The Ongoing Fluoride Controversy

 

I feel compelled to make a statement on municipal water fluoridation.  In the past couple of weeks, the news has had stories about the state of Utah banning water fluoridation and that was followed by a unanimous vote by the Lakeland, Florida City Council that has done the same thing.

I've tried to make this post as neutral as possible.  If anything here sounds argumentative, please understand that isn't what I'm trying to do.  I don't think arguing over something is the way to solve problems.  I'd much rather have a rational discussion and sometimes people need to respectfully agree to disagree.  I'm not trying to stand on a soapbox and shout my opinion.  I'm trying to be as factual about this and as middle of the road as I can.  If this post upsets anyone, I apologize.  That isn't my intent.  

Here's my take.  This is America, a country where we normally expect majority rule.  If a majority is opposed to something, we don't do it.  It's pretty simple.  That's apparently what has happened in Utah and Lakeland, Florida.  Personally I'm fine with that.  I have access to all the fluoride toothpaste and varnish that I need to keep my teeth healthy.

In fact, this is one of the few public health subjects that doesn't directly affect others.  Let me explain.  Opposition to vaccines has caused outbreaks of disease.  That can affect others.  No vaccine that I'm aware of is 100% effective.  There are rare instances of people contracting a disease they were vaccinated against.  However, if no one else has the disease, anyone's chance of catching it is pretty rare.  When lots of people are running around unvaccinated and shedding pathogens like my cat sheds fur, that's a problem... and it can affect others.

Fluoride isn't like that.  It really only affects one person... and that's the person who isn't receiving fluoridation.  It's especially true for children.  As children consume fluoridated water, it is passed into the permanent teeth developing in the jaws.  That uptake of fluoride means that the enamel develops stronger and when those teeth finally erupt into the mouth, the fluoride that has been deposited into their developing enamel makes that enamel less prone to decay.

What I want the lay public to understand is this: every decision has consequences.  There is an upside and a downside to everything.  By removing fluoride from drinking water, you are more or less trading a very unlikely outcome for a bad one.  Teeth that haven't developed with fluoride 'built into them' are much more prone to dental decay.  No fluoride in the enamel pretty much guarantees that your children are going to suffer more decay... not just in their primary (baby) teeth, but in their permanent teeth and that means it's a lifelong problem.  If you are comfortable with that decision (and the potential risk), then go ahead and remove fluoride nationwide.  However, just remember what you are asking for.  Your kids are going to grow into adults and throughout their life, they are going to have to deal with this decision.  Every parent I know wants their children to have a life that is better than their parents had.  This is going in exactly the opposite direction.  I know that some people have concerns, but I feel the science for safety is pretty convincing.

I always want people to know dentistry wanting fluoridation like is not some kind of a conspiracy.  In reality, no fluoride in the drinking water is going to make dentistry a lot busier and dentists will financially benefit from it.  The reason we, as a profession, are so pro fluoride is that we don't enjoy seeing people suffer with problems.  Dentists are busy enough.  We don't *need* to be busier.  There are enough dental problems right now to keep us busy.  Community water fluoridation has been touted as the most important public health measure in history and I don't know that I can argue against that.

So as longs as everyone understands the repercussions of this decision, I'm good either way.  What I don't want is a situation I heard in an old joke someone once told me about a cowboy.  The cowboy goes into the saloon and drinks an entire bottle of whiskey.  On his way home he takes off all his clothes and jumps on a cactus.  The next day, as the town doctor is pulling hundreds of thorns out of him he asks the cowboy, "What were you thinking?"  The cowboy replies, "Well it seemed like a great idea at the time."

What I want is for people to make an informed decision. I hope I've presented some good information here.