The dose makes the poison

When I was growing up in East Tennessee in the 1960s, there was a local grocery chain owner and right-wing politician named Cas Walker who railed about, among other things, water fluoridation. Water fluoridation was alleged to be a communist plot. If so, then God must be a communist, since water in some parts of the country is naturally fluoridated. In fact, that natural fluoridation, and its correlation with lower incidence of tooth decay, helped lead to the widespread use of artificial fluoridation.

“The CDC maintains that community water fluoridation is not only safe and effective but also yields significant cost savings in dental treatment. Public health officials say removing fluoride could be particularly harmful to low-income families — for whom drinking water may be the only source of preventive dental care.

“If you have to go out and get care on your own, it’s a whole different ballgame,” said Myron Allukian Jr., DDS, MPH, a dentist and past president of the American Public Health Association. Millions of people have lived with fluoridated water for years, “and we’ve had no major health problems,” he said. “It’s much easier to prevent a disease than to treat it.”

Yes, fluoride can be poisonous in high doses. And baked goods contain acrylamide, which is a neurotoxin. Grilled meats contain a variety of carcinogens. Tylenol is hepatotoxic at high doses. Plastic containers used for beverages and canned goods leach bisphenols. As they say in pharmacology, the dose makes the poison.

Anti-fluoridation is making a comeback. It is true that fluoride is in toothpaste, and you can get fluoride treatments for your teeth (I had them as a kid), so maybe artificial fluoridation of drinking water is an anachronism. And yet:

“Juneau, Alaska, voted to remove fluoride from its drinking water in 2007. A study published in the journal BMC Oral Health in 2018 compared the dental records of children and adolescents who received dental care for decaying teeth 4 years before and 5 years after the city stopped adding fluoride to the water. Cavity-related procedures and treatment costs were significantly higher in the latter group, the study found.”

Look, access to clean, safe drinking water is a human right. It is already meaningfully imperiled by climate change. If you don’t want fluoride in your drinking water, there are alternatives (but note that some commercial bottled water is just overpriced tap water in plastic). In the political battle between folks who fear artificial fluoridation and those who embrace it as a public health measure, I don’t have an easy answer. But it ain’t a commie plot and there’s no evidence that people are being poisoned from it. The science I’ve read is most solid on the side of water fluoridation as a public health enhancement.

Fluoridation of water divides communities