Reframing the Fluoride Debate

This post was originally published on this site

For decades, the war over fluoridation has been going on. 

The war is sometimes hot, sometimes cold, but the hostility between the pro- and anti-fluoridation sides has never cooled down completely. In many ways, it mirrors the hostilities over vaccinations, but with an important twist: vaccines, to the extent that they are both safe and effective, protect not just the individual who gets vaccinated but have an external benefit to society as a whole by helping reduce the disease burden on others. 

If enough people get vaccinated (with, as I said, a safe and effective vaccine), herd immunity can develop to deadly diseases and, as in the case of smallpox, even get wiped out. 

I don’t want to get into the weeds arguing about the safety of individual vaccines or whether each of them is as effective as claimed–the debates over each of them aren’t the point of this piece. 

Fluoridation is nothing like vaccines in one crucial respect: my drinking fluoride has no health benefits to others or to society as a whole. Kids getting a smallpox vaccine might help create herd immunity, but kids being forced to drink fluoridated water doesn’t benefit anyone except that particular kid, assuming it doesn’t cause more harm than good. 

If you concede that this is the case–and it clearly is–then fluoridating water for everybody is a violation of the basic principles of public health. We give public health officials authority because, in some cases, individual choices can impose horrific costs on others. Allowing a person infected with a rare and deadly disease to roam around can harm or kill others, so we allow the radical step of quarantining people, for instance. 

By any measure, quarantines are hideous violations of our civil rights–akin to imprisoning people without trial and for committing no crime but being unlucky enough to catch a disease–but we accept the necessity because the alternative is allowing somebody to kill or maim others. We create an implicit exemption to our Constitutional rights because the alternative is something akin to societal suicide. 

Or, in the immortal phrase, “The Constitution is not a suicide pact.” We can argue endlessly about where to draw the line, but there IS a line. 

Fluoridation is nowhere near crossing that line. Fluoride is everywhere in our society. It’s hard to get toothpaste WITHOUT fluoride. A lot of mouthwashes have fluoride. Fluoride could be cheaply added to drinks if people wanted them. In fact, there is so much fluoride floating around in our food supply that some people get so much of it that it has negative impacts on their bones and teeth. 

Fluoride doesn’t even help your teeth through ingestion. Its benefits are entirely based on topical application. You get the benefit by swishing it around in your mouth, not by internal consumption. In fact, consumed fluoride weakens your bones and can be positively toxic. Fluorosis causes brittle bones, yellows your teeth, and has neurological impacts. That isn’t controversial in any medical circles. 

Zealots may deny it, but doctors and biologists don’t. According to the Mayo Clinic, 23% of AMERICANS have dental fluorosis. 

Fluoride is added to water to prevent tooth decay. Fine, whatever. Tooth decay is a bad thing. Americans don’t think about it much, but if left untreated, it can be a serious problem. 

But if somebody gets tooth decay solely because they refuse to rinse their mouth with fluoride (actually, fluoride is a minor benefit compared to brushing your teeth and flossing, but whatever), that is their problem, not yours. In a sane world, you don’t make people drink something because, without it, you think they will be harmed. Public health is about somebody preventing harm to OTHERS, not themselves. 

All the arguments about medical costs to society that are used to justify fluoridation are hand-waiving BS. If you want to reduce the overall disease burden in society through coercion, you could start by banning trans fats, preventing people from eating fast food, making people eat kale until their crap is green, banning alcohol and motorcycles, pools, limiting the speed limit to 5 miles per hour, and any number of other measures based on the principle that eliminating anything that imposes some minor cost burden on society can be regulated out of existence and any forced measure that lowers it is a positive good for society. 

But the reality of living in a free society is that all other things being equal, we value liberty over “societal benefit” almost always because an unfree society is much worse than people getting cavities or wiping out from driving their motorcycle unsafely. 

If we drop the argument about whether fluoride is beneficial to individuals or has some small impact on overall health care costs and just focus on what exactly we are doing–forcing people to ingest a product they don’t want to “for their own good,” the answer is clear: you really have no right to do that. 

Chance are your toothpaste has fluoride, and there is a 100% chance that your fluoride toothpaste is CHEAPER than the non-fluoridated one (compare yours to Toms of Maine!), so it’s no skin off your nose if fluoride is taken out of our water systems. The only reason most people support it being there is to “own” the people who object if they are honest with themselves. It is a culture war issue the elite won, and they will never back down. 

But if you look around the world, almost every rich country in the world has rejected fluoridation. Japan tried it and decided, “Nope,” and almost none of our peers fluoridate water. Here’s a partial list:

AustriaBelgium

Croatia

Cyprus

Denmark

Estonia

Finland

France

Germany

Greece

Hungary

Iceland

Ireland

Italy

Latvia

Lithuania

Luxembourg

Netherlands

Norway

Poland

Portugal

Romania

Slovakia

Slovenia

Spain

Sweden

Switzerland

United Kingdom (except for some areas in England and Wales)

Other Continents: 

Australia (except for some areas in Western Australia)

Canada (except for some areas in Ontario and British Columbia)

Japan

New Zealand (except for some areas in the South Island)

South Korea

Except the UK, none of these places is known as a hotbed of rotten teeth. And, for that matter, the English, who are famous for bad dental health (perhaps unfairly now), fluoridate their water. The vast majority of Europeans actively oppose fluoridation, and it is not a culture war issue there. 

Our battle over fluoridation is not about public health. It is a culture war issue, and one the elites won until RFK, Jr. got into his position. We will see a huge battle over this issue once again because Americans have been convinced that only conspiracy theorists oppose fluoridation. 

That is the result of propaganda, not reliance on science. It is no more true than believing that a man can become a woman. Even if most scientists believe that topical application of fluoride is a net benefit to dental health, not one seriously believes that ingestion does anything for your teeth because it doesn’t. They may hem and haw to evade that fact, but the science is clear. Fluoride may be relatively harmless when ingested in small quantities, but it is a natural poison, and in the US–again, according to the Mayo Clinic, nearly 25% of Americans are suffering at least some symptoms of fluoride poisoning. 

No doubt a bunch of people will attack me in the comments for being a conspiracy theorist, but I will bet you not one of them has read the science on the issue beyond the stage of “fluoride is good for you!” stage. But even that is beside the point. If you can’t answer how YOUR dental health is improved by somebody else not drinking fluoridated water, you simply have no right to make them. 

If you think you do, I probably have a list of YOUR lifestyle choices I don’t like.