suppose a minimum number would be an increase from 100 to 151 and a max of 12,039 to all 18,179.

latchkey7• 5 years ago

Fluoride supplementation in water is less of a concern for me than chloramine. All my friends strongly defend the quality of Hetch Hetchy and I just don't get it. Fish can't even live in the water you're drinking. It affects plant growth too. We're showering in this stuff and vaporizing ammonia directly into our lungs.

SapporoChris• 5 years ago

Okay, are there any epidemiological studies indicating a problem with chloramine?

https://www.epa.gov/dwreginfo/chloramines-drinking-water Chloramines have been used by water utilities since the 1930s. More than one in five Americans uses drinking water treated with chloramines.

I need more than hyperbole before I get concerned.

latchkey7• 5 years ago

I don't think anything I said was hyperbole. Chloramine is ammonia and chlorine. You heat it up and vaporize it and it splits apart. That's basic chemistry. Ammonia is well-known to be an irritant. We are questioning the addition of fluoride, but not chloramine?

But to respond to you, well, that's the thing... there are very few studies. It is one of those things where they just say "trust us" and there isn't much data to back it up in either direction. There are some definite hyperbole websites that suggest it causes (or increases) IBS, which you can google, they come up first in the search results.

https://chloramine.org/ccacflier.htm

https://www.google.com/search?q=chloramine+ibs

https://www.wired.com/2016/02/chloramines/

I was living in San Francisco when they switched. I had two fish tanks and all the fish died immediately upon a water change. I ended up having to add neutralizer to the water. I was also commercially growing some plants in my basement and it definitely had an effect on them. Immediately stunted growth. I did a lot more research and found that chloramine is hard to filter out as well. You need higher quality carbon or RO systems. It doesn't just dissipate naturally like chlorine alone does.

If our plants and fish can't live in it... why would we want that anywhere near us?

jjoonathan3• 5 years ago

Fish can't even live in the water you're drinking. It affects plant growth too.

Yeah, that would be the point -- kill the nasties that otherwise get into the broken-ass pipe system, and kill them with something that our physiology is well prepared to handle but theirs is not.

I am sure there are some nature fetishists who prefer their water "raw." I do not.

latchkey7• 5 years ago

kill them with something that our physiology is well prepared to handle

Source?

cheeseomlit2• 5 years ago

So the article seems to imply that fluoride is effective when applied topically and need not be ingested. So isn't fluoride toothpaste enough? Does it really need to be added to the water supply? How many studies have been done on the effects of bathing, cooking, watering plants, ingestion by pets, etc. with fluoridated water?

One thing the article doesn't mention is where the fluoride is sourced from. Is it true that the fluoride that goes into the water supply is a waste product from fertilizer production? If this "waste" wasn't being put into the water how much would it cost fertilizer manufacturers to dispose of it? Is there some perverse incentive here?

https://www.cdc.gov/fluoridation/engineering/engineering-sho...

The three fluoride additives used for water fluoridation are derived principally from phosphate fertilizer production.

LeoPanthera2• 5 years ago

Most people don't leave toothpaste in contact with their teeth for long enough. My dentist recommends not rinsing after brushing, and just leaving the toothpaste in there.

(Fun aside: This is also the procedure on the ISS to avoid having to spit in zero gravity.)

cecilpl2• 5 years ago

My dentist recommends not rinsing after brushing, and just leaving the toothpaste in there

Is that not common practice? Just spit and you're done?

micromacrofoot• 5 years ago

So isn't fluoride toothpaste enough?

something like 25% of the population don't brush daily

debacle• 5 years ago

You can use a flouride rinse. Most kids with braces use a flouride rinse. I'm not sure how long you're supposed to use it for, I think it's 45 seconds twice a day.

davesmylie• 5 years ago

One problem with relying on toothpaste, is that for many children, the parents are not good at parenting and don't provide tooth brushes/ toothpaste or enforce regular tooth brushing

(and from experience, my teens/twenty somethings are somewhat hit and miss in this area as well since they moved out)

Putting it in the water supply ensures most people will at least get some fluoride.

One big problem not covered in the article, is this leads to fluorosis - my eldest has permanently stained teeth due to me not making him spit out his tooth paste after brushing when he was a toddler combined with the fluoride he was getting from town supply water.

veemjeem2• 5 years ago

Once we figure out how to repair the tooth enamel properly, there will be no need for fluoride in dental care. We're still relying on epoxies & other glues.

welder• 5 years ago

Trials begin on lozenge that rebuilds tooth enamel

https://news.ycombinator.com/item?id=27328663

ben7799• 5 years ago

I don't see in the article how they control for the IQ drop they think occurs (up to 5 points) being the same as the error margin for IQ tests (+/- 5 points).

How does that work.. ? It's not like IQ tests are considered that reliable or unbiased.

Also looking for studies.. they're observing the IQ drops in children who were exposed to excessive flouride beyond what's supposed to be in water. US levels all fall into the "low exposure" range in these studies.

mmastrac• 5 years ago

Hey, my hometown was mentioned. Calgary has been on and off again with Fluoride for decades and the evidence definitely shows an increase in caries when we don't add it.

AamosSinervo• 5 years ago

Maybe we should just stop putting gross amounts of sugar in everything. People have no problems getting rid of beef or meats. We should be able to get rid of some of our worst industries. Environmental case for this stuff is bad because of insane amount of chemicals necessary to grow unnattural (i.e. GMO) products. Those chemicals then run off and poison the environment. Then we need to add more chemicals, (i.e. flouride) to deal with consumption. Economically sugar/corn-syrup receive an enormous amount of subsidies. From a human rights perspective sugar farming is terrible (google Fanjuls to learn more). Obesity was the greatest risk factor besides age for COVID-19, so if as a society we can start mandating the jab, we can mandate some people don't get their "treats".

efirman4• 5 years ago

Tooth decay and the disease that comes with it is a multi-factorial disease - its not enough to simply eliminate "sugar" from the diet.

So, although I agree 100% that we need put systemic interventions to make those that promote a sugary diet accountable for the externalities they create, like hospitalizations, lower quality and length of life, lower incomes and educational attainment etc., We still need to focus on preventing cavities. Cavities are caused by all carbohydrates, including crackers, bread, etc. that have time on teeth allowing the bacteria that cause cavities to digest them and excrete acid on the tooth.

Eliminate enough risk factors and you will prevent the disease - in fact cavities are 100% preventable - with proper hygiene, enough fluoride, healthy diet and early prevention of the bacteria that spreads the disease from childcare provider to baby.

Booktrope• 5 years ago

One alternative to fluorine that has been shown clinically to be equally or more effective is nanohydroxyapatite, which was developed by NASA some time ago to treat astronauts for loss of tooth enamel and bone density. (Some background info here https://www.oralscience.com/en/ingredients/mhap/

The rights were sold to Japan where a leading toothpaste has for decades used nanohydroxyapatite rather than fluoride. The exclusive rights of the Japanese company have expired, so nanohydroxyapatite toothpaste is not also made in Canada and the US. It's more expensive than fluoride toothpaste but if you'd like to avoid these questions, might be worth it.

efirman4• 5 years ago

Fluoride works both topically and systemically to reduce tooth decay and is delivered through water, salt, milk, toothpaste, varnish, rinse depending on age, country of origin, income etc. For children ages 0-8 it is incorporated into the enamel of the teeth growing under the gums. After that, the mechanism is largely "topical" - however, that includes fluoride ions incorporated into the saliva and plaque in the process of ingesting it. Sipping water throughout the day bathes the teeth in fluoride each time and allows there to be a very small but impactful amount of fluoride in the mouth environment. This assists in the remineralizations of teeth enamel after acid attacks. The "topical vs. systemic" debate is a bit of a red herring. Its asking how does it work, not if it works. The evidence is clear that fluoridation does work to prevent tooth decay.https://fluorideexposed.org/fluoridescience/fluoride-mechani... additionally, a recent economic review of fluoridation found that the benefits in terms of reduced cavity rates and related dental costs outweigh the cost of implementing the strategy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171335/

The Fluoride Wars Rage On

Related Stories