Fluoridation of water isn't the best grounds for arguing the US is backwards, given that it has hitherto been an outlier in how much fluoridation is happening [0]. Most of the developed world doesn't come close to the reach that the US has.
You can provide lots of stuff yourself if the state abandons the whole idea of public health. Of course, be prepared for your taxes and/or insurance going up to cover your neighbors who don't pay for the same preventative care.
Pretty much-was told by an insurance broker one of the biggest factors past history of weather and the obvious things (flooding possibility, dry trees) is my neighbors. Didn't get into specifics but I suspect drugs and gangs.
Those are based on countries with much higher levels of fluoride than the USA adds.
Follow up studies have found the levels in the USA to be perfectly safe and in fact beneficial since poor people don't get dental care like they do in other countries.
Please share study that shows it is safe in the US for children. The EPA allows up to 2mg/L in water and we have some evident that 1.5mg/L has negative effects on children.
HN Comments were very credulous before the election. Shows how flexible belief in science is.
It doesn't take much to observe that we've been fluoridating municipal water for over half a century and children are doing mostly fine. It's the actions of children's parents that contribute the most to their IQ losses.
I think the argument they make is fair. The levels that the US aims to have fluorinated water concentrations. If theres a bad actor county well thats on them not the standard thats set.
I didnt look too closely, but the concentration recommended by the FDA is much lower than many of the sample sets in that linked study. Some 10 times as much. One is a hundred times as much.
The second link showed a concentration as little 2x the US amount was impactful.
*The NTP monograph concluded, with moderate confidence, that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children. The NTP review was designed to evaluate total fluoride exposure from all sources and was not designed to evaluate the health effects of fluoridated drinking water alone. It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ.*
Fluoride is known to be problematic at high concentrations (hell, everything is). The problems of fluoride really start to come into play at concentrations of around 10-20mg/L, and some of the areas being studied are running well in excess of 100mg/L of fluoride.
The EPA limit for fluoride is 4mg/L. There's an argument to be made that it should be lowered to 2mg/L. When fluoride is added to drinking water, the target is around 0.9mg/L--no one's coming close to the EPA limit, and that exists because groundwater sources can end up being naturally high in fluoride. (I'm not sure what the typical natural occurrence of fluoride is in Utah, but I strongly suspect that they're not making any moves to actually remove fluoride from existing systems.)
Seems to cause problems at lower levels than that:
> The NTP monograph concluded, with moderate confidence, that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children.
Generally kids don't use toothpaste with fluoride because of the risk of swollowing it. Yes, we know it's bad in high doses, which is why kids toothpaste often doesn't have it. You have to wait until they are old enough to spit when brushing.
In reality what will happen is that rich kids will be just fine because they will get their fluoride treatments at the dentist every six months.
It's the poor kids who will suffer because they don't see the dentist regularly because it's expensive, so they won't get their treatments.
The recommendation from doctors is to use a small amount of toothpaste with fluoride. Apparently even if they cant spit yet. I was surprised to be told that, even though there are a ton of fluoride free toothpastes available.
You sound concerned about the kids. We are on the same side. There is evidence that fluoridation level is correlated (dose dependent) with sleep problems, lower IQ scores, early onset puberty and bone cancer in children. There are specific areas outside blood brain barrier that it accumulates to the degree of fluoridation (100x to 200x levels of other tissues), all postmortem tests verify this.
It is true that many studies were at higher doses(2x to 4x), but that should not mean that it is acceptable to intentionally raise fluoride levels to half of harmful levels, because we want to protect teeth.
If you don't want cavities decrease sucrose, brush and floss. Can I brush my teeth with use baking soda, use whatever? Arent they are OUR teeth? What if we find some additive might help some other health issue? Should we add that to everyone's drinking water?
Afaik these findings primarily involve populations exposed to fluoride levels above 1.5 mg/L, which is higher than the 0.7 mg/L recommended for U.S. water supplies. There is insufficient evidence to conclude that fluoride at recommended levels negatively impacts IQ.
At safe levels fluoridation is a public health measure akin to fortifying foods with vitamins (e.g., iodine in salt or folic acid in flour something we do all the time).
Honestly 1.5mg is not that different than 0.7mg..is there some reason to believe a 2X factor makes a big deal? I was expecting to hear of 10x differences or something, but 2x is not much of a factor in these kind of gradient effects.
1.5mg is literally twice the recommended limit. I don't really understand the logic in saying 2x overdosed is negligible. If you consistently eat 2x your daily calories you'll see the results fast. If you drink twice what you can handle, it would be bad. Etc
Toxicity testing is often carried out on mice, up to the dosage required for any observable effect. From that safe levels for humans are derived, e.g. the NOAEL (No Observed Adverse Effect Level).
To say that a study done in humans, got observable effects at only twice the intended dose (who knows what the s.d. of the dose is, but anyway) and we conclude there's simply not enough evidence?
Many chemicals have been banned on the basis of far less evidence.
Well, we don’t have that many things that can be added to water and have health benefits with basically no downside. Fluoride is one of the few things where it makes sense to do this. (If you are willing to broaden your horizons, you can buy things like iodized salt or golden rice to get the benefits of those. But food, alas, is not a government service.)
> Should we add that to everyone's drinking water?
Consider the following: Many water sources have a ton of salts and such in them naturally. Fluoride being one of them. The reason why water fluoridation became a thing in the first place is because it was noticed that higher natural levels of fluoridation resulted in fewer caries.
Water treatment in order to make it safe to drink often involves processes that remove and filter out these minerals and chemicals. Which means said things need to be added back in, as part of the treatment process.
Kids until which age? Ime somewhere between 4-5 seem to be perfectly able to spit their toothpaste without swallowing. Guidelines in the EU typically suggest normally fluoride toothpaste in increasing amounts after 4.
Also, fluoride helps with remineralisation when it is used pretty much regularly, not once per 6 months. Fluoride treatments once per 6 months are not gonna bring back the enamel lost.
I do not understand what is the big deal here. In many countries there are specific recommendations wrt to fluoride and kids brushing their teeth that seem to work fine. This seems to be a solved issue in many places in the world without fluoridating water.
There is a such thing as baby teeth. Presumably most children learn to brush properly while they still have them. If they do something wrong, they get a second chance when their adult teeth replace them. Why does this even need to be explained?
As for “fluoride treatments”, those are applied to the teeth, not drank. They are not a substitute for regular brushing.
There isn’t any. The very little research showing any effects on cognitive abilities are experiments using very high fluoride levels - nowhere near the levels in water. Like most conservative “stances”, it’s a farce.
> Is there scope to believe they just think it may be better not to have it in the water?
Are you asking if there's room to believe it's just a sincere "everything you eat or drink should stay untouched, like it's found in nature" belief? OK sure, let's go with that. So why aren't they working to dismantle water treatment plants altogether and e.g. fighting against modern industrial farming practices in that case?
> No, I’m asking if it’s possible they might just rightly or wrongly believe water fluoridation is bad.
I'm happy to believe it if I can understand what is leading them to that belief, which is exactly what I'm asking. Is it a general aversion to unnatural stuff (hence my previous comment) or based on some evidence (hence my initial question) or something else (what?)?
> I believe they think water fluoridation is linked it lower IQs, again, rightly or wrongly. I could be mistaken but that’s always seemed pretty clear.
Again, we go back to my initial question [1]: what is the best evidence in favor of this?
By default, we should not add anything to the water.
The burden of proof should be on the people who want to add it. Because that is extra cost, extra chemical. If they can't prove it, then we don't do it.
> However, in 1973, the Dutch Supreme Court ruled that there was no legal basis for fluoridation…. The debate hasn’t been meaningfully revived since then, Hofman told Euronews Health. "People started to say, ‘Well, the government should not give us some medicine [when] we cannot choose where to buy our drinking water from," she said.
That’s the “little c” conservative viewpoint. You don’t need to prove it’s harmful. The default should be not putting chemicals in everyone’s drinking water.
but youre taking chemicals out right? and lots of water has natural flouride?
there is definitely an argument for an optimal amount of minerals in water being non zero (not only because having it that clean would be practically expensive) but also because we benefit from natural minerals. now if some natural water source isnt as good as another one, why not correct it? we have the technology.
especially at the community level. the little c stance should be to let communities decide, not ban it from the top down.
im not saying they are putting too much in. im saying natural water is already fluorinated in many places and doesnt need supplementation. so to treat fluorinful water as unnatural is disingenuous.
You are assuming they are just randomly flouridating water without measuring for target levels. I don't even know if you are thinking this through clearly as if they are just randomly dumping flouride into water supplies without measuring against specific targets.
Because if adding fluoride to water isn't additionally preventative beyond the use of toothpaste, then adding the fluoride to the public water system is just wasting public funds.
How do you prove no effect on any bodily system long term? People don’t like to talk about it, or they pretend otherwise, but this is basically impossible.
If the benefit is great enough then the risk makes sense. That is the case in a lot of areas. Is it worth taking a risk of an unknown effect somewhere in the body in exchange for… a marked but not even drastic reduction in cavities…? Not sure…
The bitch about scientific studies is you can’t find what you don’t know to look for. That has to be part of the trade off calculus when deciding what substances to introduce to our internal environment.
Okay? You can still come up with a correlation between net fluoride mass of bones and teeth and negative health traits or outcomes. You can also compare occupational exposure against normal exposure, no drinking water exposure (lived life in country without this policy), etc. There are many different types of scientific studies.
I am much less confident than you appear to be that we are able to detect a significant percentage of negative health traits.
Let’s say that hypothetically there is a 3rd order effect on the excretion pattern of some neurotransmitter. Can we detect that? Could it negatively affect mood regulation? There are a million things like that.
I guess the question is why your priors are so far weighted to the side of negative outcomes. If we're talking about yet undiscovered effects of something it seems equally plausible for those effects to be positive. Aspirin is a pretty good example of this where we keep discovering more positive effects. And I can understand somewhat the bias toward the state of nature but there's lots of examples where our deviations were positive, the biggest one being the cognitive effects of cooking food.
> If we're talking about yet undiscovered effects of something it seems equally plausible for those effects to be positive.
Where do you get this from? If you ingest a random chemical (or imagine licking random objects...), do you really expect the chances of it being beneficial vs. detrimental to your health to be remotely close to 50/50?
> The bitch about scientific studies is you can’t find what you don’t know to look for.
This is only true if you assume that all effects are too small to notice. If you run an experiment on adding fluoride to water, declare an interest in enamel thickness, and then observe that 30% of the experimental group died within six months, you just made a finding that you didn't know you should have been looking for.
> The fractional retention or balance of fluoride at any age depends on the quantitative features of absorption and excretion. For healthy, young, or middle-aged adults, approximately 50 percent of absorbed fluoride is retained by uptake in calcified tissues, and 50 percent is excreted in the urine. For young children, as much as 80 percent can be retained owing to increased uptake by the developing skeleton and teeth (Ekstrand et al., 1994a, b). Such data are not available for persons in the later years of life, but based on bone mineral dynamics, it is likely that the fraction excreted is greater than the fraction retained.
> .9 Radiographic detection of teeth and skeletal changes and microscopic examination of affected bone are helpful adjunct procedures for diagnosis.
> Histopathologic and radiographic examination of bones detects bone lesions and tentatively confirms osteofluorosis.14,26 Biopsy or rib or coccygeal vertebrae is used to obtain samples for skeletal fluoride analysis.23
> We have developed a localized noninvasive nuclear magnetic resonance (NMR) method for determining the accumulated bone fluoride content in human index fingers
I'd like to point out that fluoride was previously very much a liberal stance until the rise in MAGA/Qanon conservatives.
I grew up in the PNW of the USA and lots of small hippie towns have been removing fluoride for decades. It comes up on city ballots every year in Oregon.
When it comes to things like radioactivity we assume a linear no threshhold model (e.g. that lower concentrations still have effects, just our measuring tools aren't good enough to detect it) and spend billions as a result. Why wouldn't we do the same for flouride?
How did you compile this list? Asking some LLM service?
From the first link:
> It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ
Regardless of where they got the list (edit: which I do think is a fair question)...
> the first link [...] doesn't seem in favor of this?
To me that falls under "the best evidence [available] in favor of this." It's not great, but it's not nothing; it's certainly something in favor. After all.. I guess I don't know about you, but I feel like if someone told me dose X of something is toxic, I would not feel comfortable feeding myself and the entire country 50% of that dose, on that basis alone.
Why does it matter how the list was compiled? Is the information accurate or not? The first link you referenced with the cherry picked sentence about uncertainty for levels below .7mg/l was a meta analysis of 74 different studies, 64 of which showed a negative correlation between child IQ and fluoridation. This isn’t even taking into account evidence of a positive correlation for early onset puberty, sleep disruption and bone cancer with fluoridation.
It matters when you say it has the "most convincing" evidence as if you have read them all and are keeping up with the field and didn't just summarize them with some service like https://consensus.app/
I don't know if what you are repeating is slop, etc. I can't trust the source.
A single recent systematic review is more trustworthy than that.
Okay, well, let me know how you came up with the list?
Also, nothing in that list of papers supports your initial claim? I know you'll say you didn't claim anything, so I will say also, that nothing in those links provides for what the prior commenter asked for evidence for.
Other than, fluoride consumption at high concentrations is bad (which is something that was already agreed upon, and is not being questioned in this thread)?
It matters because your statement of "Here’s a list of the most convincing studies or meta analyses." assumes some kind of curating. If all you're doing is providing something akin to a google search, it's not really valuable.
So what? Asking “What is the best evidence in favor of this” is equivalent to saying I don’t want to google this, so google this for me. Literally all researchers at all levels in all fields use google for this stuff. I was in academia for years.
Put simply, it's a wall of links. No quotes. No claims. Its valid to ask if the person posting the links has actually read those articles, or if there is a primary source recommending them. (Or no source if it's LLM copypasta.)
It was a direct response to a question with the answer they were looking for. It was provided in good faith, previously researched and sourced by me within the last 12 months.
I am the OP and someone asked for evidence and the only answer after an hour, falsely stated there was no evidence. I didn't want to challenge anyone directly so I posted what I thought were the top few more convincing links I have compiled out of 30+.
I am disappointed that I am getting downvoted and this is somehow being made into something political when people deserve to see the evidence for and against supplementing fluoride the drinking water of every living thing because the government wants to improve the health of our teeth. It is a fair question to ask.
The main problem with your wall of links from a professional medical PoV is it utterly lacks any context.
The very famous meta studies with all the negative correlations get all the bad associations with flouride from regions where water naturally has extremely high (relative to most other parts of the world) levels of fluoride in addition to high levels of many other uncommon concentrations.
Some of these regions also have additional problems with industry waste.
Put simply, negative correlations about unattended children in swimming pools cannot be extrapolated to infer negative correlations about young children and sippy cups of water.
It’s basically coping responses from people who are starting to realize they have been loudly wrong for years. It’s a fairly human response I suppose. They’ll get over it eventually after they go through the stages of grief or whatever.
No? What is a coping response? I asked the commenter to provide context to their links that supposedly show evidence for what the initial question was (does fluoride at the concentrations in drinking water cause harm), which they definitely do not show evidence for.
> You are basically putting your head in the sand and goading at people to drag it out for you
Nah. I pretty much agree with what Utah is doing here (though I’d prefer just not mandating it and making the decision as local as it needs to be). OP’s link list looks AI generated. That’s just not a good-faith comment.
You need to stop attacking people on HN. It's not permitted here. You are free to disagree with their statements and positions, but making character judgments like this is not OK.
> I am disappointed that I am getting downvoted and this is somehow being made into something political when people deserve to see the evidence
I didn’t downvote. (I don’t think.) But as a non-expert, I also didn’t see value in a wall of links. (Particularly when you wouldn’t confirm it wasn’t AI generated.)
A better presentation would pull quotes or make an argument, in your voice, with the citations as scaffolding for your arguments.
To illustrate the issue, I believe I could construct a context-free wall of links justifying just about anything.
Honestly, I think people downvoted it because it sounded a lot like LLM output.
If you could explain the process that led to the production of the list & what led you to the belief that those are the best studies/evidence so far, that would probably help people view it more favorably.
> Asking “What is the best evidence in favor of this” is equivalent to saying I don’t want to google this, so google this for me.
Perhaps I should note that I had indeed (believe it or not) already Googled this before asking the question. I asked not because I was too lazy to search but because I didn't know if my search was turning up the best studies from anyone's perspective.
So, no, this wasn't equivalent to saying "I don’t want to google this, so google this for me."
Yeah finding some random links through google that one does not go through to -to some degree- verify/vouch for is identically bad practice. Researchers do not cite studies that just happen to come up in their google searches, they actually try to assess the quality of the research, understand the methods/results etc. Nothing like this happened here. Giving such a wall of links as an argument to a discussion without checking their quality or relevance is more akin to trolling behaviour than academic research.
Actual reseachers don't really talk about links to IQ. The main concern is actually around dental fluorosis. Too much flouride can replace minerals in your teeth causing them to become brittle over time
There's a subset of researchers that argue that now that fluoride toothpaste is widespread, the benefit of fluoridating water is much much smaller than it first was and the (small) risk of fluorosis is now comparatively more significant
Where "main concern" means not a practical concern at all. You are adopting the talking points of cranks when what is of actual concern is things like drinking sugar, negligent parents or basic access to dental healthcare or even just dental education.
The CDC tracks some key indicators like mean decayed, missing or filled teeth (DMFT) and in critical age groups like 12-15 there has been no progress made in the past 20 years and the US continue lagging behind European countries: https://www.cdc.gov/oral-health/media/pdfs/Oral-Health-Surve...
And none of that has anything to do with fluoride in the water or not.
“ Actual reseachers don't really talk about links to IQ.”
Sorry but this reddit consensus is out of step with actual researchers. The #1 paediatric journal has published quite a bit on this recently. Basically the evidence isn’t of high quality but what we have doesn’t look great.
Another question is whether there's still evidence for continuing to fluoridate water with how common toothpaste use is now. If nothing else, if it isn't providing benefits over toothpaste use, then fluoridating water could just be a waste of public funds.
Highly recommend visiting the link for details about each point an references (it is not that long), here is a summary, don't comment if you haven't visited the link:
1) Fluoride is the only chemical added to water for the purpose of medical treatment.
2) Fluoridation is unethical.
3) The dose cannot be controlled.
4) The fluoride goes to everyone regardless of age, health or vulnerability.
5) People now receive fluoride from many other sources besides water.
6) Fluoride is not an essential nutrient.
7) The level in mothers’ milk is very low.
9) No health agency in fluoridated countries is monitoring fluoride exposure or side effects.
10) There has never been a single randomized controlled trial to demonstrate fluoridation’s effectiveness or safety.
11) Benefit is topical not systemic.
12) Fluoridation is not necessary.
13) Fluoridation’s role in the decline of tooth decay is in serious doubt.
14) NIH-funded study on individual fluoride ingestion and tooth decay found no significant correlation.
15) Tooth decay is high in low-income communities that have been fluoridated for years.
16) Tooth decay does not go up when fluoridation is stopped.
17) Tooth decay was coming down before fluoridation started.
18) The studies that launched fluoridation were methodologically flawed.
19) Children are being over-exposed to fluoride.
20) The highest doses of fluoride are going to bottle-fed babies.
21) Dental fluorosis may be an indicator of wider systemic damage.
22) Fluoride may damage the brain.
23) Fluoride may lower IQ.
24) Fluoride may cause non-IQ neurotoxic effects.
25) Fluoride affects the pineal gland.
26) Fluoride affects thyroid function.
27) Fluoride causes arthritic symptoms.
28) Fluoride damages bone.
29) Fluoride may increase hip fractures in the elderly.
30) People with impaired kidney function are particularly vulnerable to bone damage.
31) Fluoride may cause bone cancer (osteosarcoma).
32) Proponents have failed to refute the Bassin-Osteosarcoma study.
33) Fluoride may cause reproductive problems.
34) Some individuals are highly sensitive to low levels of fluoride as shown by case studies and double blind studies.
35) Other subsets of population are more vulnerable to fluoride’s toxicity.
36) There is no margin of safety for several health effects.
37) Low-income families penalized by fluoridation.
38) Black and Hispanic children are more vulnerable to fluoride’s toxicity.
39) Minorities are not being warned about their vulnerabilities to fluoride.
40) Tooth decay reflects low-income not low-fluoride intake.
41) The chemicals used to fluoridate water are not pharmaceutical grade.
42) The silicon fluorides have not been tested comprehensively.
43) The silicon fluorides may increase lead uptake into children’s blood.
44) Fluoride may leach lead from pipes, brass fittings and soldered joints.
45) Key health studies have not been done.
46) Endorsements do not represent scientific evidence.
47) Review panels hand-picked to deliver a pro-fluoridation result.
48) Many scientists oppose fluoridation.
49) Proponents usually refuse to defend fluoridation in open debate.
50) Proponents use very dubious tactics to promote fluoridation.
Way past time. The link between fluoride ingestion by children and pregnant women to lower IQ in children has been known for years. It's incredible how the scientific community in the US is so ignorant of this fact.
Also, dentists have no neuroscience background! So let's take recommendations by dentists to ingest a neurotoxin with deep deep skepticism, shall we?
A low dose of this neurotoxin can still have smaller adverse effects on IQ, and in all likelihood do, especially for fetuses and small children. Lots of countries have banned fluoridation of the water supply. The US has one of the highest fluoride levels in the water supply. The default should be to not add neurotoxins into the water supply (I cannot believe I have to actually say this).
If that were true, nearly the entire state of California would have developmental issues.
Anyway, lots of things in this world that are bad for people in high doses are beneficial in smaller doses. Water is a great example, as are salt and sugar.
This logic is so flawed. We. know the biological mechanisms in the body that makes use of salt and sugar. And we know both are safe in relatively large amounts too.
With fluoride, relatively small amounts in the drinking water is known to cause lower IQ.
But somehow even smaller amounts are safer?
Do you just not see the problem here or are you purposely blinding yourself to the reality because of your political biases? Is it an unconscious thing for you?
You are simply not being rational. You are making excuses and excuses for holding a belief you have had and probably defended for years. And now you are too invested to left the belief go. Just let it go already.
Badgering people isn't an effective persuasive technique. If you want to convince people that you are right, support your argument with evidence and data.
> We know the biological mechanisms in the body that makes use of salt and sugar.
Yes, that's how nature works. Take a look at some typical prescription pharmaceutical doses sometime; many of them are awfully small. Like micrograms per kilogram.
The other thing to consider is that in life we balance risks and benefits with the aim of achieving a net positive. Most things that are good have some risks, and many things that are bad have some benefits. We know the benefit of water fluoridation, and the value to society is large. Meanwhile, we suspect there is a possible drawback of water fluoridation, though there is not a lot of data, and the risk is small at the amounts added to municipal water supplies. Nobody has been able to characterize the offsetting loss to any degree of certainty, so we cannot effectively recalculate the cost/benefit analysis.
The problem is that people have been characterizing the offsetting loss for decades while people blinded by political biases refuse to admit the evidence, however clear it is.
To a degree, it becomes impossible for them on a subconscious level because of the social costs involved.
This is a mass psychology problem, not a scientific evidence problem.
I would encourage you to speak with subject matter experts if you truly believe that this is a mass psychology problem.
It's too convenient to discount people who disagree with you as being "politically biased" and "blinded." A better explanation is that they observed the same input you do and concluded the benefit is still worth the risk.
And if it turns out that millions of Americans became stupid because of fluoride and not, say, bad parenting, phone addiction, and manipulative media, I won't be too proud to admit you were right.
The relationship appears to be linear down to zero, but it’s very hard to study near those levels. From what I’ve seen, the best current science is that the fluoridation levels in typical western countries are reducing average IQ by about 0.5-1.5 points.
For reference, adding lead to fuel was far, far worse.
I suspect it is hard to control for confounding correlations - specifically I would guess it is more likely that poorer areas are flouridated. HV electric power lines and nuclear stations have the issue that poorer people are more likely to live next to those, and poorer people have have worse health outcomes so it falsely appears that both of those cause the health problems.
> Republican state lawmaker Stephanie Gricius - who introduced the bill in the state legislature - has argued that there is research suggesting fluoride could have possible cognitive effects in children.
It's kind of amazing to say something like that then be so inconsistent on things that will have real outcomes that make life better for kids. They're all for cutting school support and social services.
Fun anecdote: Utah's Republicans actually rejected the MAGA candidates in the Republican primary for both Senator and Governer by a wide margin, despite the MAGA candidates having Trump's endorsement. If nothing else, Utah doesn't vote MAGA-or-bust like some other states have been.
Utah and Massachusetts are basically the steel-man versions of their respective ideologies. But Utah doesn’t have the benefit of Harvard and MIT, major Pharma companies, etc. It’s surrounded by desert and has no natural resources to speak of.
A lot of that is due to the Mormons. While they tend to vote Republican, they are some of the biggest socialists out there. They believe in giving 10% of their income to the church (and enforce it!).
Then they redistribute to their poorest members in the form of free private education at all pre-college levels and highly subsidized college as well. And with food banks, free or subsidized medical services, and whole bunch of other things the government doesn't provide.
They've essentially traded one government for another, but theirs requires belief in their religion and only applies to their believers (who happen to concentrate in Utah).
> [The Mormons] believe in giving 10% of their income
Is that income before tax or after tax?
"After tax" seems like it should be obvious, but then wouldn't that require tax specialists to decide how to deal with tax exceptions (retirement taxation incentives, donations, etcetera).
If the 10% donation is tax deductible, doesn't that require some mathematics to work out the 10%?
Irrelevant aside: I think the efficient altruist 10% is "We're often asked how exactly to calculate income — should it be pre-tax or post-tax? Generally, we recommend choosing the option that makes most sense to you, though we think it makes sense to choose pre-tax if your donations are tax-deductible (for example, GiftAid counts towards your Pledge!) and post-tax if they're not.". https://www.givingwhatwecan.org/pledge
I'm not Mormon, so I don't know for sure, but what I hear from people are or were Mormon, the enforcement is a combination of social pressure and the Church demanding you provide them with a copy of your taxes to remain a member. I assume it's pretty loose from there.
I can't speak to how enforcement was in the past (I haven't researched it enough to say), but the way it currently stands is there is a yearly "tithing settlement". No tax documents are requested, all that our church has is the amount I donate. The bishop asks if I'm a full tithe payer, and accepts my answer.
Social pressure perhaps? But at least where I've been it's appeal to morality as taught in our canon.
Membership is not rescinded for not paying tithing, but a temple recommend requires being a full tithe payer (as reported by me).
Not that I know of? I double-checked the handbook and there's nothing in there that mentions requesting tax forms, so it's certainly not official policy and if it did happen it should be reported. (We're very bureaucratic, lol)
The only tax form I can think of is a form they send me so I can deduct it from taxes (as it's legally a tax-deductible donation).
EDIT: Section 34.4, 34.5.2, and 34.5.6 are applicable.
34.4:
> Confidentiality of Tithing and Other Offerings
> The amount of tithing and other offerings paid by a donor is confidential. Only the bishop and those who are authorized to handle or view these contributions should have access to this information. Stake presidencies, bishoprics, and clerks should never inappropriately discuss a member’s tithing status. Nor should they discuss the total amount of tithing or other offerings received.
34.5.2:
> Receiving Tithing and Other Offerings
> The Lord has given bishops the sacred trust of receiving and accounting for the tithes and other offerings of the Saints (see Doctrine and Covenants 42:30–33; 119). Only the bishop and his counselors may receive tithes and other offerings. Under no circumstances should their wives, other members of their families, clerks, or other ward members receive these contributions. The only exception is when Aaronic Priesthood holders are assigned to collect fast offerings (see 34.3.2).
> Church leaders and members should not leave donations unattended.
34.5.6:
> Donation Statements
> Donor Statements of Contributions are available to all members at donations.ChurchofJesusChrist.org. Leaders should encourage members to regularly review their donor statements. Where applicable, official tax statements are also available at donations.ChurchofJesusChrist.org, from the local unit, or from the area office.
No. I've been a member all my life in several U.S. states and internationally, and I've also been a volunteer finance clerk at church for many years. I've never been asked for tax forms, or even heard of anyone being asked for tax forms. It's not a thing.
Also, there's no prescriptive guidance on pre-tax vs. post-tax, or how to handle many edge cases, such as capital gains, tax deductions, etc. The church's stance is that it's between you and God to figure out how to apply the "pay 10%" guidance.
“...the simplest statement we know of is that statement of the Lord himself that the members of the Church should pay one-tenth of all their interest annually, which is understood to mean income. No one is justified in making any other statement than this. We feel that every member of the Church should be entitled to make his own decision as to what he thinks he owes the Lord, and to make payment accordingly.”
The quote you provide is grossly misleading, as that isn’t what tithing meant in the early days of the church. The church just says “which is understood to mean income” so causally that it’s essentially a lie. They say that to get more money. They hold peoples salvation at gun point to make sure it gets paid. And then they use their wealth and influence to drive state policy. It’s all very gross.
Not quite following your point? What about that is a lie?
At the beginning of The Church of Jesus Christ, saints were asked to consecrate all that they had to the bishop. Legally they signed away all rights to their property and the bishop leased it back to them.
They found that that wasn't sustainable (due to debts and disputes) and switched to 10% of interest (see Section 119 in D&C, https://www.churchofjesuschrist.org/study/scriptures/dc-test...). While tithing was paid in the past with animals, food, etc, that just doesn't scale beyond local communities.
Yes, our church does use funds for advocacy, but it's hard to ascribe pure malice to a church that spends $1 billion annually on humanitarian aid every year, and is expanding affordable education to tens of thousands of people in developing countries.
Not all of us agree with how much money is being held in reserve, but it's important to understand that we don't have a testimony in the church because of what we get from it, or even agree with all policies, but rather because of a personal witness of its truth. It is true that some stay in our church because of social pressure, and I'm not going to defend that practice. But, that's not what our core doctrine teaches.
I understand that it's easy to think that we are all a homogenous group that all thinks the same, but peek under the surface and you'll find many of us who find the core doctrine so compelling that we are willing to stick with the church and to enact change in constructive instead of destructive ways.
Bing says as of 2023, the church's net worth is estimated to be around $265 billion which would be income of $16 billion (assuming a conservative 6% annual ROI). I'm unsure how correct those numbers are since the article says (US$15.7b land and US$100b investment fund).
The Mormon church earns $7 billion a year from tithing. Even if humanistic aid were $1 billion - it is a relatively poor percentage.
Let's consider healthcare to be humanitarian aid (yeah, obviously not external). Governments spend 30% of taxes on healthcare, and people pay 30% in taxes so we might estimate that people are paying appromx 10% on humanitarian aid via their government. Although perhaps that is just a form of insurance you've paid in and you get paid out. I'm unsure of the statistics but my guess is that most people pay a lot in and get a little out due to skewed distribution of sickness costs. With health insurance the best deal is to never get sick and never claim (and your premiums help the poor bastards that do get sick - the best outcome a society could hope for). Note that health insurance in New Zealand is wildly different from the US model.
I've had a little experience watching how the Mormon church acts in Samoa which is definitely not a wealthy country. I would be interested to know how much of that humanitarian aid was paid for by countries that needed the humanitarian aid? The equivalent to paying in and getting paid out (with the church claiming doing good with the paying out, but not talking about what it keeps).
I'm a little cynical that there's some dissimulation by the LDS church - they are not well known for frank openness.
Hi! Yes, I believe that is correct for 2015. It's been fairly recent that the amount spent has ramped up a lot[1].
A lot of money also goes towards subsidizing education (All the BYUs, including the online classes that are targeted towards developing countries), building churches and temples, supporting local congregation budgets, and supporting church members who are financially insecure (I'm not sure if they counted that last part in the 2024 summary though).
> I've had a little experience watching how the Mormon church acts in Samoa which is definitely not a wealthy country.
> I'm a little cynical that there's some dissimulation by the LDS church - they are not well known for frank openness.
Yeah, it would be nice if they were more transparent here. I understand the legal reasoning--essentially security by obscurity--but it's frustrating to only get peeks and glimpses. I don't blame you for some healthy cynicism.
There are endless debates about gross vs net and as with many things in the CoJCoLDS it is left up to the members to decide/define and to self-certify their compliance. Welfare programs are financed via a separate donation program via a monthly fast where the skipped meals expenses are donated to the program.
It’s up to personal interpretation. Some do before tax, some do after. Some only pay tithing on their regular income (i.e. from a normal job) but not on “already tithed” income (e.g. birthday money from parents), while others do it differently.
The church’s stance is that they say you should pay 10% tithing on your income. They don’t define income. And all they do is ask “do you pay a full tithe?” And it’s up to you to decide if you do or not based on how you view what “income” means.
That’s the steel-man version of (american) conservatism: civic institutions provide the safety net instead of the government.
And in terms of aggregate outcomes, Utah’s results are impressive. The LDS apparently does a better job teaching kids to read than the government here in Maryland.
Utah has less money to start with, though. It doesn’t have big industries or things like that. Median income is $40,000 versus about $50,000 in Maryland and Massachusetts.
Yeah, but extremely regressive views on equality and women's rights come along with it....
You can get a lot done when you establish regressive control structures for enforcement. Generally speaking, most people usually don't want that trade-off.
> and only applies to their believers (who happen to concentrate in Utah)
Worth noting here that the church additionally spends north of $1 billion annually on humanitarian aid across the globe [1] (separate from the redistributions to the poor mentioned by OP). Aid is provided independent of religious affiliation.
Al Capone ran soup kitchens. He seemed like a good dude. What percentage of their global wealth is $1 billion? I wish I knew but for some reason they keep that a secret. And don't leave or they'll expect your family to cut you off.
*: searches suggest the wealth of the church to be around $265 billion. So their members give 10% annually to the church and the church gives less than 0.5% of their total wealth to the poor (but mostly to other Mormons or prospective converts). If you're wondering why they keep this massive horde of wealth, it's because they think it'll be needed for the apocalypse. Yes, it's for the apocalypse.
Calling Mormons socialist is inaccurate. Socialism is government-forced redistribution of wealth. A large majority of Mormons, at least in Utah, are very much opposed to that. You are correct that a large majority of Mormons voluntarily share their wealth with the poor and needy.
You are incorrect saying that you have to be a member of The Church of Jesus Christ of Latter-day Saints (the actual name of the "Mormon church") to receive these benefits. In some cases there will be conditions, like if you want to attend one of the church universities you will need to promise to abstain from alcohol (one example), but becoming a baptized member of the church is not required
I would say it's very accurate. They are forced to share their wealth to get into the Kingdom of God. The only choice they have is to not go to heaven. I'd say that's being forced, just by a different power.
> but becoming a baptized member of the church is not required
You don't get the BYU discount unless you're baptized.
I think you are missing the key element, that socialism isnt just a structure or institution, but a government policy and applied to all people within a society.
It is neither optional or excludable.
This is why the monopoly man choosing to share caviar with his family or paying dues to a yacht club does not make them a socialist. The monopoly man retains full agency over who they share with.
That's pretty different than getting arrested and thrown in jail by government thugs for not paying up, whether you believe in the cause or not, but ok?
Even the non-member BYU tuition is subsidized and a much lower price than other comparable colleges. But really, BYU is not the best example of Mormon charity, it can only accommodate a limited number of students.
Note that while this may be first state to ban fluoride, it's not the first state to not have fluoride in the water. That would be Hawaii (effectively).
Hawaii does not add fluoride to their water. Utah may be the first to out-right ban it, but there are quite a few local communities and cities that opt-out of adding it to their drinking water.
The US is, according to Wikipedia, among a small minority of countries in which a majority of people drink fluoridated water. Various European countries have discontinued doing so. <https://en.wikipedia.org/wiki/Water_fluoridation>
Yeah, this is one of those places where because RFK Jr took the anti- stand there's an understandable assumption that it's more nutty anti-science stuff, but it's much less clear cut when it comes to fluoridation. Europe has much lower rates than the US, which is an outlier on these stats only approached by Australia, and before Utah the major high profile anti-fluoride stance was made by Portland:
Using certain family members as a personal rubric, fluoridated water has been a right-left issue for at least 2.5 decades. I think it’s been pretty polarized for longer, though it may have taken a long time to gain steam in mainstream “discourse”.
I'm not sure you can use personal anecdotes to come to any conclusions about broad trends. To look at some actual data, I took the 2008 and 2024 election results and compared them with fluoridation rates. The split is pretty even:
The top 10 most fluoridated states went 5/5 Rep/Dem in 2008 and 6/4 Rep/Dem in 2024. These were Kentucky, Minnesota, Illinois, North Dakota, Virginia, Georgia, South Dakota, Maryland, Ohio, and South Carolina. Hardly a blue wall.
The bottom 10 least fluoridated states with 6/4 Rep/Dem in 2008 and 6/4 Rep/Dem in 2024. These were Hawaii, New Jersey, Oregon, Idaho, Montana, Louisiana, Alaska, Utah, New Hampshire, and Mississippi. Hardly a red wall.
The bottom three least fluoridated states are all hardcore blue: Hawaii, New Jersey, and Oregon.
I just don't see any evidence here that this has been a left-right polarized issue until this year. The distribution of fluoride by political leanings is just too random.
I'd be happier if that broken-but-correct-2x-a-day guy banned HFCS (High Fructose Corn Syrup) instead. It is my personal hypothesis that it is the cause of 'sugar cancer' (general cases of bad sugars / imbalances of sugars in the body), including Diabetes.
Interesting hypothesis, is it based on anything specific? I think refined/added sugars in general are probably something best avoided, but admittedly still eat plenty. The idea that one sugar is materially worse than another feels off, but I can't quite put my finger on why.
The GI of sugar (sucrose) and HFCS is largely the same. Indeed, the HFCS-55 used in colas actually has less glucose and more fructose, and fructose actually doesn't lead to a blood sugar spike (or, more correctly, a much lower impact), leading to HFCS-55 having a lower glycemic index. HFCS and sugar are both just combinations of glucose and fructose molecules.
HFCS is not worse than sugar unless you're consuming such an outrageous amount that the fructose leads to a fatty liver (which does happen). But if you're consuming that much HFCS, it's only a small amount more of sucrose to yield the same outcome, as of course both have loads of fructose.
The one viable argument to vilify HFCS is simply that it's so convenient and inexpensive (courtesy of massively subsidized corn production) that it led to many more products having added sugars. But people who carefully pour over ingredients looking for HFCS, but treat sugar as wholesome, are usually operating on ignorance.
Not a chance that will happen, given the corn production of America. We have the most productive land in the world for growing maize, and Lord knows we’ll find shit to do with it.
We grow lots of corn because it is very heavily subsidized and insured by the US government. At scale you are guaranteed to make a profit, even during bad weather years.
Have you ever tried to purchase things in a US supermarket that lack HFCS? Chances are good you're looking at raw meats and vegetables and the like for a high effort meal made out of relatively high cost components.
I don't buy anything with HFCS at US supermarkets. I get all sorts of prepared foods: bread, yogurt, crackers, sweets, cereals (and a lot of more basic things to make meals with).
Sucrose is 50% fructose, 50% glucose. HFCS has from 42-55% fructose (there are grades), the rest being glucose (well some 25% of HFCS is water, but simplifying to the nutritive parts)
In the body it's literally all the same with minor variations in ratios. Indeed, the revered Mexican coke with cane sugar...the sucrose is broken down to component glucose and fructose in the acidic environment [1], exactly as happens with HFCS variants, and it would have been the moment it hit your digestive tract anyways.
There is zero scientific justification for the weird focus on HFCS. Yes, glucose and grossly excessive amounts of fructose are a serious problem. Especially in forms that rapidly get absorbed and go off like a glucose bomb -- our bodies are not adapted to the extremely rapid intake of glucose forms of food we eat now, including ultra-processed foods fill with refined carbs.
The #1 source of glucose in most diets is white breads, rices and so on. White flour is 60-80% starch, while white rice pushes 90% starch. Starch is strings of glucose molecules, and indeed enzymes turn that starch to free glucose almost immediately when eaten. So from a glucose perspective flour is much worse than an equal amount of sugar.
And of course nutritive sweeteners in all their forms should be avoided. But table sugar isn't more wholesome or better than HFCS.
I was surprised to learn this. "Worldwide, the Irish Republic, Singapore and New Zealand are the only countries which implement mandatory water fluoridation."
I live in New Zealand and my town doesn't put fluoride in the water but it seems like they'll be made to do so fairly soon. I don't really care one way or the other from the point of view of ingesting the stuff, but I do consider it a bit of a waste of money. People who brush with toothpaste don't need this and people who don't are probably drinking too much soda. A more useful thing to do might be to subsidize toothpaste for people who can't / won't buy it for their kids.
> People who brush with toothpaste don't need this and people who don't are probably drinking too much soda
I think every person in my social circles with any kind of illness or disability would be incredibly grateful for fluoridation, and it's not because of drinking too much soda
Yeah fair call. There's always some edge cases which is why I'm not the one making public policy. Although I don't think they sell the policy very well. There would be other ways to spend money for better dental health, NZ really doesn't subsidize dental care much compared to European countries.
Yes, for nearly any restaurant this is the unspoken recommendation, and sometimes enforced automatically if your group is larger than 6-8. Source: I am an American.
Yes, it's pretty common. It's also common for businesses where customers tip to underpay their employees on the expectation that they'll make it up with tips. It's legal to do this in many jurisdictions.
As an American, I wish we didn't do this, but it's a collective action problem that's very hard to solve.
What exactly is the definition of "underpay" here? Back when my wife was a server, it seemed like a cheat code to the service industry - she was making way more money waiting tables for $2.65/hr + tips than she had made at any other job she'd had (something like $18-20/hr 15 years ago)
Correct. bruckie has never actually worked as a server; otherwise he would know that tipping in the US is hugely beneficial to waiters, bartenders, etc., even with the legally allowed lower minimum wage. This is why tipping has never gone away through legislative means despite no shortage of waiters and bartenders in the populace, and why the occasional restaurant that proudly announces that it is a "no-tipping" establishment, and gets the requisite amount of slavering coverage in the usual virtue-signaling subreddits, never stays open long.
My dislike of tipping isn't to help the "poor servers" (and other employees partially compensated via tips). You're correct that I've never been a server, but I've had several friends and roommates who have been, and I'm aware of how it works. The good ones make (relatively) a lot of money; the bad ones sometimes don't, and usually find a different job pretty quickly. (I totally see how mentioning the lower minimum wage muddled my point, though.)
The reason I wish we didn't tip is because I think the list price should reflect the true cost of whatever I'm buying. I think that is more honest, encourages healthy competition, and is a pleasant consumer experience.
I was really glad when the DOT forced airlines to include taxes and fees in ticket prices in 2012, and wish there were a similar law/regulation that applied to all commerce. (And yes, I realize this is hard, given the incredible complexity of U.S. tax laws in a bazillion different—and often overlapping—jurisdictions.)
One thing that annoys me is that some states, like California, don't have a tipped minimum wage. (Well, we do, it's just set to the same number as the non-tipped minimum.) And yet we're still expected to tip. I guess the real problem is that it's expensive to live in CA, and our minimum wage needs to be hiked up quite a bit.
Yep. My favorite thing is when I am not even at a restaurant and I'm being asked to tip a retail worker making well above minimum wage. As a former bartender who made $2.65US an hour and relied on tips for my "paycheck" each week, seeing this new "tipping everyone" trend is like a slap in the face.
Bottom line, if your business can't afford to pay its people a living wage, then it can't afford to operate.
Two of the most hilarious things I've seen are tips at self-serve kiosks, and tips where you carry the food to the person behind the counter. Tipping them for ringing up an item..
At a corner store I frequent, they recently changed POS systems, and the new ones show a tipping screen. The person there always quickly dismisses it; I think they haven't figured out how to disable it, and are a little embarrassed that the machine is asking you to tip for just ringing up your items.
(Well, they also make espresso drinks and made-to-order deli sandwiches, so I guess it's appropriate to tip if you order those.)
Sorry for the late reply, but I'm wondering if you can explain why you tip for delivery?
In my area, pizza delivery drivers (read: not DoorDashers, etc. I am not sure what they make since I refuse to use those services) make about $12 - $15/hour and get paid for mileage (usually between $0.50 - $0.62 per mile.) I'm not seeing a reason to tip them. They are making well above minimum wage in my State, unlike the restaurant servers/bartenders that only just barely crested $4/hour as of 2025. The latter is in a position to rely on tips, the former is far from it.
I ask because we don't seem to have an established "hard line" on when tipping is appropriate in the United States, and when it is not. This extremely fuzzy understanding is allowing companies like DoorDash, coffee shops, etc to under pay their staff by off-loading part of the cost to the customer, which makes your $7 latte cost $10, or whatever. It's steamy bullshit and needs to be shoveled into the bin.
If we had a hard line on when tipping is justified, we'd quickly see a change in the other direction. I've always felt that the hard line should be "if you are making less than minimum wage, then tipping is justified." That's it. No soft maybes, no washy-washy justifications.
That being the case, if a barista (avg $15/hour in the US) is not happy _without_ the tips, then they have two options: demand more from their employer, or find a different job that pays better. Either way, the employer is left to consider either raising wages to keep people satisfied, or doing the same just to keep people in the door and stay in business. The barista is, in essence, the face of the company. They do the work the customer sees, which makes them important to the sustainability of the company. Ergo, the company needs to put more resources in the barista's pocket to ensure quality work.
It sort of blows my mind why everyone else in the US does not think this way, but I have tried to dissect my own stance on tipping (from the standpoint of having spent nearly a decade working front-of-the-house in restaurants), and I'm really having trouble poking holes in my own logic. So, I'm always interested to hear other people's takes on why they tip the way they do.
Imagine it’s raining, or they come really fast. Even if not so, it is always expected to tip the person doing delivery. That’s just the custom, like tipping in restaurant or tipping the bartender is the custom.
This is the problem. You basically said "we do it like this because that's the way we've always done it," which is the weakest form of justification for anything.
Rain, snow, etc...do you tip the person who delivers your mail? They do it in an LLV (a rather treacherous vehicle with little to no climate control) or on foot, but nobody tips them. When the pizza delivery person applied for the job, they did so knowing they would have to deliver in bad weather, but somehow we reach the conclusion that the responsibility of making sure that driver is being paid adequately for their risk and efforts is shifted to the customer, rather than than their employer.
Now, I should clarify that despite my years of restaurant service where my $2.65/hour paycheck existed nominally for the sole purpose of covering taxes (hence, my "take home" pay coming directly from the customers to my pocket), that I am in the camp of abolishing tipping altogether. Raise the wages of all service workers to a livable wage, which all these companies can certainly afford, and we'd be done with it. But I know that's a huge leap, so we need to take baby steps to get there.
Having a well-defined notion of which positions should be tip-based and which should not is the first baby step.
Great film, but bad scene, honestly. The arguments it makes are intended to make Mr Pink look like the pseudo-intellectual a-hole of the group, rather than be the social commentary on capitalism, labor relations and whose responsibility employee compensation actually is or should be, which is at the crux of any good discussion about the appropriateness of tipping.
I guess what I am getting at with my other comments is that we do not have a clear understanding of said appropriateness, and thus, we, the consumer, along side the food service worker, are generally taken advantage of by the companies that perpetuate the idea while said companies are off the hook for labor costs.
Now, before someone (if anyone is still following this thread) chimes in with "but if the restaurants pay the bartenders/servers a full wage, the food and drinks would be way more expensive!" I am here to tell you "travel more." I have been to many other countries where tipping is not at all a thing, and the food costs about the same as it does in the US.
When you walk into a restaurant in the US, you're getting ripped off. The dish you just paid $16US for cost them about $3 to make, including wage. It's not like the cooks are prepping one dish at a time, or the servers are only taking one table at a time...not to mention most restaurants in the US are using frozen, prepared ingredients that they are really just heating up or re-hydrating. Overhead costs like electricity and rent? A drop in the bucket compared to what small businesses have to deal with. The staff is making bare-minimum wages as it is while the parent companies and investors are making bank. That money from your $16US meal goes up, but very little of it actually comes back down.
Tipping exists because greed at the top exists and its unfair to both food service workers and the customers, but we've been at it so long that it's been normalized. And now it's spreading to other industries, like retail and online sales.
One of the many reasons I left the USA. Too bad US-Americans are so used to tipping 20% they even do it when traveling... giving the rest of us a reputation as being suckers.
Yes, one of the MANY cultural reasons. One less thing I have to think about when paying for food. There's honestly too many reasons to list: cost, safety, food, transportation, work life balance, education, being near family, and to see more of the world.
"Guilt" is an exaggeration, but the human behind the machine might care. It's a tiny inconvenience all things considered, and more of a principal than a practical issue. It helps tip the scale of where I'd rather live.
Yes, at least in NYC. And you get to tip in coffee places too, even when your coffee is to go. The card payment device (whatever they are called) gives you options such as 20%, 40%, 60% when you try to pay.
for some people it is. Maybe you'll become a believer when you realize that waiters wages are only around $2.35 an hour plus tips. Some states require that wait staff make -at least- federal minimum wage ($7.50? or so). Most do quite a bit better than that in all but the worst restaurant jobs. Not really a living wage tho. Some people do well on tips in upper crust restaurants, and often bartenders have enough turnover to do pretty well too.
Many other places fluoridate salt. There’s many ways to get flourish (toothpaste being the best if you can get people to use it correctly) but the evidence that mass fluoridation of some kind is good for dental health is enormous.
It seems like they could compare states/countries/cities while controlling for other factors (age, income level, etc) to see how well fluoridation works. I'm pretty sure you'll find that fluoridation helps lower the number of cavities, but it's not going to be a slam dunk.
I initially dismissed it as the same category of stupid as anti-vax beliefs, but it turns out that there are a decent amount of good studies showing a link between fluoride in water and (slightly) lower IQ when pregnant mothers ingest the fluoride. Note that there is no significant effect after birth.
The idea is to remove fluoride from water and advise pregnant women to use fluoride-free toothpaste.
Everyone else can get enough fluoride from modern toothpastes, or regular dentist treatments.
The logic is that fluoride in tap water made sense in the era before toothpaste had it, but now it is “overmedicating” a vulnerable fraction of the population.
In the actual research the main "risk" posed by flouridated water is actually fluorosis. This causes minerals in your enamel to be replaced with flouride which can cause them to be brittle in the long term. It's pretty uncommon but the thought is that now that flouride toothpaste are commonplace, the benefit of flouridated water is also way less. Which changes the calculus.
A not insignificant number of researchers are advocating for the view that flouridating water just isn't worth it anymore and the (slight) risk of flourosis is more significant than the (slight) benefit of decreased dental caries.
That's just not true. Most of the studies simply compared areas with different amounts of natural fluoride in their local water supply, and applied some basic statistics comparing dental health. There have also been some A/B studies possible in areas that stopped or started using fluoride in their water.
Multiple such studies have been done, globally, over many decades.
There is limited modern evidence (ie. in a world where everyone is brushing their teeth with fluoride toothpaste) of some reduction in tooth decay in children. There were no studies on adults that met the review criteria.
Overall it seems like we just don't really know how much impact CWF currently has.
Once ingested, the fluoride has a systemic affect on teeth before they erupt, incorporating into the matrix of developing teeth to increase the mineralization content and decrease the solubility of enamel. [1]
Fluoridated toothpaste says not to swallow because it contains much higher concentrations of fluoride than drinking water. If you ingest too much toothpaste, it can cause your teeth to get blotchy: https://en.wikipedia.org/wiki/Dental_fluorosis
Yup, but even for fluoride gels it says explicitly not to swallow. One because fluoride is toxic when concentrated, two because it needs to be on your teeth, not inside your belly.
You can’t win. Freedom, IQ, precious bodily fluids. There’s no end to the nonsense.
My city started fluoridating a few years ago. The crazy was off the chart, they’re still active. NYC has fluoridated for 60 years, you’d think someone would have figured out that the entire city is dumber.
Not just regular toxic chemicals, either, through the is plenty of that. Quite a bit of radiation too.
And companies that adulterate, misrepresent and obfuscate what they put in food as well. No-one is putting corn syrup or brominated vegetable oil in food with any intention other than money money money.
In fact, if I were an evil subgenius and really actively wanted to damage the IQs of the nation for some nefarious purpose, and it has to be substance-based, I'd avoid things with annoying oversight like public drinking water and vaccines and focus on food and pollution as a vector. If challenged, I just say "why do you hate my freedom to make a profit and provide jobs". Sure, the FDA and EPA exist, but even then you can get away with far, far more in those areas. Food wise, HFCS, BVO, etc, pollution wise, almost everything to with plastics or polymers, oil, coal, gas the list goes on and on.
Do you think bodily autonomy is absolute? Your comments seem to imply that bodily autonomy is the only relevant thing to consider when discussing patient care. The world doesn't work that way. Believe it or not, a doctor won't amputate a limb when you show up with a runny nose even if you insist that that's the procedure you want. Search up the 4 principles of biomedical ethics if you want to learn more about the factors that influence doctors' ethical decisions.
Or do you mean that your opinion should trump that of any doctor or expert in any field when the issue pertains to your person? If that's the case, I wonder why you choose to participate in society at all, given that you're uncomfortable with the idea that other people might know more than you.
No. When decisions I take could affect others, that can, in a limited way, justify overriding bodily autonomy. E.g. preventing someone with an infectious disease from spreading it by quarantining them. Or when they can't make their own decisions, e.g. if they're children, suffering dementia, or are unconscious and time is critical.
> Believe it or not, a doctor won't amputate a limb
I struggle to understand how this is a reasonable, much less charitable, interpretation of my words. Bodily autonomy does not include commanding others. But people can refuse care, even when it is medically sound. Except in very limited circumstances, doctors may not force procedures or medicine on unwilling patients.
> Or do you mean that your opinion should trump that of any doctor or expert in any field when the issue pertains to your person? If that's the case, I wonder why you choose to participate in society at all, given that you're uncomfortable with the idea that other people might know more than you.
One does not at all follow from the other. Experts in the field will tell me excessive sweets are bad for me (and I believe them) - should they get to put a block my credit card so it cannot be used to buy unhealthy snacks, only healthy food?
I have humored your post, now please explain to me: How does believing people have a right to refuse medical treatment imply I am uncomfortable with others being more knowledgeable?
But being serious if it’s relatively low and the negative effects only occur during pregnancy it’s not that easy to measure it.
Obviously there is no conclusive evidence (even if the studies from China seem somewhat credible) but IMHO even if the likelihood of this being true is e.g. only 5-10%, risk of a population wide loss of 1-2 IQ points seems like a massively too high price to pay just to slightly reduce cavity rates.
Also dismissing all credible (albeit weak) scientific evidence out of hand just because crazy people hold similar beliefs is a about as stupid as what they are doing..
Well one issue with your snark here is that IQs within the country are going down, and nobody really knows why. [1]
The Flynn Effect was the observation that real IQ scores were increasing over time. But sometime around 1990 this seems to have stopped in pretty much the entire developed world, including the US. I'm not implying that this is solely due to fluoridation, though it's certainly a plausible contributing factor. But as for your snark about 'someone would have figured out people are getting dumber' - well, they have, and we don't know why.
Flouridation of drinking water does not happen in the entire developed world, though.
And lower IQ scores don't necessarily say much about pure intelligence directly, a worsening education system could also contribute and that's not exactly far fetched. And your linked source says:
> The steepest slopes occurred for ages 18–22 and lower levels of education
Absolutely. And nutrition in general, the internet, and a large number of other factors. Starting around the 90s the world started changing far faster than we were able to measure the consequences of in many different domains. That's even when the rates of autism and other mental disorders also started to skyrocket. That's why I think it's a viable contributing factor rather than the alpha and omega.
But it's relevant here because most people don't know that general intelligence levels (so far as IQ can measure) have begun to decrease, to the point that the GP here was overtly mocking the mere possibility of such as a [implied] practical impossibility.
> IQs within the country are going down, and nobody really knows why.
I’m no expert, but I have seen the public education system attacked and defunded for decades, at home and abroad. Even libraries are being shut down in places with enough anti-intellectual sentiment. This goes much deeper than the fluoride in water.
If you can point to IQ values of New York specifically, going down more significantly starting with the introduction of fluoride into the water system, then you might have something there.
Until then, policy discussions like this will continue to take focus from the things that actually have an impact on IQ, like public education, healthcare/nutrition, and poverty.
Education stuff is more of a political talking point than reality. In reality US education spending per student has continually increased and is always near the top of the world. As of 2019 we're 4th in the world for spending on elementary/secondary spending $15,500 per student contrasted against $11,300 for the OECD average. [1] Of course we are having increasingly poor educational outcomes in spite of spending more, more, and more. So if there is a causal relationship between the reversal of the Flynn Effect and poor educational outcomes, it would seem much more likely that the former is causing the latter.
And I'm certain one could trivially dig up data correlating the decline of IQ in New York to fluoridation. The Flynn Effect reversal began in the 90s, and New York began fluoridating their water in 1965, so there's an excellent age correlation there. But that correlation does not necessarily mean causation. What matters are more controlled studies determining definitively whether fluoride is intellectually harmful by using fluoride levels in urine to control for various confounding variables (people in the same regions getting fluoride from multiple sources, consuming more/less products with fluoride, etc). And we do have those studies, and the answer is yes it is.
That certainly doesn't mean it's the sole cause for the reversal of the Flynn Effect as its seen across the developed world, and many countries do not add fluoride to their water. But it is likely a contributing factor. In recent decades we have begun moving far faster than we're capable of evaluating the consequences of, and long-term consequences may well be stacking from multiple sources of mistakes.
> Education stuff is more of a political talking point than reality. In reality US education spending per student has continually increased and is always near the top of the world.
This is disingenuous, and itself a political talking point.
> In reality US education spending per student has continually increased and is always near the top of the world.
It is much more nuanced than “money in equals IQ out”.
Where does the money end up? Not in classrooms, unfortunately.
What is the average ratio of teachers to students? Is this number going up, up, up?
Now do counselors, nurses, etc.
How much are teachers spending out of pocket for classroom supplies? Has this number gone down, down, down?
Yes, it does end up in classrooms. Feel free to look up the metrics you're talking about. Here [1], for instance, is the student to teacher ratio which has continued to decline dramatically over the years. And this difference becomes even more stark when contrasted against many of the countries, particularly in Asia, with substantially greater educational outcomes with far less in the way of every resource.
By "most" metrics the US should be having phenomenal educational outcomes. The one variable that's not controlled for is the quality of students. Also, I put "most" in quotes because it's a weasel word - to my knowledge we outperform on every single typical educational metric, except result.
There isn’t any! GP doesn’t have that authority! Well done!
On the other hand, the society you live in probably has some sort of document establishing who does have the authority, and how it devolves to the actual policy-makers. Google “$YOUR_LOCATION government” and you’ll have some good starting points. If you’re lucky, you might even get to participate in the process; “$YOUR_LOCATION elections” will give you good pointers in that case.
The people of Flint, MI were (and some still are!) forced to drink bottled water for years when their water was contaminated with lead.
When you drink from publicly supplied water, you accept risks that can be much worse than fluoride in your water. If you want to avoid that, you need to procure your own drinking water.
7mg/L? Where the heck did you get that figure?
The correct value is a tenth of that: 0.7 milligrams per Liter (mg/L)
The limit is 2mg/L, and that's only found in places with naturally occurring high levels of flouride.
Fluorosis is very common afaik. My dentist told me I have it: slightly whiter patches on my teeth. Then he showed me his own fluorosis. It actually is stronger than the old enamel.
Does the study not literally refute the claim that fluoride's negative impact on IQ is lacking in evidence, contrary to the original claim? What exactly do you think needs to be updated?
the original refutation was "fluoride in the drinking water concentrations is proven safe and it doesn't affect brains". Your study does not show that IQ is effected at concentrations that are being added to water supplies. Just because X can result from Y levels of some substance does't mean X results from Y-n concentrations.
> the original refutation was "fluoride in the drinking water concentrations is proven safe and it doesn't affect brains".
No, this is the original claim:
> but it turns out that there are a decent amount of good studies showing a link between fluoride in water and (slightly) lower IQ when pregnant mothers ingest the fluoride.
Then the parent replied that this IQ link is lacking evidence, which it's not, per the meta-analysis I cited.
For fluoride measured in water, associations remained inverse when exposed groups were restricted to less than 4 mg/L or less than 2 mg/L but not when restricted to less than 1.5 mg/L
There were limited data and uncertainty in the dose-response association between fluoride exposure and children’s IQ when fluoride exposure was estimated by drinking water alone at concentrations less than 1.5 mg/L.
The meta analysis you linked gets the strongest results in areas of the world with outstandingly high levels of fluoride and other elements in the ground water .. water with so many additives it rings like a bell when tapped with a hammer (okay, that's an embellishment).
Children are the main group that benefits from fluoride in water because the fluoride helps strengthen teeth as they form. Lack of fluoride increases childhood cavities, leading to decreased academic performance.
This was a real problem in the San Jose school district until recently. They started fluoridation of water in the last ten years, and were the biggest US city that didn’t fluoridate. The evidence of the above is clear according to SJ dentists I have talked to.
The National Toxicology Program recently completed a fairly substantial meta study and concluded that "for every 1 mg/L increase in urinary fluoride, there is a decrease of 1.63 IQ points in children.". [1] This is also relevant to OP since it's not just pregnant women at risk from excessive fluoridation but also children. For now it seems that adults are, somewhat oddly, unaffected.
> It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ.
Yeah, note the measurement is in urine. So there are two separate issues. Determining whether fluoride is damaging to IQ, and then whether the levels in water can drive this. The former is way easier to evaluate than the latter. The reason comes from that study's intro pargraphs:
---
"Since 1945, the use of fluoride has been a successful public health initiative for reducing dental cavities and improving general oral health of adults and children. There is a concern, however, that some pregnant women and children may be getting more fluoride than they need because they now get fluoride from many sources including treated public water, water-added foods and beverages, teas, toothpaste, floss, and mouthwash, and the combined total intake of fluoride may exceed safe amounts."
---
So the issue is trying to isolate the exact amount and source of fluoride people are getting. And that probably has no answer because it's going to vary dependent on how much fluoridated water somebody drinks, the rest of their diet, their other dental hygiene composition, and more. So levels that would be safe for one percent of the population, will be dangerous for another percent of it.
> but now it is “overmedicating” a vulnerable fraction of the population.
Makes sense, but the intention also is that many people do not brush their teeth, or at least do not brush them as often as they should, and so fluoride is added to drinking water to compensate so people's teeth don't start to fall out at an alarming rate.
Sadly, an alarming percentage of Americans don't drink water. I’ve spoken to way too many people who think water tastes wrong because it’s not sweet enough.
It’s heartbreaking, but not surprising. When you’re dealing with limited resources, constant stress, and often living in areas where healthy options are harder to access or more expensive, sugary drinks can feel like an affordable comfort. Instead of judging SNAP recipients, we should be looking at the systems that make soda more accessible than clean, appealing
, and fresh food.
> I judge them the same way I judge anyone that drinks that crap: harshly. Don't tell others they shouldn't judge people for their misdeeds.
Good job ignoring absolutely everything in the comment except the part that offended you. Nothing more American than having a hard-on for being judgemental and then defending the right instead of actually trying to solve the underlying problem.
Are SNAP recipients not allowed to enjoy a soda at all? I really don't understand the problem with this. Society acts like signing up for SNAP involves signing a contract to lose 100 pounds and only eat iceberg lettuce or something.
Americans seem to love to gatekeep what the poor are allowed to have or not have.
They have this image of the Welfare Queen driving a pink Cadillac to cash her welfare checks at the liquor store.
It seems that no matter how desperately destitute someone might be,
there's a person who will point at something they have,
whether it's a tent to sleep in under a bridge (a gift from an organization providing assistance to the houseless),
a bicycle that's their only means of transportation,
or a garden planted on public property,
and say "they can't be that poor if they have that!
When someone lives off of public benefit, there's a sense in which the public can have an interest in how the money is used -- its use should correlate with its intent.
That's why SNAP money is restricted to particular categories. So caring about how it's spent is already a foregone conclusion, and rightly so.
If someone wants to spend money however they like, they'll have to earn it themselves. Even inherited money carries a sense of obligation to honor the family with how it's used (like not blowing it all in a week of lavish partying in Vegas, as an extreme example).
If an individual spends 10% of their SNAP benefits on soda, they’ve spent about ~$30 over a month on it, which is ten 20fl oz drinks. People drinking a bit more than a gallon of soda per month only supports the notion that they can subsist on that without any water if you believe that they categorically have some sort of exceptional unhuman biology.
Water is great for hydration without filling you otherwise. Like, say you need to drink a lot of fluid because you are really active, you would probably get sick of milk pretty quickly.
But anyway, in most cases, the fact that drinking milk doubles as a source of food is clearly a benefit. It's hard to explain a common behavior by reference to a rare circumstance.
The idea of sports drinks is that you can drink them without getting water poisoning. This is only a concern if you need a lot of water because you've been sweating a lot, but I thought that was the scenario you were pointing to.
Well, it's true that water has zero calories and is neutral tasting. It's not filling to any degree, and milk will give you a lot more of what your body needs.
When traveling by vehicle (pickup truck for me) I've thrown in a 5 gallon cooler of water from home. It was so nice to want to drink water because it was my own good well water that tastes like I'm used to.
When I had to fly to NY for work I felt like I couldn't get water anywhere that was worth drinking.
Where in New York? If NYC, this sounds insane to me, because New York municipal water is objectively speaking among the purest (if not the purest) in the country.
San Francisco tap water is almost as good. It was better before they started mixing reclaimed water into it, though I’ve either gotten used to the new taste or they’ve fixed the treatment process.
I question this as a bad take or a data-point of one, because NYC water is the best of Upstate water.
I’ve travelled and lived across the country during my high school and college years; and I’ve travelled my
extensively within Upstate very (Adirondacks, Catskills, and Finger Lakes) and the taste of local water is the first thing I notice.
Bad building pipes aside, I have not tasted any water that exceeds NYC’s tap water in taste.
I’m not the only person who’s expressed this, and guests from other regions have also admitted the same consistently over the years.
When travelling where? The blanket statement here just doesn't work. Every major area has very different water in the tap. A lot of the bottled water is just tap water from another region.
Probably because the overwhelming majority of countries chlorinates their water to various degrees because they don't have the exceptional plumbing quality needed to otherwise guarantee potability.
Countries where the tap water is drinkable without chlorination have quality that exceeds bottled water, and it might even be sourced from the same aquifers.
It can vary much more closely than that. I moved from one town to another 12 miles away, and the tap water in the new town tasted horrible compared to my old town's tap.
Important sentence is "..or at least not as often as they should" :)
I have no doubt most people brush their teeth in one capacity or another, but do you really think 98% of people brush them regularly and sufficiently? I reckon that drops down quite a few double digits at that point, and since we're talking about populations here that's quite a lot of people.
I'm pretty sure that no amount of fluoridated water is going to save you if you do not brush your teeth.
Even if the fluoride somehow manages to overcome all that and prevent you from getting cavities, the gum disease will eventually cause all your teeth to fall out.
Agree, my biggest issue is often where they source the fluoride and whether they test it. We found out in my (liberal) hometown that they were actually sourcing some derivative which has no human studies.
Given that everyone gets enough in toothpaste I just don’t see the reason to keep doing it, too much can go wrong. It’s kind of a strange mass medication that I’m not sure the government needs to be involved in.
> Everyone else can get enough fluoride from modern toothpastes, or regular dentist treatments.
The advantage of putting it in water is that it ensures all children get it, not just the children whose parents can and do make sure they brush their teeth and go to the dentist.
The levels of fluoridation in order to cause difference in IQ as I understand it, from the Chinese studies, suggest that basically the effect if true occurs at around 2x+ the concentration found in supplemented water supplies.
My understanding also is that if you’re a dentist wanting to get rich, move somewhere that has unfluoridated water.
2x is honestly pretty small. I would expect the amount required to drop IQ to be larger by an order of magnitude or more to conclude that fluoridating water is totally safe.
So if your training and double your water intake your basically lowering you IQ? (according to the Chinese studies) I wonder the method this uses.. has anyone looked at dementia rates in high fluoride areas.. Particularly in people with high water intake?
There is also a host of things we use water for from cooking to preserving, distilling and cooling.. i wonder if any of these things could concentrate the fluoride.
Also since fluoride has a lower boiling point any studies tracked what breathing in fluoride gas over long periods cause?
2x is basically no safe margin for something like water. Of course you can question the quality of the study, but if it's actually 2x, fluoride in tap water should be treated like lead pipes.
> The idea is to remove fluoride from water and advise pregnant women to use fluoride-free toothpaste.
What most people don't understand here are the levels of fluoride being ingested. You can very easily remove all fluoride from your water with a relatively cheap RO system. But the recommendation to use "fluoride-free toothpaste" is just plain misinformation.
The reason is that you don't eat toothpaste. And even when adults ingest small amounts of toothpaste, again, the amount of fluoride is basically beyond negligible. Fluoride can both be applied to teeth as a varnish and/or consumed in drinking water. Using a flouride-free toothpaste can oftentimes do more damage than good because of SLS in those alternatives and because those alternatives often have abrasives that do far more harm than good. It's amazing people will recommend a product that may likely be worse because they have no domain expertise. So, yes, people should talk to their Dentist about these things and ask questions of them vs the Internet.
Really the downside to removing fluoride from city water is that low income families will be worse off with respect to dental related issues compared to more well off families that spend time instilling dental hygiene and preventative care for their kids. As you mentioned most people who have decent oral hygiene get enough flouride.
Where we live we have well water. Fluoride in the water isn't a concern, and if it was in our drinking water it generally wouldn't be consumed because of the water filtration anyway.
My anecdotal experience says that using fluride-free biomine toothpaste makes my tooth highly sensitive than using a good ol' Colgate. Now, I use it only twice or thrice per month randomly.
> I initially dismissed it as the same category of stupid as anti-vax beliefs
Dismissing things out of hand like this is a category of stupid in itself.
Look at the current research, listen to people who devoted their careers to studying this, make up your own mind. If you're on HN, then you're qualified enough to at least figure out who the genuine experts are and read what they recommend.
Putting any science-based debate into a "category" to dismiss is turning yourself into one of the stupid people.
This is bad advice that no one could possibly follow.
> Look at the current research, listen to people who devoted their careers to studying this, make up your own mind.
Do you honestly do this with every single belief you have? Even every single controversial belief? Have you looked, yourself, into whether the world is flat? Whether the 9/11 conspiracy theories are true? Whether crop circles were created by aliens? These are all absurd conspiracy theories, but I assume most people don't know the "up to date" research on any of them, or what people who have "devote their careers" to research them say.
And those are incredibly common and well known to be false theories.
You have to take some things on faith to at least some degree - though to be clear, by "on faith" I mean "on faith of people you trust", which should really start with professional scientists etc. Also, it's totally fine to just say "I have no actual idea" about most things, and just go with what your current understanding of the status-quo position is.
> Have you looked, yourself, into whether the world is flat? Whether the 9/11 conspiracy theories are true? Whether crop circles were created by aliens?
I’m disappointed in the news media fails to mention the cascading effects of dental health. Yes, the primary and direct benefit of fluoride is to have a healthier mouth.
But having a healthy mouth is far from the end goal, imo. If your mouth is full of cavities you’re more likely to build up bacteria that cause downstream effects as serious as heart disease. Also if your mouth is routinely uncomfortable you may gravitate towards soft processed foods and away from healthy whole foods like fresh fruits and vegetables.
I know water is not the only way to get fluoride into people. But these politicians who are trying to take it out of the water are just saying basically “it’s fine, let’s do nothing”. They’re not going to fluoridate the salt. They’re not going to run public health campaigns stressing the importance of regular brushing. They’re just willing to let people’s teeth rot to score points.
It’s disgusting, and no matter how you feel about the water you should be able to see that these people are not on your side.
> I'd actually just like to see more money put into public dental assistance. And education.
I would want to see that in anti fluoride campaigns and laws as well, but have not see that happen in the laws and campaigns I have followed. Or in the HN comments I have responded to on the subject, most focus on banning and provide no follow, or no structured follow up like - free toothpaste, required educations, and follow up studies, reassess in X years.
The Canadian Dental Care Plan (CDCP) was introduced to provide dental services to uninsured Canadians meeting specific criteria. Its rollout began in December 2023, starting with individuals aged 87 and above, and is set to expand to all eligible adults earning less than $90,000 annually by May 1, 2025.
This is actually a perfect example of how under-served dental needs have been. It was only passed via some interesting political wrangling and alliances. And it hasn’t been a smooth rollout with some dentists not getting on board. Starting with aged seniors is good from a compassion standpoint, but the emphasis should be on prevention at earlier ages.
> They’re not going to run public health campaigns stressing the importance of regular brushing. They’re just willing to let people’s teeth rot to score points.
Do you really think there are sizable native born populations that are not aware of tooth brushing?
There’s plenty of people that don’t bother with it, but I don’t see a PR campaign being particularly effective at changing that.
I think there are lots of kids who don’t know how bad their teeth can get and how that can impact their life in the future (and I mean kids like teens, not like four year olds).
I think there are lots of adults who don’t realize that poor dental health can cause heart failure and worsen basically every chronic condition.
I think there are lots of goobers who don’t realize that there’s no reason that United and Elevance and the rest couldn’t be forced to cover dental care via regulation.
I get your point, but big picture there are a lot of impactful education campaigns that should be possible.
If I went to the store to grab a bottle of water, and they were selling fluoridated water and fluoridated water, I would choose the non-fluoridated water.
I drink tap water now with fluoride so its not like I care strongly, but its a bit weird that many people buy only non-fluoridated water themselves and are confused when other people show a preference for non-fluoridated water in their own taps.
This is one of these US-specific polarised debates I find really bizarre, around some kind of issue that the rest of the world has by large solved but without any acknowledgement of this fact. Maybe the US should look into how other countries have solved it? It is completely bizarre witnessing both sides getting so polarised around a basically non-issue.
There are a few studies out which say fluoride is bad. But as is often the case with these health idiots, the studies actually refer to places where fluoride is naturally way too high in the water. The entire debate is dumb.
This was my perspective for awhile — recommend you look into more recent studies if you haven’t in the past 2y or so. I don’t think it’s the worst thing in our water but do think it’s objectively a bad idea.
They are experts in this field, and, unlike “random person on the internet who spent 2 minutes on google”, have informed opinions on this topic.
If you want a serious discussion on why fluoride is good or bad, that’s where you need to go.
Random person on the internet is very easy to disagree with, because we’re all idiots right? It’s a very easy lazy way of self confirmation.
…but if you are serious about critically considering the issue and facing your own biases, talk to an actual topic expert.
My dentist told me he had carefully reviewed the literature and determined to his satisfaction that public fluoridated water was in the best interests of public health, currently. He offered to share some reading that he was convinced by.
You can’t really ask for more that that.
Discussing this here is a bit like protesting by posting on social media; yes, I suppose it’s better than doing nothing and not engaging with the topic at all… but only barely, and not in any meaningful way.
If you're not prepared to listen to an expert, and that's what your dentist is on this topic, then nothing I, or anyone else can say, makes any difference to you.
At some point, you have to accept that your random wikipedia page and 5 minutes on google is not a convincing argument.
This is right up there in the conspiracy theory territory.
Rational discussion means listening to experts and admitting that you are not an expert.
What do you want me to say?
You aren't a qualified expert on this topic. If you want an expert opinion, talk to an expert, not some dubious fucking provenance wikipedia page.
Who do you think conducted those peer-reviewed systematic reviews? I'm sorry if I don't take the word of some random guy's dentist over multiple meta analyses in major medical journals.
And I don't need an expert to tell me people should have the right to make their own medical decisions.
And finally, I live in a country where public health experts have decided against water fluoridation. This is represents the vast majority of countries. What now? Should I pick some other experts to listen to?
You are not an expert in this field, and cherry-picking random articles in random journals does not make you an expert.
> Should I pick some other experts to listen to?
I think it's reasonably clear that you haven't spoken to an expert in this field.
> I'm sorry if I don't take the word of some random guy's dentist over multiple meta analyses in major medical journals.
Are you certain you're competent to review and understand the literature on the topic? It takes a lot of time and effort; that's what dentists do as a job. That's why they have to go to school. That's why random people on the internet do not do dentistry.
If you don't trust my dentist, then talk to your dentist.
This is literally my point: I'm not telling you how it is; I'm telling you, talk to someone who knows what they're talking about; and, don't believe that you are an expert because you put some trivial amount of effort into investigating it yourself.
I'm also not convinced that a dentist is credibly an expert here. Sure, I would absolutely expect my dentist to understand what benefits fluoridated water might provide to my teeth. I would not, for example, expect my dentist to be an expert in whether or not fluoridated water could cause damage to other parts of my body.
My previous dentist pushed these $80 (not covered by insurance) fluoride treatments on every cleaning visit. There's no research that shows much of anything about their effectiveness (good or bad). Yet they push them anyway, because it (their words) might help and probably won't harm. That doesn't give me a good feeling about their competence to have an expert opinion on this sort of thing.
I would, however, trust the opinion of someone who is doing medical/dental research, and holds a doctorate in a relevant field.
Who do you think conducted those peer-reviewed systematic reviews? I'm sorry if I don't take the word of some random guy's dentist over multiple meta analyses in major medical journals.
I don’t understand what you mean here. Are you just wholly rejecting the concept of expert knowledge, trials, meta analyses, basically the foundations of science, just because in order to participate in it you have to have tainted yourself by rigorously studying it?
Your dentist is not an expert in this — that’s like saying the guy implementing your frontend is an expert in design. Yes, they’re working in the space, but their job isn’t understanding the whole system.
If you’re this deep on the appeal to authority train, the NIH released a report in the last year linking fluoride exposure to moderate drops in IQ with moderate confidence.
It’s probably not the worst thing in the world, but is definitely not inert.
I would be really surprised if dentists had much expertise on the impact of fluorine on physiology or the mechanisms of action for its toxicity. They know what it does to your teeth, and maybe that it is known to have positive effects for cardiovascular health, but that is about the extent of it. The systematic effects on the rest of your body are outside their domain.
Chemists who work in fluorine chemistry on the other hand have to become experts on the biological effects of fluorine exposure. Small and seemingly innocuous exposures can do a lot of damage and kill you, though not in a way that lends any support to the idea that municipal fluoridation will harm you. If you do understand how it kills you (basically by being exceptionally narrowly focused on making free calcium ions and to a lesser extent magnesium ions biologically unavailable), it is hard to describe a chemically plausible scenario that somehow avoids this basic fact of chemistry. Fluoride behaves the same way outside the body.
Municipal water exposure is far below the noise floor for fluoride. Food has far higher levels of fluoride than municipal water and the body has ample excess calcium and magnesium to absorb the loss of bioavailability of a microscopic amount of those minerals. Humans consume calcium measured in grams per day, multiple orders of magnitude more than can be lost via municipal fluoridation. Natural dietary variation will have a far larger effect.
I am competent on this particular subject matter, I have worked in fluorine chemistry and am familiar with the biology and medical literature of fluorine toxicity. The report made much weaker claims than people seem to think.
There is a very serious mechanism of action problem. Fluorine poisoning is a thing that happens. The observed effects and empirical evidence, as well as the mechanisms of action that cause them, are incompatible with any mechanism of action that supports the hypothesis that it causes brain damage. Basically, it would invalidate the entire history of actual fluoride exposure.
The other serious problem is that people are exposed to far more fluorine through what they eat than through water. What is special about trace levels in municipal water? And many parts of the world have far higher natural fluoride levels in their water than any municipal water supply with no evidence of adverse consequences. This has been studied many times in many countries! In fact, the only consistent correlation with naturally high fluoride levels is better cardiovascular health (for which there is a known mechanism of action).
This notion that trace levels of fluoride in some municipal water is adversely impacting IQ based on thin evidence from the developing world is just the public health version of “faster than light neutrinos”. Someone thinks they measured it but it contradicts everything we know about the subject. The rational approach isn’t to discard everything we know without a hell of a lot more evidence.
I don’t think adding fluoride to municipal water does much these days but it also isn’t harming anyone.
It also seems to mirror the rhyme with the vaccine "debate."
That debate is framed around being vaccinated vs the scare of "vaccine caused autism" (or myocarditis), but that frame is missing the risk of things like measles.
Likewise tooth decay is not only expensive, but it can have dreadful health consequences if left unaddressed. Missing teeth is also socially costly. Being poor or "ugly" or poor looking is a serious adverse health consequence. Imagine parents barely making ends meet or working multiple jobs. It's easy to imagine disadvantaged kids missing out on dental care.
I also explicitly remember reading multiple reports of poor tooth health correlating with dementia development. I've also read that serious infections of any sort can harm IQ.
Sure, but we need to look at this from the other side, too. Does fluoridating water provide benefits? I think it's safe to say it did way back when we started doing it. But we didn't have fluoride toothpaste back then. Putting fluoride in the water is presumably more costly than not doing it. If it's actually providing benefits, and the risk of harm is below some very low threshold, then sure, let's keep doing it. But is it actually providing benefits?
That study is taken grossly out of context. It doesn’t claim what people claim it does and even the study states that the quality of the data on which the weaker claim was made is suspect.
The bigger issue is that we have vast amounts of scientific data and empirical evidence around fluoride toxicity. People are injured and die due to fluorine exposure, we understand how it interacts with biology. Any mechanism of action that can support the hypothesis that fluorine causes brain damage necessarily invalidates all of this evidence and is difficult to explain as a matter of basic chemistry.
And then we have to explain why fluoride in water has this effect but the much higher levels of fluoride in food does not.
Fluoridating municipal water may not offer much benefit but there is no credible science that it is actually harmful. Large regions of the world have water that naturally has far higher fluorine content than municipal water and there is no evidence of IQ reduction in these regions either.
The vast majority of dentists are not public health experts, and will have little to offer other than “exposing your teeth to fluoride regularly is good”.
> Talk to your dentist. They are experts in this field
No they are not. The are experts are filling cavities and treatment. They have no additional knowledge of fluoride in water vs any other interested person.
For that you need to talk to someone in research, which is not someone seeing patients.
What they're referring to is the fact that very few countries in the rest of the world even consider the possibility of adding fluoride to the water supply. It's basically just the US, Australia, and to a much lesser extent Canada.
It's not a debate everywhere else because adding fluoride to the water is objectively an unusual thing to do that they just... don't. Presumably they get fluoride other ways.
How has the debate been solved by the rest of the world? My understanding is that many countries in Europe don't fluoridate the water supply.
I'm skeptical of results showing IQ loss but I also think fluoridation should be phased out as fluoride toothpaste and mouthwash are now widely available. Banning it seems like the wrong move to me...states should simply decide to continue adding it or not.
Right. The state made the decision to stop it from being added, which is what OP proposed.
Did OP mean that municipalities should simply decide to keep adding or not? If so, how do we decide (from our various armchairs in most cases far away from Utah) what the appropriate level of government for making this call is?
The state’s Department of Health can issue a guidance explaining the states’ experts’ analysis of the available data and tradeoffs of the decision, and let the municipalities sort it out.
I think the bigger complication though is going to be - depending on the state - how water districts are apportioned. I think even many counties (let alone municipalities) will share water infrastructure so it’s not really clear who has the jurisdiction to make that decision other than the state.
It also makes it easier for the consumer: don’t want fluoride, move to Utah. Rather than having to figure out what random water district is doing what.
> How has the debate been solved by the rest of the world?
By having official country-level guidelines by the health ministries or similar for people to brush their teeth with toothpaste containing fluoride, and specific guidelines around it for kids, as trivial as it may sound. Along with experts' reviews providing more details on these decisions, and explaining tradeoffs properly.
Fluoride containing toothpaste is the main recommendation, even in places that fluoridate the water (which are the minority). There is not much to add to this apart from refining these guidelines. Eg in the EU where some countries fluoridate water, most don't, there is no huge debate about it overall. Most eu countries that fluoridated the water stopped doing it some point mostly because it was no longer needed in preventing cavities, and prob largely due to logistics/costs than possible risks.
Your second paragraph reflects my personal views on it, too. The "banning" is weird, esp since, according to the article, it comes from people that seem to advocate against use of fluoride in general in toothpastes etc. The discussion should be around best policies to prevent cavities etc, but it does not seem to be around that. I see nothing wrong with local communities deciding if they want to put fluoride or not in their water, based on their own opinions but also general situation. Maybe in some much poorer areas fluoridation of water could be beneficial until some other measures take place, for example.
By not adding fluoride into the tap water and let people choose whether to buy toothpaste with fluoride themselves. a.k.a. the European way.
Adding fluoride into tap water always sounds borderline insane to me. The only benefit is to protect your teeth, which, to me, strongly suggests that the correct approach is to put it into toothpaste or other oral hygiene products instead of water.
The US rarely looks into how other countries solve problems. (i.e. Universal Healthcare, High Speed Trains and so), this is the sad part of "American Exceptionalism"
A less cynical framing is that the US is a much different culture from European countries, and is massively larger in scale. Depending on the problem, some of their solutions simply can't or don't apply.
The other weird thing in US discourse about other countries is that when it does enter the conversation, the "rest of the world", or at least other developed countries, are often treated as some kind of monolithic entity culturally and politically. For example, a lot of people on both left and right in US believe that the rest of the world is single payer, and generally that "single payer" is synonymous to "public healthcare". Similarly with gun control, there's no recognition of the fact that there are countries in Europe where you can own an AR-15 just fine, and countries (different ones!) where silencers are over the counter items not requiring any special registration.
edit: But I will say it works both ways. Most countries do not know what it takes to keep hundreds of millions of people of various backgrounds together under a common way of life with a certain risk vs entitlement balance. Americans as a whole are more risk tolerant AND accepting of failure and reinventing yourself. In most cultures it's a great shame to quit your job with benefits, start a business and not succeed. In the states it's not shameful. You tried? Awesome.
Yes, that's my point. We are literally different people with different cultures, values and problems. Case in point: the firearm control you mentioned. I won't get in a gun control debate here, I have my own complicated views on the matter, but it's an undisputed fact that Americans have a right to own guns (maybe with limitations, maybe not) and many Americans deeply cherish that right. There is no gun control solution we can take from Europe that you could apply to the US, it's simply not compatible with our culture, not to mention our own Bill of Rights. It's not a bad thing to recognize that.
A lot of people are uncomfortable having an opinion without being able to rationalize it.
I have to assume many, maybe most, people that give reasons like you mention just flat out don't want the policy and reach for a reason to justify it.
I can say I don't want gun control laws. Not because it doesn't work elsewhere or couldn't work here. I just fundamentally disagree with it and don't want to live in a place where the only ones with guns are state officials.
I got a Master's Degree in Education and spent 2 years in Educational Psychology Ph.D. program and absolutely 0 time was spent looking at how other countries do education.
It's baffling how despite numerous other countries outperforming the US in educational outcomes we do not even look at other approaches!
Yes, in the Netherlands we have a culture of moaning about everthing. Youd beter not dare suggest sonething is good enough! This complaining is the only thing we are proud of. lol
(If we had patriotic songs worth remembering im sure i would have)
The problem is this, hoe do you fix something you are proud of? It seems a contradiction?
Agreed, I lives in the Netherlands for a couple years and can agree there isn't much patriotism so much as pragmatism! (I actually mean that as a good thing, I was a very fond of NL and the friends I made there).
Speaking as an American, though, I can both be proud of something and recognize its faults. I'm proud of the core principles that America was based upon, for example, but very much recognize how far we've deviated from them and how much we need to fix.
> I'm proud of the core principles that America was based upon
I think there's never much to gain in being proud of things you have nothing to do with or control over. If you like some principles you would be proud when you uphold them personally. It is when we start feeling proud in the abstract that we start having issues.
Can't help but agree. I would go even further and say that pride itself is problematic. Sure, it can perhaps have some good effects, but pride usually blinds people to faults, even if the do acknowledge there are faults.
"Pride goeth before a fall" is a time-worn saying for good reason.
I'm not a big fan of patriotism in general, but something I noticed about the US patriotism is the tendency to call the US "the best country in the world". This crosses all political differences, e.g. I recall being surprised how Michael Moore was saying it in an interview or movie (when justifying criticising policy, he said he does it because he knows that America is the best country in the world). Even the most patriotic friends I have in other countries would typically not say this.
Yeah, as an American I've always found this cringe-worthy, even kinda icky.
Claiming to be the best (at anything) is just tacky and arrogant. Especially with something as impossible to quantify as "best country". There's no such thing as the best country in the world. Every one has strengths and weaknesses, and you can't really balance and rank them.
What does leftist mean in this context? Sure you could say the "nationalist" movements against monarchies and for more democratic processes were progressive at the time, i.e. they wanted to change the status quo. Calling them leftist in the modern sense (again with a huge caveat about what leftist even mean), doesn't make much sense IMO. Also it's important not to forget that the internationalist movements (which I'd argue fit modern definitions of "left" much more closely) developed quite quickly (in historical timeframes) after, e.g. it was only 50 odd years between the Warburg festival in Germany (generally considered the birth of German nationalism) and the Paris commune.
I guess "the best" is doing a lot of work there, for example the most sung anthem for Denmark "Der er et yndigt land" - there is a lovely land does not explicitly say that Denmark is the best ever, there may indeed be other lovely lands, and in comparison with say America the Beautiful it is downright humble, but on the other hand it is my experience that anthems talk up their country, and if they are talking up their struggle for independence or freedom, like say Il Canto degli Italiani, it will be talking up the martial valor of the people so freed and probably talking about how they aren't going to be put down again, another aspect that America the Beautiful goes into.
The difference between America the Beautiful and other anthems is how much it does, for how long, and making sure it gets everything it can possibly cram in there. It's like a bunch of people standing on a stand at a sporting match shouting "America, America, America" unremittingly, whereas most people might be satisfied to shout "Go {my country}" and be done with it.
You're not wrong in that our culture is different, but that cultural difference is chiefly a self fulfilling prophecy of "the government can't do it," promoted by billionaire owned media, so that those same billionaires can run for-profit industries like healthcare and transportation.
The cultural difference is that our rich people are too rich, our media is too centralized, and none of those in power want to enrich and empower the country, when they could enrich and empower themselves.
Which part here exactly cannot work in the US? I am talking about brushing one's teeth with toothpaste containing fluoride, which sounds as plain simple as possible to me. Is it regular brushing teeth that fails in the US for cultural reasons? Fluoride in the toothpaste? Supervising kids while brushing their teeth to make sure they do not swallow? It is an honest question.
In a word: poverty. People do not have free dental care, and poor people aren't guaranteed to have a toothbrush, toothpaste or sometimes even a sink to brush their teeth in. Fluoridated water is one of the few dental protections available to everyone regardless of their income. It's cheap, minimal and cost-effective cavity protection at scale for the entire country.
> poor people aren't guaranteed to have a toothbrush, toothpaste
There is no person in the world who cannot have a toothbrush and toothpaste if they want to. And if you find one such person, they won't have access to any centrally treated water.
Assuming the "less cynical explanation" you're referring to was my original response talking about the cultural and scale differences between America and most countries, that was not in reference to fluoride or dental care. I was specifically referring to the OP's assertion that "American exceptionalism" is the reason that America doesn't just copy things like universal healthcare and gun control policies from other countries.
I'm not sure what you're getting at here, I think we may have lost the plot. Are you simply implying that you find the cynical answer more appealing and believable than the non-cynical answer? In my opinion, the internet and today's modern zeitgeist has instilled a sense in everyone that if it's cynical, or dark, or depressing, it must be the correct answer. That's usually the laziest and easiest answer too.
The scale argument is thrown around a lot as a justification for why the US couldn't possibly implement universal healthcare. The elephant in the room that I'm always surprises at how rarely it's mentioned in these discussions is Brazil, which is a huge country of comparable size (both territory and population wise), and it manages to make UHC work even though it's also a much poorer country.
It's not perfect by any means, but it's definitely much better than nothing. So the US should absolutely be able to at the very least match that, but really most likely it should be able to do much better. That it doesn't is very much a choice.
> I think the US would prefer a UHC if we were starting from a blank slate. The difficulty is mapping a path from what we have now to that.
Do you remember when Republicans went on and on about how "Democrats rammed through the ACA without a single Republican vote"? As if that represented a problem on the Democratic Party side, and not the Republican one? Despite the similarities to models proposed by Republicans in the past, and the relative conservative step it represented from "Byzantine kludge of often poor-to-no-coverage" to "something with a higher floor"? That's how hard it would be to find a Republican to "prefer a UHC if we were starting from a blank slate."
It's important not to underestimate the distrust of government services and regulation of any sort of the Republican base. The conservative media - talk-radio, then cable, then social/podcasts - has been intentionally undermining the credibility of government services at every opportunity for 40 years. And the politicians hamstring and sabotage whenever they get a chance to try to make sure that services offered in the US are sub-par compared to elsewhere.
It's a well-oiled machine running a cycle that keeps people focused on anything else but the services they actually use all the time so that cognitive dissonance can't creep in. (Granted, sometimes, when necessary to acknowledge those things, they'll fall back to making it clear that YOU earned/paid for the things you use, but those other gross poor people are just freeloaders.)
It's like with abortion - for decades "overturning Roe V Wade" was what Republicans said they wanted to do. And people kept trying to convince themselves "oh they don't really mean that, they wouldn't do that actually anymore." Take their word on it about wanting to tear down government services.
> It's important not to underestimate the distrust of government services and regulation of any sort of the Republican base. The conservative media - talk-radio, then cable, then social/podcasts - has been intentionally undermining the credibility of government services at every opportunity for 40 years. And the politicians hamstring and sabotage whenever they get a chance to try to make sure that services offered in the US are sub-par compared to elsewhere.
This is partly what I was getting at when I said the culture of the US is different and the scale is much larger than European countries. It's not just geographically larger, but it's politically and ideologically broader too. If you have a wonderful idea like UHC, you need to make it work with liberals, conservatives, and everyone in between. Like it or not, a universal healthcare or Medicare for all plan is either going to be DoA in Congress, or a considerably watered-down and Americanized version if it has any hope at all of getting enough senators to pass it without first seeing massive electoral college reform in this country first.
That is the scale of the US. You can't assume that an idea that's well-liked and popular in another country is going to be popular and well-liked here.
Considering that Europe is composed of many countries with massively different histories, cultures, economies and languages I find that a very unconvincing argument. The US are much more culturualy homogeneous than Europe. I mean just go across the country and look at the patriotic displays of flags which also transcends political differences. In contrast in Europe you first would be seeing different flags, but also displaying flags has very different acceptance rates in different countries.
Right, but we're not talking about "Europe", we're talking about each individual country. I don't think it's reasonable to say that France, for example, is more culturally diverse than the US.
And the various countries in Europe do have different healthcare systems, sometimes significantly different.
> The difficulty is mapping a path from what we have now to that.
It's difficult, but not as difficult as it's often presented to be, as long as you're okay with giving the finger to a relatively small number of wealthy health industry executives.
That depends on who "you" is. Quite a few people in Congress are ok with doing that, but not anywhere near enough to get anything passed. Look at the GOP side of the aisle and you'll essentially find no one willing to do that. Not to mention they are just simply ideologically opposed to the concept of government-provided universal health care.
And that, is the difficulty. Sure, I agree that it wouldn't be too logistically difficult to implement universal healthcare in the US. But that doesn't matter when more than half the country has been propaganda'd into not even wanting it in the first place.
Hell, I expect that there are a ton of Medicaid and Medicare recipients in the US who would tell you that they think government-provided, single-payer healthcare is a bad idea, when that's essentially what they have, to some degree.
The elephant in the room is that in every other sphere, scale is the solution, not the problem. The US should find it easier to implement UHC just because of its scale. More tax dollars, more average outcomes, more resources for outliers, more incremental money for research into rarer conditions. That 10x smaller countries like Canada do it effectively is an indictment of America's inability to do it.
America doesn’t do it for political and cultural reasons. It has absolutely nothing to do with scale, economics, or America’s “inability” to do it. Americans (unfortunately imo) have consistently chosen not to do it by not electing politicians who have pledged to do it.
This is the excuse all American use about literally every single issue anytime anybody points out that other do things better. Most often without actually having thought about it beyond 'muhuhu US BIGGG! USA! USA! USA!'.
If you want to make that argument, actually make it, because if you try, 99% of the time its not actually true, its simply ignorance.
The point is that flouride has the same effect on your teeth no matter how many hectares of lifeless desert happen to be controlled by your government.
Interesting, though I think you may have missed a good deal of my own point. Regardless, I wasn't actually commenting on the fluoride situation, I was commenting on the belief that American exceptionalism is the reason we don't look at Europe and other countries for a slew of solutions that won't work here. It had nothing to do with fluoride, so I think your comment and hostility are a bit off the mark.
My point is that those that continually point out 'but some things don't apply to the US because X and Y' are mostly themselves just falling into the same trap and almost never actually explain why X and Y change anything, making their 'defense' just more of the same.
The US isn't several countries put together, region by region. It's one big ass country. I really don't see how taking it region by region somehow eliminates scale issues when you still have to apply it to the entire country.
It's a federal country of many states though. The original design of the US is fairly similar to the design of the EU today, US states used to be offered much more independence.
Sure, I don't disagree that in a vague sense the EU and US are kinda similar in terms of countries and states.
> US states used to be offered much more independence.
But even in your own example with the EU, the EU still mandates many health policies for its member countries: food safety; air and water quality; tobacco, sugar and alcohol regulations; and so on. That's not at all dissimilar to what the federal government does in the US, except our states don't implement those policies/directives themselves because the feds enforce it all.
The comment I was replying to pointed out that the US isn't several countries put together. As you describe, the EU is several countries put together and yet the US actually pushes more power to the states.
> yet the US actually pushes more power to the states.
Doesn’t their comment claim the opposite?
Unlike the US Federal government EU has very limited direct means of imposing any if its laws or regulations on member states of they chose not to comply with them.
There shouldn't be a scale issue with regards to fluoride in the water. It is either scientifically shown to be beneficial or it isn't, scale and geography likely have nothing to do with it.
Does it not depend on the chemical composition of local water? The US is vast, geologically diverse, and water quality varies hugely across it. Denmark can likely make a decision that's good for the entire country.
Actually, what most countries seem to do (according to other comments I’ve seen here), is just delegate to local bodies, so country size is a complete non-issue.
If you focus only on the scale part of my argument, sure. But I think the culture part of my argument is more than enough of an answer for insurance and healthcare:
Maybe it's just me, but I find the argument that "Americans won't do X cool thing that Europeans/the rest of the world do because they [are dumb/are corrupt/love money/hate each other/believe in American exceptionalism]" to be a very cynical and lazy argument. Note that the person I was replying to was talking about policies and goals like UHC and High Speed Rail, not specifically about fluoridated water – that was the context in which I was replying.
The simply reality is, culture matters. And if your culture has a strong believe in exceptionalism pointing out how others are better at something often creates backlash and an increase in opposition rather then a decrease.
And this is known by people who do professional advocacy work, on topic I am familiarly with, such as city design and transportation. They take great care to make sure all the examples are from the US, even if those examples aren't nearly as good as others. Because they know, when speaking to American audiences, you lose the audience if you suggest in X town, they should do Y that is done in Europe. In the US selling something as domestic innovation is usually the best, "if people in Indiana can do it, you can do it even better".
To just ignore any explanation that points out that culture matters, and believing that only 'hard' factors matter, is incredibly foolish. Cultural believes, such as exceptionalism absolutely do a play a huge role in determining what happens in the real world. To point that out, is not cynical or lazy.
And this does not just apply to the US, it many countries have different forms of that.
I feel like this always comes up in these sorts of arguments, that the US is so unique that solutions that work elsewhere can't work here. And yet this point is always hand-waved in, without and specifics discussed, and is just presented as a given.
I really don't buy it, at least not as a general statement.
Those are two odd examples. The Affordable Care Act is similar to the Netherlands health insurance system: https://www.commonwealthfund.org/blog/2011/lessons-abroad-du... (“These similarities are not entirely coincidental. American public officials, health industry leaders, and scholars made frequent visits to the Netherlands in the run-up to the debate over U.S. health care reform, borrowing ideas and, on occasion, citing the Dutch system as a model for what the U.S. might achieve.”).
As to rail, both the first-gen and second-gen Acela is based on the French TGV.
The U.S. has a pitiful amount of high speed rail. It serves no point to mention that this pitiful amount of high speed rail is based off of TGV.
The comparison to the Dutch healthcare system is not apt. While the Heritage foundation may used ideas from the Dutch system our system is quite a bit more Byzantine and inefficient. We spend twice as much per capita on healthcare and have worse outcomes and fewer people covered. Our citizens have far more per capita medical debt than the Dutch.
We didn’t really implement the Dutch system and we didn’t really learn from the French how to build and maintain high speed rail. Saying we learned healthcare from the Dutch because we have doctors like they do makes as much sense as your argument.
The original claim was "The US rarely looks into how other countries solve problems". That claim appears to be false.
Why does the US execution not match that of the countries it looks into? I think it's because talented people in the US disproportionately go into the private sector, leading to an incompetent public sector. American distrust of their government is arguably justified.
I thought the ACA was based on the Swiss system of mandatory insurance? The heritage foundation copied the Swiss, Romney took that proposal to Mass, and Obama thought going with a Conservative initiated plan would make it more bipartisan (it didn’t, but mainly because republicans hated Obama).
IMO the most distinct parts of the Swiss health insurance system is that (1) copay is obligatory but limited (i.e. healthcare isn’t free but it’s not expensive either), and (2) it’s individual, companies cannot pay for it, so there’s no US-like extreme benefit of having a good job.
Yes, having lived in Switzerland I experienced that, and it was the personal buy rather than having group plans was the feature missing from the ACA the most.
aca di. implement a market, it's just that most people buy through their job, because if that's legal you obviously want to be part of a larger bargaining pool for buying.
Group plans suck away cream of crop risk pools. People with good stable high paying jobs tend to be a lot healthier than people working part time crap jobs or working in the trades for themselves.
It isn’t really bargaining power of the pool, but the risk assessment of the pool you are in. Being in a hodge lodge personal pool means you are sharing risk with people who will have more expenses. That’s why Switzerland throws everyone into the same pool, so no crème low risk can be siphoned away.
In the Netherlands we have those two as well, but it is also regulated:
- the cheapest plan must not cost more than 115 eur (dont know exactly), and it has mandatory coverage (‘basisverzekering’)
- there is a maximum copay of 850eur per year (‘eigen risico’)
- some services are not allowed to have copay
- low income people can have extra subsidies to pay for insurance
- insurance is mandatory
- insurance is a personal thing, not a work-thing. Your work absollutely knows nothing about your health insurance
Due to the regulations it is not a big run to the bottom
When I was a kid the schools taught us the metric system, telling us it was the world standard, and would become the standard is the US by the time I was an adult. That was over 40 years ago. And that pretty much sums it all up.
The US legally switched to metric when England did. It is taught in all schools and used for international trade. But, just like in England there is a mix of imperial and metric units used domestically. If you dont travel internationally, like many Americans, there is little need to use metric. Another generation and there won't be many people left in the US that didn't at least learn metric.
It's not like England in that respect at all. Yes, there is a mix of usage in the UK but it is very limited. People use metric for everything except miles in cars, pints in pubs, and height and weight of people.
From what I have read about metrication, England required all industries to change. The US government doesn't have authority to do that and US industry wasn't going to change all their tooling at great cost if they didn't need to.
Banning its addition is a step beyond — but in Queensland, Australia for example, the state government no longer mandates its inclusion, and thus the local councils are able to set their own policy.
> While more than 90 per cent of Australians have access to fluoridated water, that figure is significantly lagging in the sunshine state, where local councils have ultimate authority over whether it is adopted.
> A decade after the Newman government handed responsibility for fluoridated drinking water to local governments, 51 out of 77 have opted out. That means about 28 per cent of Queenslanders do not have fluoridated drinking water
There’s evidence that despite widespread availability of fluoride toothpaste and mouthwash, fluoridated drinking water improves dental outcomes at the population level.
There’s also evidence that at high levels (not the normal levels it is added at, but at higher levels which can happen on accident) fluoride may reduce IQ.
I’m ok with either trade off but the “solved” phrasing makes it sound like there is an obviously superior choice.
What I love about this comment is that one person thought "of course every other country just does the right thing when the US doesn't" and posted it, and then a bunch of other people thought "of course every other country just does the right thing when the US doesn't" and upvoted it, and not a single one of them thought to check what the "right thing" is.
> Water fluoridation is considered very common in the United States, Canada, Ireland, Chile and Australia where over 50% of the population drinks fluoridated water.
> Most European countries including Italy, France, Finland, Germany, Sweden, Netherlands, Austria, Poland, Hungary and Switzerland do not fluoridate water.
The world map is hilarious. Germany sure does not look like this anymore (and this is not the GDR split but goes further back). Maybe they should update this. Draws into the question, the whole data.
Both non-fluoridating countries and country borders are white, so it's not that Germany is drawn wrong, but that that countries near Germany (Czechia, Netherlands, Luxembourg) look like they're part of the same white blob.
> 1. The beneficial effect of fluoride occurs only when fluoride is applied externally, in contact with the tooth enamel
I think you are kinda misusing science/not science arguments.
This is indeed the scientific reason why there is flouride in the water. It is also scientific reason why some countries removed it.
In some countries people take care of their teeth on average and in other countries not so much. So there is science for why fluoridation happens. You can read many articles about the fluoride benefits for teeth and what is the impact of teeth for overall health.
>The problem is that fluoridation of the drinking water is not supported by any science.
Yet it is supported by science.
Indeed even the discovery of this property of fluoride came about from the observation of people who naturally consumed fluoride had fewer dental caries and tooth decay.
Further studies cemented the benefits of the passive inclusion of fluoride in drinking water versus control groups.
So no, the science you speak of is almost certainly politics dressed up as science.
Just a note for future people reading this comment. This is completely and totally wrong, and arguably should be deleted from Hackernews for being so deluded.
There have been countless studies that show that communities with flouride in the water have consistently lower rates of tooth decay than communities without fluoride in the water. In fact, community water fluoridation has been recognized as one of the great public health achievements of the 20th century.
Systematic reviews and meta-analyses have shown repeatedly that water fluoridation reduces tooth decay in both children and adults by approximately 25-30%.
Why is that missing context? I don't think anybody who is against fluoridated tap water rejects the benefits of fluoride, they just think the harms of adding it to tap water outweigh the benefits.
The lethal dose of fluoride is in the 5-10g range for an adult [1] with immediate gastrointestinal effects at 15-20x lower. While those levels are quite obviously far above the recommended level of 0.7mg/l, it's very reasonable to call anything that's lethal at 5g, to a human adult, as dangerous.
The latest report from the National Toxicology Program has found a causal reduction of ~1.63 IQ per additional mg/L concentration of fluoride in their urine [2], which would seem sufficient to also call it a neurotoxin, though the NTP under extensive pressure chose to avoid any particular label after having previously declared it a "presumed neurotoxin."
Notably the study from NTP also mentioned something most people here seem to be missing: "There is a concern, however, that some pregnant women and children may be getting more fluoride than they need because they now get fluoride from many sources including treated public water, water-added foods and beverages, teas, toothpaste, floss, and mouthwash, and the combined total intake of fluoride may exceed safe amounts."
Fluoride being seen as desirable at safe levels, may have drove excessive multi-domain inputs of it, which can combine to drive it to unsafe levels.
> it's very reasonable to call anything that's lethal at 5g, to a human adult, as dangerous.
No it is not. It is sensational and intentionally inflammatory. It is especially damming coming from someone in his position.
Vitamin A, vitamin D, vitamin B, iron, and caffeine are all deadly at that level. The first 4 are mandatory for life, shall we call them dangerous too? Or perhaps we have some nuance and acknowledge the co spirit oriel background (and other beliefs) of the people pushing the anti-fluoride message.
Obviously. In looking up the LD50/lethal dose for vitamin A, I ended up here. [1] You might notice the big red symbol "Health Hazard" at the top. And the LD50 for vitamin A ranges from 1500-3700mg/kg, contrasted against fluoride's 26-94! But really one of the biggest issues here is that unless you're actively trying to kill yourself with vitamins, an overdose generally has no major effects beyond some gastrointestinal issues. I've experienced it myself by supplementing with vitamins while body building and consuming an already extremely high nutrient diet.
But with fluoride we're talking about extremely low doses, well below the lethal level, being able to potentially permanently damage the mind's of children. Such an extreme risk justifies an abundance of caution, especially when the reason we're doing it is for some relatively modest dental gains, which are likely increasingly obsolete with fluoride being in tooth paste and many other sources besides water. In fact, as per the study I linked to up above, this is precisely the problem!
"Since 1945, the use of fluoride has been a successful public health initiative for reducing dental cavities and improving general oral health of adults and children. There is a concern, however, that some pregnant women and children may be getting more fluoride than they need because they now get fluoride from many sources including treated public water, water-added foods and beverages, teas, toothpaste, floss, and mouthwash, and the combined total intake of fluoride may exceed safe amounts."
> which are likely increasingly obsolete with fluoride being in tooth paste and many other sources besides water.
See the rest of this thread. If you think the group (at RFK doing so in an official government capacity) using such inflammatory language is going to stop at removing fluoride from just water I don't know what to tell you.
I disagree there. When you actually listen to what RFK says instead of the media's spin on the most extreme cuts taken out of context, it's nowhere near as sensational. In particular RFK has consistently and repeatedly stressed an opt-in view on all things health/pharmaceutical related. If you want it, you can have it. But when you do things like fluoridate public water supplies, you turn it into an opt-out system where unless you go out of your way - you're going to get it.
Tooth paste, and other commercial products, are opt-in systems. And indeed there are already numerous unfluoridated options available.
IIRC _some_ of the European countries that “do not fluoridate their water” have naturally occurring fluoride levels in their water, obviating the need for them to do it.
That is not true. You are probably thinking of iodine. Actually fluoride is prohibited in children's toothpaste in Germany because of its suspected neurotoxicity.
EDIT: I checked. It is possible to buy salt with added fluoride in Germany but it comes with the health note "Zusätzliche fluoridhaltige Präparate sollten nur auf ärztliche Empfehlung eingenommen werden.", which means you should only use it on recommendation by your MD.
Thanks for pointing that out. I wrote "prohibited" from what I remembered when my child was little and the discrepancy to the info you provided made me research the topic, so here is a summary of what the law (1223/2009 Cosmetic Products Regulation Annex III) has to say:
Tooth paste with more than one per mille of fluoride has either to be marked as unsuitable for children or has to have a note that children have to be supervised using it and a doctor or dentist has to be consulted in case the child swallows more than a pea-sized amount.
So, not quite prohibited, but far from recommended.
Supplementation mainly concerns iodine for non-marine salts. Sea salt naturally contains iodine and fluorine. Salt from salt mines contains much less. For this reason, iodine deficiency was relatively common in the Alps until the beginning of the twentieth century.
To my knowledge, there is no debate or controversy on the subject. Endemic goiters are exceedingly rare and are linked to behavioral and eating disorders.
What does the UK do? This will tell you what people should do because I’ve seen English teeth.
> In England, approximately 10% of the population, or around 6 million people, receive fluoridated water, either naturally or through water fluoridation schemes, mainly in the West Midlands and the North East.
Uh oh. I know it is better now but in 1978 a third of people in the UK didn’t have their natural teeth.
I was reading a while ago about populations that moved to England, and within 2 generations their teeth are messed up (the first gen of kids born is usually raised on the food of their original culture).
You saw it too in Canada when the Inuit went on food stamps and went from eating mostly meat to mostly plants: their teeth went all over the place and full of holes within a single generation.
We also saw that with the advent of agriculture in general, along with a massive decline in average height.
You’re right that dietary changes can impact health, but there are other factors at play. Stress from moving to a new country or experiencing forced dislocation can have serious effects on physical health, weakening the immune system and disrupting overall well-being. Along with this, shifting away from nature-based vocations to more sedentary lifestyles contributes to health decline. The increased consumption of sugar and alcohol also exacerbates dental and general health issues. So, it’s not just diet but a combination of stress, lifestyle changes, and modern substances that contribute to health problems in these populations.
This was not much different everywhere else. Public dental care campaigns helped a lot, the same with affordable dental care products. Looking at my parents generation there are lots of false teeth going around. (Not uk)
My grandfather, who was still alive in 1978, had all his teeth removed and was given a set of dentures when conscripted into WWII. From what I can gather this was pretty common - the service dentist would check you over on arrival and if you had at least one cavity they'd whip the lot out so that they wouldn't need to do anything else to them for the rest of your service.
The point is basically no one else has politicised this to the extent the US did. Pointing to how different countries solve it differently is missing the point completely.
"Well, whether it's better to fluoridate the water or not, ~half the world got the answer wrong. But the important thing is they didn't argue about it."
I'm not in the US but doesn't that downplay it a bit? Hasn't this been a contentious topic for some time? It's not like no one's been talking about it and Utah suddenly decided out of the blue.
> I'm not in the US but doesn't that downplay it a bit?
No, not really. There are a couple municipalities (Portland, OR, e.g.) that have famously not fluoridated their water forever, but for the most part this is not something most places argue about. UT is an exception.
The irony is that people on the Left will claim that red Utah is ignorantly making public health policy, while deep deep blue Portland is considered “progressive.” The public health “experts” are ripping into Utah but haven’t seemed to care about Portland. Perhaps because the public health people are mostly Democrat and care more about politics than actual health? I would love to be wrong — but why is Portland (and much of Europe) getting a free pass from the controversy, but a (relatively low population) red U.S. state isn’t?
Portland, Oregon is a city so the effects of their policies are a little more limited in scope. IMO if it really is a contentious health issue (well-founded or not, I guess people really do disagree about this issue) it is better to make the decision at the lowest level practical.
I think most cities manage their own utilities. So, Portland has to make some decision on this issue. Utah doesn’t, it was an active choice to intervene.
I'm not sure what you're getting at. What I meant was that it was my impression that the argument over fluoride has been going on for longer and is bigger than this one case. How and why the judge ruled and what the ruling was is tangential to that.
They do have a point. If you look at history, Americans do seem to have a bizarre habit of turning everything into a great controversy.
The British abolished slavery with a vote of parliament. The Russian emperor signed a decree, and freed the serfs. Compromised were made, compensation provided and people were made free. But for some reason, Americans felt the matter is important enough to start a civil war around it.
People complain about America being divided and both sides there being unable to compromise, but if anything, that's been the defining feature of the nation since it's creation. "Y'all should take a chill pill, this ain't that important" is a perfectly valid position to have.
England has 3 or 4 civil wars in it's history entirely focused on the matter of whether people should do as they're told and shut up. The usual result in those conflicts was a resounding victory for the "No" side.
What's rare is for a nation to have a civil war between sides that agree on almost everything, from the structure of the government to the economic system.
> The British abolished slavery with a vote of parliament
The situation was fundamentally different. Colonies that allowed slavery had no representation in parliament and the slave owners received massive “compensation” that the British people had to spend decades paying off..
Also AFAIK most slaveholders were living in Britain and just viewed their plantations as just another investment. There was very little ideological/“way of life”/racial supremacy stuff involved. So if some Liberals wanted to buyout their not necessarily very liquid “property” with cash they didn’t really have much reason to oppose it.
And then there were 5x more slaves in the US in 1864 while the population was only ~30% higher than that of Britain in 1830 (only if we don’t count the colonies).
Not sure how excited would the inhabitants of New England and other free states would have been if they were forced to buy out all the slaves in the country (if that was even an option).
Slavery for the British was a side note at that point while it was a fundamental component of the US economy.
Serfdom was fundamental to the Russian economy, but was abolished nonetheless. Alexander II forced the serfs to pay for their own freedom.
The idea that no compromise was possible sounds somewhat absurd since America did end the civil war with a compromise. "You can free the slaves, but then we oppress them for 100 or so years." Not that it was a good compromise or anything, but it does show that the civil war was fundamentally pointless.
Russia was a centralized absolutist empire. The Tsar could more or less do whatever he wanted as long as the army and some other elements of the bureaucracy supported him.
So it’s hardly applicable to the US (or Britain)
> end the civil war with a compromise
I’m not sure it’s was a compromise per se.
Most people in the north didn’t really actively support country wide abolition before the war (neither did Lincoln) nor were they necessarily particularly concerned about the treatment of the African-American population.
Opposing slavery is a very low bar. Most people in the free states were still deeply racist and segregation was effectively (while not necessarily legally) still a thing there. It only became a major issue in the mid 1900s.
> Americans felt the matter is important enough to start a civil war around it.
The answer was the same then as it is now: big business. Slave labor cash crops were central to the economy of the South. Great Britain was not dependent on it in the same way.
While I acknowledge it is not a "solved" issue, I find it bizarre nonetheless, simply because it is so disproportionately low-stakes compared to the amount of controversy around it. Increased risk of cavities versus tentative evidence of losing 1-2 IQ points at 1.5 mg/L? Sounds like a Monty Python sketch to me that people would get so worked up over this.
It’s not at all the same, that’s a terrible example. Child vaccinations help reduce the Rt, regardless of whether the benefit to the individual is significant. Statements to the contrary have just confused the public. (biochemist)
Im sorry, but I think it’s ridiculous that thinking something that knows off an IQ point or two isn’t a big deal.
For one, we’re literally making everyone slightly less intelligent. While it’s a very small factor, I sure as hell wouldn’t want that for my daughters.
For two, IQ is easy to measure. Through that, we know it’s affecting the brain during development. How else is it affecting it? We don’t know.
Weighed against potentially higher risk of cavities pretty much only during childhood and the math seems incredibly clear to me. I feel like the only reason we haven’t banned adding it to water supplies is because people have a knee jerk reaction to anything that sounds even vaguely anti-vax nowadays.
The fact that until 10 years ago the US allowed significantly higher levels should be a really big deal to people.
I’m on reverse osmosis well water so it doesn’t matter to me personally, for what it’s worth.
The risk of cavities is reduced by using toothpaste or mouth washes with fluoride, not by drinking fluoridated water.
Almost all fluoride from the drinking water does not have any effect on tooth enamel, because it has contact with it only for a few seconds, except for an infinitesimal fraction that may exit again the body in saliva.
On the other hand, the harmful effects of fluoride in drinking water are certain and it cannot be predicted exactly how much water will be ingested by someone, i.e. which will be the harmful dose of ingested fluoride.
The only argument of those who support water fluoridation is that most people must be morons who cannot be taught to wash their teeth. I do not believe that this theory can be right.
> The risk of cavities is reduced by using toothpaste or mouth washes with fluoride, not by drinking fluoridated water.
it always surprises me how willing people are to just make something up and be confident in doing so. We've know for almost 75 years that water fluoridation reduces tooth decay[1] and yet here you are straight up denying that.
Do you just not care if you are correct? or do you know you aren't but are driven by the beliefs you already hold?
> Almost all fluoride from the drinking water does not have any effect on tooth enamel, because it has contact with it only for a few seconds
The contact via toothpaste or mouth wash isn’t all that much longer, so why would they be effective if fluoridated water isn’t? People intentionally wash out toothpaste and mouthwash after this short contact.
To straw man, you could argue that 1-2 IQ extra might have a large affect on the salary as everything is relative.
If you are on the lower IQ scale, a ten point reduction would double your likelihood of doing crime.
I put in a spelling error in the above paragraph of 215 characters, you still understand it but what was your perception of me from this very small error?
IQ points is just an indicator that could be measured consistently. Who knows what else is going on.. and statistically (especially depending on the distribution) 2 IQ points is quite a lot. After all 50% of the population fall into the 20 point range in the middle..
Of course it comes down to whether the relationship actually exists. But picking a slightly higher risk of cavities when the other option is potential mental impairment (however mild) seems like a no-brainer..
you're really genuinely shocked that people would get worked up over chemicals being added to their drinking water without their consent? chemicals which have not been conclusively proven to be non-toxic? chemicals which are already in toothpaste giving people the choice to use them anyway?
flouride naturally occurs in water all over the world, and if you don't want any chemicals in your water you should be drinking distilled water. Almost nobody does, because "chemicals in the water reeeeeee!!!" is just a mindless idiotic shreak, not anything insightful or debatable
having to resort to childish attempts like this essentially invalidates anything "insightful" you might want to say. if you can't see that manually adding safety-unproven chemicals to water without people's consent is a weird and unethical thing to do, then that's fine, but don't embarrass yourself and everyone else like this
> if you can't see that manually adding safety-unproven
Nobody is doing that, so maybe don't embarrass yourself like that?
> without people's consent
Also not happening. Consent was established when it was voted on, and if people want to change their local policies they are always free to do so. People that object against majority are also free to drink alternative water from the free market instead of relying on socialist handouts
If you want to have an actual, good faith debate about the pros/cons of a specific additive that's wonderful. But you didn't, you reduced the entire thing to "chemicals bad because chemicals". But, more significantly, so too has the US's administration which Utah is following suit on. The US is full on "feels not reals" government mode.
my friend at this point you are just wildly throwing whatever pops into your mind into the air and hoping it sticks somewhere
when was it voted on and by who? tell me.
you're also aware that people pay for water, it's not free? quite an odd thing for an adult to not know
"good faith debate". from someone who started making mocking autism noises in the middle of a normal conversation? that's what I suggested was embarrassing, you simply didn't read my comment because you yourself have no interest in having a good faith discussion and you're just blindly throwing terms like that as a way of dismissing an opinion you disagree with.
"chemicals bad because chemicals" I never said anything of the sort, this is a strawman you invented to strengthen your struggling argument. there have quite literally been studies linking increased fluoride to toxicity. it's not "chemicals bad because chemicals" it's "there have been studies suggesting this chemical may be toxic so why are we putting it in drinking water without a public consultation in the last 70 years?"
>The US is full on "feels not reals" government mode.
okay and here we have your real motivation. 90% likely you quite obviously don't give a fuck about fluoridated water or human rights, you are pissed about the current executive branch and you're looking to take it out somewhere. this "debate" is over.
What rights of minorities have been targeted? If the only example is trans rights, it's dumb to think it's a simple issue of trampled rights. There are two competing sets of rights, you grant one set you take away from the other. There isn't a good solution.
If you think all the people advocating for small government must be fools or hypocrites, you don't understand the issues an any depth.
Why do trans people not count as a minority being targetted?
I'm curious, what rights are "granted" by making it illegal for doctors to prescribe puberty blocks when they as a medical professional and a child's parents as their guardian agree they're the best medical course of action for a child?
Saying "it's about granting and taking away" like rights are some zero-sum game feels like it's ignoring the complexity of these issues more than what I'm saying.
> What rights of minorities have been targeted? If the only example is trans rights, it's dumb to think it's a simple issue of trampled rights
So it's not an issue of trampled rights if it's just trans rights, yet you can't come up with a reason that trans rights need to be restricted to ensure freedom of others. And it's being disingenuous to call you out for saying trans rights don't matter when you say this...
Example: trans rights in sports. You let them play, you take away the rights to a fair playing field for women born women. You don't let them play, you take away their right to play sport. There isn't a good solution.
You knew the example. You know why society restricts people below 18 from all kinds of things. You are the very definition of disingenuous.
Trans people playing on the sporting team they want to is not "rights", and your focus on it to deflect from the very real issue I brought up is telling...
I don't mind being called "the very definition of disingenuous" by you.
Once you start trying to cross-reference a public health campaign with something related to peoples' diets, it becomes difficult to make super broad and conclusive statements.
Here's some interesting data (2003 I believe, so pretty old) [1]: It reports that most of Europe, Canada, Australia, and South America experiences cavities at rates higher than the United States. However: Many of these countries have public health care; the US does not. Is the US under-reporting? (I didn't dig much deeper into the underlying data; may not be a relevant concern).
Three things I think are likely to be true: (1) Fluoridated toothpaste is widely available and cheap. (2) Cavity rates are significant even in countries with high rates of fluoridation. (3) Fluoridating the water supply carries with it a non-zero monetary cost. I tend to believe that these three realities, at the very least, justify the conversation as being one we should have. It could be the case that water fluoridation made a ton of sense in a world where people didn't have as much access to fluoridated toothpaste, but nowadays the typical person has hit the limit on what it can do for them, and ingesting more is, at best, doing nothing.
Here's another way I like to think about it: Put the science aside for a second (I know, hard, not ideal, but bear with me). You've got two people who are low income. Person A believes, for their own health and in the expression of their own personal liberties, they want access to fluoride; but the Government is not fluoridating their water. They can spend $5 a month to buy fluoridated toothpaste; possibly not even more expensive than the toothpaste they were already buying. Person B is living in the opposite world: They believe that they do not want to ingest fluoride, but the government is fluoridating their water. They would have to spend many dozens to hundreds of dollars a month buying water bottled somewhere more natural. From a personal liberty and economics perspective: Its pretty clear-cut.
Direct monetary cost is entirely insignificant, though. Potential risk of mental impairment (of course there is no conclusive evidence of that) seems like a much bigger issue.
Using your "person a" "person b" story, what about "persons c-z" that also want fluoride because they trust doctors?
If one out of a hundred people don't want fluoride, can't they can spend slightly more on bottled water? Why require the other 99 to be up-to-date on research to get the best personal medical outcome?
Generally speaking I see fluoridation as a ridiciulous idea, on the grounds that the vast majority of tap water ends up being used for things other than brushing your teeth. It is wasteful and damaging to the environment, that excess flouride that has no business being there ends up in the drain, or the water you use for your plants.
Flouride should be put in the toothpaste. Then people can make a choice on whether they want it, but most importantly, its in the only product that is actually used for brushing teeth
It's basically a waste product and water naturally has fluoride in it at the same levels, or more, that fluoridated water has, and the environment has been just fine in those places.
Germany and France don't fluoridate water, but they add fluorine compounds to table salt.
Meanwhile growing up in Poland in the 90s as kids we had these fluoridation sessions in school, for which everyone had to bring their toothbrush and brush their teeth with some kind of sour tasting fluid that contained fluorine.
I thought the comment was about resolving the issue one way or the other without it becoming yet another polarization topic . It probably matters less in either resolution than the cost due schisms and distrust the "debate" causes.
Regardless of whether the water is fluoridated or not, the main guideline is "brush your teeth with fluoridated toothpaste". No policy maker elsewhere is pushing narratives against fluoride at large like in the US. These narratives there are even dangerous. One can easily look at dental associations reviews, or official state guidelines and see that more or less they say very similar things. It is very easy to find these policy-informing reviews online.
And regardless of whether the water is fluoridated or not, there is no big debate elsewhere about it, nobody cares that much about it, because all the evidence is that in smaller amounts prob it is does not matter much either way, in the presence of people brushing their teeth. A lot of countries stopped it due to logistic purposes. In netherlands they tried fluoride in the water, a court said they should actually pass a law in order to be able to do it, and they did not even bother with that and dropped it. The fact that some countries may not use fluoride in the water is not due to some deeply-held conviction about how destructive fluoride is for the iq of the kids. In terms of risks of fluoride, fluorosis is what is mostly discussed anyway, and to a degree, unless it is too serious, this may just be an aesthetic issue.
From the perspective of one that watches this craziness from outside, the whole debate is non-sense, and whether some european countries use water fluoridation or not is not very important, it does not cause any heated debate in the EU. The debate in the US is not because the US considers some things that others do not consider. There is no actual truthseeking mentality from the current administration or anybody on this to actually find for sure if fluoride decreases iq, or if fluoride in the water is absolutely essential for dental health even if people are brushing their teeth.
The issue, to my eyes at least, is much less of water, and much more of fluoride itself. That is what seems mostly a settled and non controversial topic elsewhere such that it is not perennially raised anew with tone of fans quoting Dr. Strangelove except meaning it.
I remember the first time I went to a German dentist and he told me how amazing my teeth looked and that he could tell I must be American. Fluoride may have some downsides but it definitely has upsides.
Food often has much higher levels of fluoride than water, but the fluoride isn’t as bioavailable to teeth when it is in food, hence putting it in water. Fluorine in food may become more bioavailable further down the digestive tract where it does much less good.
> This is one of these US-specific polarised debates I find really bizarre, around some kind of issue that the rest of the world has by large solved but without any acknowledgement of this fact.
> Maybe the US should look into how other countries have solved it?
I mean Utah is trying, sorry it took a while. I know Germany and Sweden don't fluoridate its water, I assume you mean Western Europe by the "world" (sorry if I am interpreting too much here, but that's usually what's popular to compare US to and bash US on how bad it is), so US is getting "with the program", finally I suppose. States having individual laws here is a benefit, one state doesn't have to wait for the Federal Government to act.
> This is one of these US-specific polarised debates I find really bizarre,
I don't think it's that polarizing? Unless 1) you're listening to US media more and 2) you're not getting many non-polarizing issues in the news, because those are well are just boring and don't sell ads.
completely bizarre witnessing both sides getting so polarised around a basically non-issue
This isn't a sensible way to think about it. Every contentious conversation I've ever had has gone this way:
Me: why do people want to ban fluoride
Them: [anti government paranoia]
Me: um...but how about tooth decay
Them: pineal gland calcification
Me: idk sounds pretty far-fetched
Them: THAT'S WHAT THEY WANT YOU TO THINK
It's irrational to complain about 'both sides' when only one side is insisting on making it into an issue. I generally just try to disegnage from people as soon as they start freaking out about fluoride/ chemtrails/ vaccinations etc, but people like this frequently treat skepticism as a personal attack. Increasingly they occupy positions of political power (see eg RFK) having acquired them by public displays of conviction rather than any objective criteria.
The same discussion happened in Netherlands in the 70s, and water in NL is no longer fluoridated since the 70s for that reason. So it's not that "US-specific". I don't know about other countries from the top of my head.
Funny thing you mention that. Since it is now monitored and maintained by natural source. There is fluoride, just not added anymore. (It is at lower levels than when added obviously)
>(It is at lower levels than when added obviously)
This is not obvious. Some water has high levels of fluoride, which can cause harm (fluoride added for public health reasons is not the highest level of fluoride you will find [in the UK]).
Fluoridation could be done by mixing of naturally high fluoride water sources into other water.
If you look at the US as a simulation that branched of the mother tree of Europe in the 15th century, you won't find it odd that it is rediscovering what Europe has already figured out. Just in it's own way and time. (No chemicals/colors in foods and adequate drinking water) Wait till they figure out mass transit, that will be a shocker.
Has Europe figured out mass transit? In Barcelona, a trip that takes me 1.5 hours of total time using “transit” takes me 28 minutes on my motor scooter. I think there is still some figuring out that needs to happen before I’ll add 2 hours to my daily commute.
No no, in the US we figure out the worst way to do something, and then do that, and invent reasons why the US is unique such that the reasonable solutions that other countries employ just couldn't possibly work here.
(To be fair, though, many [most?] Western countries do not fluoridate their water. The US is actually not doing the common thing here.)
It's honestly not clear if water fluoridation in the US is necessary or all that useful here anymore, as we started doing it when fluoride toothpaste wasn't really a thing. Now pretty much all(?) toothpaste in the US has fluoride in it. If someone can't afford toothpaste, then they probably can't afford regular dental care either, and fluoridated water isn't going to make much of an impact anyway.
Here in England, there's some areas that put fluoride into the water and other areas already have sufficient fluoride levels. People complaining about the side effects of fluoridation often forget that water can naturally contain high levels of fluoride - it's really not an issue.
Does filtering your water with a whole house filter take the fluoride out?
Because I live in a small township that delivers well water to you tap. It tastes horrible, shortens the life of pipes and appliances, and smells like sulfur.
Every year they mail a flyer that explains how the lead levels are dangerously above the national standard and you should run the tap before you drink from it.
Like, sorry there's nothing we can do about it. =(
If it's reverse osmosis based, yes. If it's some other kind of filter, likely no, and you should buy a TDS meter and use it, because in all likelihood it's not really filtering anything. I did exactly this. It turned out that my carbon based filter had more TDS than completely unfiltered water from a tap in the garden. RO water, even re-mineralized, had 1/15th the TDS IIRC.
TDS is just Total Dissolved Solids. What solids though you don't know and you could be adding carbon while removing others which is likely the case.
Also those dinky little TDS meters don't even measure TDS. They measure electrical conductivity and with a little math they use the EC as a proxy for TDS. It's typically only calibrated to one specific ion, others will be off by some factor. Also keep in mind TDS is expressed in PPM as CaCO3.
Yes, but be that as it may, at least it shows whether _any_ filtering is occurring at all. Which in the case of even a somewhat spent carbon filter is not a thing. RO does the job so well, you have to remineralize afterwards or the water doesn't taste like anything. You could literally pee into a jar and get fresh water on the other end. That's sort of what happens on sailing vessels that are equipped with water makers - they simply run sea water through RO.
> Because I live in a small township that delivers well water to you tap. It tastes horrible, shortens the life of pipes and appliances, and smells like sulfur.
Oh man, I used to live in a place like this. You could smell if a restaurant served filtered water (lots filter for the soda machine, to keep mineralization in it down I assume, and use the same water to serve) or straight from the tap, without taking a drink. Like with your nose six inches above the cup, you could smell it. Luckily, almost all served filtered.
Turns out that carbon filters do filter fluoride, but only on the first few X litres of water, where X is in the first 0.01% or so of their expected lifespan. So, they do, but not really usefully in any sense.
My filter that I wanted to know about (so that my kid is getting fluoride) is a 2-stage filter, with the other stage being a particle filter, but fluoride is very small and unaffected.
Your filter might be different of course.
FWIW, in my city, the water has essentially zero fluoride if it isn't added, and it has been a great intervention.
Utah has naturally occurring fluoride in their water and some water systems its more than double(2.0mg/l) what they add to prevent dental issues. Why were they fluorinating their water?
> This is the US health system being lead by a bunch of woo-woo people who don’t understand how research works.
The majority of the developed world does not fluoridate their water supply. The US has one of the highest rates of fluoridation in the developed world. Within America, fluoridation rates are highest on the East Coast and in the South, and lowest on the Left Coast.
I am saying it’s weird to fluoridate water in areas with high levels of naturally occurring fluoride. Also to point out that there is naturally occurring fluoride. If Utah believed fluoride was a health risk, why aren’t they spending tens of millions to filter it out. Or is it just virtue signaling.
The people leading the health system are highly credentialed. Moreover, highly credentialed people, in medicine as in all fields, frequently disagree on what studies show, how valid a study is, what it's flaws and limits are, how conclusive it is, and so forth. And the consensus has a long, time honored tradition of being wrong from time to time.
Ultimately, the woo woo people are the ones who rely on someone in a labcoat to tell them whether ingesting government approved (there's your first red flag) synthetic fluoride from industrial byproducts is "necessary".
If it's useful, brushing it onto your teeth and into your gums 56,000 times in your life is probably sufficient, particularly given that we don't know with absolute certainty beyond any shadow of a doubt that the industrial waste options are totally without health consequences. I'll literally just take care of my teeth and cross my fingers over listening to modern medical consensus on a range of topics where I simply trust intuition and common sense more.
this is it exactly. See west virginia recently banning artificial coloring. Because MAGA said so, is basically the reason, they were completely unworried about it before it became important to MAGA world by way of RFK
It is trivial today to get whatever level of fluoride is recommended for dental health, via toothpaste. So there is no compelling need to fluoridate as there exist viable alternatives to achieve the same that fluoridation is for any other purpose than dental health.
In the USA, dental care is not covered by public insurance, and is an optional add-on to insurance through one’s employer.
So without addressing at all whether fluoridation is effective or safe, there doesn’t seem to be any compelling need to fluoridate public water, and there’s no economic down side for the public if governments choose not to do so.
Given this, why not just leave people alone to make their own choices? If the citizens in a city or state want to fluoridate the public water supply, then do so; if they choose not to, then leave them alone. It’s a free country and voters are grownups; let them choose for themselves.
If you live in a place that chooses the choice you dislike but for some reason fluoridated public water supply is a critical issue for you, either campaign to change it or vote with your feet.
This issue just doesn’t seem important enough to me to spend any effort arguing either way.
Perhaps, sadly, because if the State doesn't have to pick up the costs in health care, as in large parts of the developed world, then they lose their incentive to be proactive in addressing health issues.
In countries with some form of universal health care, simple proactive health interventions can save the State large amounts of money.
In theory health insurance in the US has the same incentive. But it's cheaper to deny preventative care and then deny or minimize or cap coverage later on.
I think one thing you're not considering (especially when you say we should vote with our feet) is poverty. It’s true that fluoride toothpaste is widely available, but for people in poverty, of which there are millions in our country, basic hygiene items like toothpaste and a toothbrush aren’t guaranteed. Neither is it guaranteed that everyone has a perfect daily brushing habit like the dentist tells us; there are people who don't brush every day, or even every week.
You talked about dental care not being covered by public insurance — is it not worth considering that some basic level of dental care is already being applied to the country via fluoridation? It's a minimal, cost-effective way to prevent tooth decay at scale. Fluoridated water is one of the few dental protections available to everyone regardless of their income.
The number of Wal-Mart employees I know who can't get their managers to schedule them for the thirty hours a week required to be eligible for dental care far exceeds the number of Wal-Mart employees I know who can.
If you're not brushing your teeth, periodontitis will get you; the resulting bone decay will cause your teeth will fall out. But sure, great, the water was fluoridated, so I guess it's nice that those now-missing teeth are free of caries?
I really don't feel like you're interpreting my comment in good faith. Do you really think I was arguing that poor people literally never brush their teeth, and every single poor person in the country will eventually suffer from periodontitis? If you read my comment again, I'm sure you could find a way to engage in better faith.
there are people who own a toothbrush but do not purchase toothpaste. money is not something everyone has and when you start having to choose between certain things, tough choices get made.
I don't believe there's a single person in the USA that's so poor they can't pay $3 for toothpaste every 3 months. I also believe that having such a low personal hygiene where you don't brush your teeth altogether, even if you drink water with fluoride, will have terrible results anyway for your teeth anyway.
I'm completely sure that any people that don't brush their teeth is just because they are too lazy to even bother.
This trope of justifying everything with "but there are millions of poor people in the USA" is really tiresome.
It's not that they can't afford a $3 toothpaste, it is the environment they are in that makes it hard to prioritize things like this. It is the education and the overall life quality (or the lack there of) that causes this problem.
In general it's some weird relic of medieval view on dentists not being medical professionals but someone akin to barbers. It shouldn't exits but it persists.
> This issue just doesn’t seem important enough to me to spend any effort arguing either way.
Your comment is well-stated, and in the spirit of a free and liberal society. The problem—not with your argument, but with the world—is that today there seems to be literally no issue unimportant enough not to argue about, or use as the battlefield for an unending ideological proxy war. My guess is that few of the people arguing this issue on HN have strong feelings about flouride qua flouride, but have strong feelings about the kinds of people they believe oppose or support the use of flouride in water, and this notion is what they're really railing against.
This rings true for my gut reaction. The family and acquaintances in my life who have been up in arms against fluoride for years now are actual neo nzs (like “deport all non whites”, “you-know-who controls america”, “superiority of the white race” level).
So my instinct is to really be afraid of this anti-fluoride wave, even tho practically I don’t care one way or another.
Trivial is what we have now. Taking fluoride from the water means people will have to spend extra time and money on fluoride and dental treatments. When I viewed it, your comment appeared directly after this one (https://news.ycombinator.com/item?id=43524171), which talks about a town in Canada that voted to abandon fluoride , saw worse health outcomes, and then voted to reinstate it. This tells us that fluoride is not trivially available to people, and taking it away from them enriches corporations while making people less healthy.
It is trivial today to get whatever level of fluoride is recommended for dental health, via toothpaste. So there is no compelling need to fluoridate as there exist viable alternatives to achieve the same that fluoridation is for any other purpose than dental health.
I also agree that people should be able to make decisions like this, but they should be aware that one of the results of these kinds of efforts could be that everyone gets less healthy, rather than everyone stays at the same level of health with less cost.
Presumably when they voted to get rid of fluoride in the water in Calgary, they didn't do so expecting the outcome would be that people in their town would be less healthy overall. Nonetheless, that was the outcome of their vote.
The anecdote shows that it's not trivial, because when the fluoride in the water went away, people were not able to trivially replace it, leading to worse health outcomes. Ultimately people found too high of a cost, seeing as that they reversed the decision.
Sadly it took a decade for them to realize their mistake. I worry people today are making the same mistake, and we will reverse it in a decade after health outcomes are shown to have worsened.
Your indifference is based on some core assumptions that are false. In reality,
1) Fluoride in water works in addition to fluoride in toothpaste to protect our teeth - rather than two highly concentrated events of reminieralization, fluoriated water reminieralizes the teeth throughout the day.
2) There is a strong economic downside to ceasing fluoridation: Fluoridation saves millions of dollars that otherwise would be spent on dental bills by the public - https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0... - shows cost savings ratio of twenty dollars for every.
dollar invested in reduced treament costs. This remains apt: https://pmc.ncbi.nlm.nih.gov/articles/PMC7164347/
3) The best way to preserve choice is to maintain fluoridation. People cannot choose to fluoridated their own water system - they can choose to live in unfluoridated areas, use filters that remove fluoride, or otherwise avoid the tap water.
4) Removing fluoridation means acces to fluoride becomes much more difficult and expensive. The reason fluoridation is so cost effective is that it is delivered through the public water system - a community resource. Bottled fluoridated water is more expensive than gasoline. It is also less regulated and less available in the U.S.A.
It's the concentration that matters. Toothpaste has over 1000x the concentration of fluoride vs 0.7mg/L as tap water. Many well water sources have naturally occurring fluoride that exceeds the additive levels.
Very low concentrations of medicine are usually ineffective at its stated purpose outside of pseudo scientific theories, so even if it is safe to ingest, it is not clear it is able to do anything for people’s teeth.
That is why I do not understand how the two can co-exist. Either the concentration is so low that drinking it for dental health is pointless, or it is not something people should be drinking. If there was a middle ground, we would have a 1 a day pill for this and not bother brushing our teeth or putting fluoride in water.
> If there was a middle ground, we would have a 1 a day pill for this
We do; fluoride tablets are common.
> and not bother brushing our teeth
Brushing your teeth does a lot of things besides applying fluoride to the surface. It's mostly about getting stuff that's already there off the surface.
My initial searches suggest that these are by prescription only. Do you have any information to the contrary? I did find toothpaste tablets, but those are meant to be used as toothpaste from what I can tell.
This is not a one a day pill then. If ingesting it is regulated, that would be consistent with it not being something regular people should ingest regularly.
(I'm having some fun, but it is in fact the first thing that comes to mind when I hear objections to fluoridated water. Since we're talking about RFK and Utah, I kind of assume it more or less stems from the same fears.)
Fluoridation is literally one of the most successful efforts at improving public health in history. Dental health is keystone to general health.
The idea that the conspiracy theorists are winning the public policy debate enrages me. There's rock solid proof of the benefits of fluoridation extending decades, and there is little to no proof of any adverse side effects.
Oh well, good luck Utah. I'm glad I don't live there, but if I were a young dentist, I know where I'd set up my new practice.
Fluoride in water wouldn't be necessary is sugary drinks were taxed heavily (or just banned altogether) and dental care was affordable. But obviously that's considered communism if you're a typical american.
Before someone tries to pin this as a decisively left-right political issue, Portland, Oregon has been virulently anti-fluoride for over 70 years (which is probably the last time Portland and Utah agreed on anything):
Portland is a bit odd when it comes to water; they drained an entire (uncovered, open to the elements) city reservoir because a guy peed in it. True story. I assume they have signs for the birds flying aloft to not defecate over the reservoir.
Edit: It appears many posts all over this thread are being brigaded with downvotes. Why? Is Big Fluoride in trouble? Grow up. You people are brain damaged (possibly from fluoride).
I truly don't care one way or the other on the dental advantage that fluoride offers in drinking water, or the alleged risks it poses to the IQ of unborn children. I simply hate the fact that public policy is now being driven by what are essentially New World Order conspiracy theorists
I think it's worth reminding people of Occam's Razor, and the point of it is: a simple explanation is often better than a complicated one.
The US has had water fluoridation for 65 years, affecting 346 million people. That's a pretty big god damn sample size and long amount of time in which to observe effects. If we still have no proof of significant negative health effects, it's probably not bad for you.
That said: you can always lower the amount of fluoride if it turns out the local area already gets a lot of fluoride from other sources. You don't need to ban it, you can just lower the levels.
So please don't defend this decision by Utah. They're being children.
Using a prospective Canadian birth cohort, we found that estimated maternal exposure to higher fluoride levels during pregnancy was associated with lower IQ scores in children. This association was supported by converging findings from 2 measures of fluoride exposure during pregnancy. A difference in MUFSG spanning the interquartile range for the entire sample (ie, 0.33 mg/L), which is roughly the difference in MUFSG concentration for pregnant women living in a fluoridated vs a nonfluoridated community, was associated with a 1.5-point IQ decrement among boys. An increment of 0.70 mg/L in MUFSG concentration was associated with a 3-point IQ decrement in boys; about half of the women living in a fluoridated community have a MUFSG equal to or greater than 0.70 mg/L. These results did not change appreciably after controlling for other key exposures such as lead, arsenic, and mercury.
To our knowledge, this study is the first to estimate fluoride exposure in a large birth cohort receiving optimally fluoridated water. These findings are consistent with that of a Mexican birth cohort study that reported a 6.3 decrement in IQ in preschool-aged children compared with a 4.5 decrement for boys in our study for every 1 mg/L of MUF.10 The findings of the current study are also concordant with ecologic studies that have shown an association between higher levels of fluoride exposure and lower intellectual abilities in children.7,8,26 Collectively, these findings support that fluoride exposure during pregnancy may be associated with neurocognitive deficits.
1. IQ is not an objective measurement, it is inherently flawed
2. A 1.5-3 IQ level difference is not noticeable in any practical way. Things like birth order have a more significant impact on IQ.
3. Comparing Canadian children to Mexican is pretty dramatic, like comparing rich kids to poor kids; you will always see a marked difference between the two, in intelligence, in health, in crime, in all sorts of things. Mexican communities often over-fluoridate their water (I know because I grew up in Mexico and my teeth are stained because of it). Again, this is no reason to ban it, just lower it.
This finding is a suggestion of a link, it's not empirical proof. The methods and findings have many questionable aspects. You can always find some paper that suggests something random like vegetables are bad for you or something. One paper does not a water-tight case make.
> The US has had water fluoridation for 65 years, affecting 346 million people. That's a pretty big god damn sample size and long amount of time in which to observe effects. If we still have no proof of significant negative health effects, it's probably not bad for you.
The problem is there will have been a lot of confounders.
E.g. despite huge sample sizes, isolating the cause of the obesity crisis is too hard because so many different things changed at once.
Sure, it's not easy to find a smoking gun. That doesn't mean we go all in on whatever we think might be the issue (if there even is an issue).
The answer to the obesity crisis wasn't to ban Pizza. We don't we ban sodas and junk food at schools, which we know would have a positive impact on health. But we do ban fluoride, without proof that it will help? With actually the only scientific proof being that it would be detrimental to remove?
If people's concern is really that it might slightly lower IQ, consider that 1) IQ has been steadily increasing since the 40's, and 2) you can get better IQ by investing in education, something that we do an embarrassing job of already and need to improve on.
The other concern touted is that it might cause cancer. As we well know by now, nearly everything causes cancer.
Banning fluoride is just a move by politicians to take advantage of ignorant scared people to drum up more votes/support. It's like every other action they take to vilify something scary or unknown and then claim victory over the evil thing they purged. This isn't new, either - this clearly partisan stance was being pointed out in the 1950's when it was first being considered for nationwide use.
"After more than 70 years of investigation, there are still questions about how effective water fluoridation is at preventing dental decay and whether the possible risks are worth the benefits. Although water fluoridation undoubtedly did improve the dental health of many children in the 1960s and 1970s, fluoride proponents were perhaps too hasty in declaring that community water fluoridation was the best (or only) solution for dental decay. A less fractious debate might have encouraged a more open discussion in which the possible harms could have been more fully discussed and other options, such as providing fluoridated toothpaste, more fully considered." - https://pmc.ncbi.nlm.nih.gov/articles/PMC4504307/
1,362 comments
[ 417 ms ] story [ 1917 ms ] threadhttps://news.ycombinator.com/item?id=43484093
[0] https://en.m.wikipedia.org/wiki/Water_fluoridation_by_countr...
One of the biggest factors of what?
For example: https://pmc.ncbi.nlm.nih.gov/articles/PMC6169031/pdf/10.1177...
Which finds that fluoridated water likely conservatively prevents about 30% of childhood dental caries.
This is so dumb, and based on psudoscience at best, and straight up falsities at worst.
In 10 years we're going to hear about how cavities are so much higher in Utah than anywhere else.
https://hsph.harvard.edu/news/fluoride-childrens-health-gran...
https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
Follow up studies have found the levels in the USA to be perfectly safe and in fact beneficial since poor people don't get dental care like they do in other countries.
HN Comments were very credulous before the election. Shows how flexible belief in science is.
https://news.ycombinator.com/item?id=39235663
because everybody drinks the same amount of water right?
ridiculous position to argue from.
Not sure if that first link was to the Harvard summary intentionally but heres the actual study: https://ehp.niehs.nih.gov/doi/10.1289/ehp.1104912
*The NTP monograph concluded, with moderate confidence, that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children. The NTP review was designed to evaluate total fluoride exposure from all sources and was not designed to evaluate the health effects of fluoridated drinking water alone. It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ.*
The EPA limit for fluoride is 4mg/L. There's an argument to be made that it should be lowered to 2mg/L. When fluoride is added to drinking water, the target is around 0.9mg/L--no one's coming close to the EPA limit, and that exists because groundwater sources can end up being naturally high in fluoride. (I'm not sure what the typical natural occurrence of fluoride is in Utah, but I strongly suspect that they're not making any moves to actually remove fluoride from existing systems.)
> The NTP monograph concluded, with moderate confidence, that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children.
https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
I don't know whether water fluoridation is worthwhile. But I do know that various European countries have discontinued it. <https://web.archive.org/web/20160303202219/http://www.appgaf...> Are they also working off of pseudoscience and falsities?
In reality what will happen is that rich kids will be just fine because they will get their fluoride treatments at the dentist every six months.
It's the poor kids who will suffer because they don't see the dentist regularly because it's expensive, so they won't get their treatments.
It is true that many studies were at higher doses(2x to 4x), but that should not mean that it is acceptable to intentionally raise fluoride levels to half of harmful levels, because we want to protect teeth.
If you don't want cavities decrease sucrose, brush and floss. Can I brush my teeth with use baking soda, use whatever? Arent they are OUR teeth? What if we find some additive might help some other health issue? Should we add that to everyone's drinking water?
At safe levels fluoridation is a public health measure akin to fortifying foods with vitamins (e.g., iodine in salt or folic acid in flour something we do all the time).
That's a very high standard of evidence.
Toxicity testing is often carried out on mice, up to the dosage required for any observable effect. From that safe levels for humans are derived, e.g. the NOAEL (No Observed Adverse Effect Level).
To say that a study done in humans, got observable effects at only twice the intended dose (who knows what the s.d. of the dose is, but anyway) and we conclude there's simply not enough evidence?
Many chemicals have been banned on the basis of far less evidence.
Consider the following: Many water sources have a ton of salts and such in them naturally. Fluoride being one of them. The reason why water fluoridation became a thing in the first place is because it was noticed that higher natural levels of fluoridation resulted in fewer caries.
Water treatment in order to make it safe to drink often involves processes that remove and filter out these minerals and chemicals. Which means said things need to be added back in, as part of the treatment process.
Also, fluoride helps with remineralisation when it is used pretty much regularly, not once per 6 months. Fluoride treatments once per 6 months are not gonna bring back the enamel lost.
I do not understand what is the big deal here. In many countries there are specific recommendations wrt to fluoride and kids brushing their teeth that seem to work fine. This seems to be a solved issue in many places in the world without fluoridating water.
As for “fluoride treatments”, those are applied to the teeth, not drank. They are not a substitute for regular brushing.
Are you asking if there's room to believe it's just a sincere "everything you eat or drink should stay untouched, like it's found in nature" belief? OK sure, let's go with that. So why aren't they working to dismantle water treatment plants altogether and e.g. fighting against modern industrial farming practices in that case?
I'm happy to believe it if I can understand what is leading them to that belief, which is exactly what I'm asking. Is it a general aversion to unnatural stuff (hence my previous comment) or based on some evidence (hence my initial question) or something else (what?)?
Again, we go back to my initial question [1]: what is the best evidence in favor of this?
[1] https://news.ycombinator.com/item?id=43518377
[1:20] "I do believe that autism comes from vaccines" [https://www.foxnews.com/video/6330950198112]
Does it matter what he actually believes? If it's different from the Trump's policy he'll keep it to himself.
The burden of proof should be on the people who want to add it. Because that is extra cost, extra chemical. If they can't prove it, then we don't do it.
> However, in 1973, the Dutch Supreme Court ruled that there was no legal basis for fluoridation…. The debate hasn’t been meaningfully revived since then, Hofman told Euronews Health. "People started to say, ‘Well, the government should not give us some medicine [when] we cannot choose where to buy our drinking water from," she said.
That’s the “little c” conservative viewpoint. You don’t need to prove it’s harmful. The default should be not putting chemicals in everyone’s drinking water.
there is definitely an argument for an optimal amount of minerals in water being non zero (not only because having it that clean would be practically expensive) but also because we benefit from natural minerals. now if some natural water source isnt as good as another one, why not correct it? we have the technology.
especially at the community level. the little c stance should be to let communities decide, not ban it from the top down.
Fluoridated water seems not to have major effects.
I wouldn't want to drink, touch, or be near fluorinated water.
Could it have something to do with the increasing use of fluoridated toothpaste?
If the benefit is great enough then the risk makes sense. That is the case in a lot of areas. Is it worth taking a risk of an unknown effect somewhere in the body in exchange for… a marked but not even drastic reduction in cavities…? Not sure…
Let’s say that hypothetically there is a 3rd order effect on the excretion pattern of some neurotransmitter. Can we detect that? Could it negatively affect mood regulation? There are a million things like that.
Where do you get this from? If you ingest a random chemical (or imagine licking random objects...), do you really expect the chances of it being beneficial vs. detrimental to your health to be remotely close to 50/50?
This is only true if you assume that all effects are too small to notice. If you run an experiment on adding fluoride to water, declare an interest in enamel thickness, and then observe that 30% of the experimental group died within six months, you just made a finding that you didn't know you should have been looking for.
https://www.ncbi.nlm.nih.gov/books/NBK109832/=
> .9 Radiographic detection of teeth and skeletal changes and microscopic examination of affected bone are helpful adjunct procedures for diagnosis.
> Histopathologic and radiographic examination of bones detects bone lesions and tentatively confirms osteofluorosis.14,26 Biopsy or rib or coccygeal vertebrae is used to obtain samples for skeletal fluoride analysis.23
https://www.sciencedirect.com/science/article/abs/pii/B03230...
https://en.wikipedia.org/wiki/Skeletal_fluorosis
> We have developed a localized noninvasive nuclear magnetic resonance (NMR) method for determining the accumulated bone fluoride content in human index fingers
https://pubmed.ncbi.nlm.nih.gov/2339643/
---
It sounds like people who have time to pay attention to this have a better chance of discerning a methodology of assay.
I grew up in the PNW of the USA and lots of small hippie towns have been removing fluoride for decades. It comes up on city ballots every year in Oregon.
When it comes to things like radioactivity we assume a linear no threshhold model (e.g. that lower concentrations still have effects, just our measuring tools aren't good enough to detect it) and spend billions as a result. Why wouldn't we do the same for flouride?
2023 – NTP Monograph on Fluoride Neurotoxicity – National Toxicology Program (USA)
2020 – Till et al. – Infant Formula Fluoride Exposure & IQ – Till C, Green R, Lanphear B, Hornung R, Martinez-Mier EA (Canada)
2019 – Green et al. – Maternal Fluoride Exposure & IQ – Green R, Lanphear B, Hornung R, Flora D, Martinez-Mier EA, et al. (Canada)
2017 – Bashash et al. – Prenatal Fluoride Exposure & Offspring IQ – Bashash M, Thomas D, Hu H, et al. (Mexico/USA)
2012 – Choi et al. – Meta-analysis on Fluoride & Neurodevelopment – Choi AL, Sun G, Zhang Y, Grandjean P (Harvard/China)
2006 – NRC Report – Fluoride in Drinking Water – National Research Council (USA)
[1] https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
[2] https://pubmed.ncbi.nlm.nih.gov/31743803/
[3] https://jamanetwork.com/journals/jamapediatrics/fullarticle/...
[4] https://ehp.niehs.nih.gov/doi/10.1289/EHP655
[5] https://ehp.niehs.nih.gov/doi/10.1289/ehp.1104912
[6] https://www.nap.edu/catalog/11571/fluoride-in-drinking-water...
From the first link:
> It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ
It doesn't seem in favor of this?
> the first link [...] doesn't seem in favor of this?
To me that falls under "the best evidence [available] in favor of this." It's not great, but it's not nothing; it's certainly something in favor. After all.. I guess I don't know about you, but I feel like if someone told me dose X of something is toxic, I would not feel comfortable feeding myself and the entire country 50% of that dose, on that basis alone.
Granted, 35% < 50%, but not really that much less.
I don't know if what you are repeating is slop, etc. I can't trust the source.
A single recent systematic review is more trustworthy than that.
Also, nothing in that list of papers supports your initial claim? I know you'll say you didn't claim anything, so I will say also, that nothing in those links provides for what the prior commenter asked for evidence for.
Other than, fluoride consumption at high concentrations is bad (which is something that was already agreed upon, and is not being questioned in this thread)?
Put simply, it's a wall of links. No quotes. No claims. Its valid to ask if the person posting the links has actually read those articles, or if there is a primary source recommending them. (Or no source if it's LLM copypasta.)
I am the OP and someone asked for evidence and the only answer after an hour, falsely stated there was no evidence. I didn't want to challenge anyone directly so I posted what I thought were the top few more convincing links I have compiled out of 30+.
I am disappointed that I am getting downvoted and this is somehow being made into something political when people deserve to see the evidence for and against supplementing fluoride the drinking water of every living thing because the government wants to improve the health of our teeth. It is a fair question to ask.
The very famous meta studies with all the negative correlations get all the bad associations with flouride from regions where water naturally has extremely high (relative to most other parts of the world) levels of fluoride in addition to high levels of many other uncommon concentrations.
Some of these regions also have additional problems with industry waste.
Put simply, negative correlations about unattended children in swimming pools cannot be extrapolated to infer negative correlations about young children and sippy cups of water.
No? What is a coping response? I asked the commenter to provide context to their links that supposedly show evidence for what the initial question was (does fluoride at the concentrations in drinking water cause harm), which they definitely do not show evidence for.
Nah. I pretty much agree with what Utah is doing here (though I’d prefer just not mandating it and making the decision as local as it needs to be). OP’s link list looks AI generated. That’s just not a good-faith comment.
I suppose you want a summary, well read the abstracts of the papers. It's not that challenging, is it?
They first went defensive when asked about it up thread [1].
[1] https://news.ycombinator.com/item?id=43519312
I didn’t downvote. (I don’t think.) But as a non-expert, I also didn’t see value in a wall of links. (Particularly when you wouldn’t confirm it wasn’t AI generated.)
A better presentation would pull quotes or make an argument, in your voice, with the citations as scaffolding for your arguments.
To illustrate the issue, I believe I could construct a context-free wall of links justifying just about anything.
If you could explain the process that led to the production of the list & what led you to the belief that those are the best studies/evidence so far, that would probably help people view it more favorably.
Perhaps I should note that I had indeed (believe it or not) already Googled this before asking the question. I asked not because I was too lazy to search but because I didn't know if my search was turning up the best studies from anyone's perspective.
So, no, this wasn't equivalent to saying "I don’t want to google this, so google this for me."
Agreed
There's a subset of researchers that argue that now that fluoride toothpaste is widespread, the benefit of fluoridating water is much much smaller than it first was and the (small) risk of fluorosis is now comparatively more significant
The CDC tracks some key indicators like mean decayed, missing or filled teeth (DMFT) and in critical age groups like 12-15 there has been no progress made in the past 20 years and the US continue lagging behind European countries: https://www.cdc.gov/oral-health/media/pdfs/Oral-Health-Surve...
And none of that has anything to do with fluoride in the water or not.
Sorry but this reddit consensus is out of step with actual researchers. The #1 paediatric journal has published quite a bit on this recently. Basically the evidence isn’t of high quality but what we have doesn’t look great.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/...
Highly recommend visiting the link for details about each point an references (it is not that long), here is a summary, don't comment if you haven't visited the link:
1) Fluoride is the only chemical added to water for the purpose of medical treatment. 2) Fluoridation is unethical. 3) The dose cannot be controlled. 4) The fluoride goes to everyone regardless of age, health or vulnerability. 5) People now receive fluoride from many other sources besides water. 6) Fluoride is not an essential nutrient. 7) The level in mothers’ milk is very low. 9) No health agency in fluoridated countries is monitoring fluoride exposure or side effects. 10) There has never been a single randomized controlled trial to demonstrate fluoridation’s effectiveness or safety. 11) Benefit is topical not systemic. 12) Fluoridation is not necessary. 13) Fluoridation’s role in the decline of tooth decay is in serious doubt. 14) NIH-funded study on individual fluoride ingestion and tooth decay found no significant correlation. 15) Tooth decay is high in low-income communities that have been fluoridated for years. 16) Tooth decay does not go up when fluoridation is stopped. 17) Tooth decay was coming down before fluoridation started. 18) The studies that launched fluoridation were methodologically flawed. 19) Children are being over-exposed to fluoride. 20) The highest doses of fluoride are going to bottle-fed babies. 21) Dental fluorosis may be an indicator of wider systemic damage. 22) Fluoride may damage the brain. 23) Fluoride may lower IQ. 24) Fluoride may cause non-IQ neurotoxic effects. 25) Fluoride affects the pineal gland. 26) Fluoride affects thyroid function. 27) Fluoride causes arthritic symptoms. 28) Fluoride damages bone. 29) Fluoride may increase hip fractures in the elderly. 30) People with impaired kidney function are particularly vulnerable to bone damage. 31) Fluoride may cause bone cancer (osteosarcoma). 32) Proponents have failed to refute the Bassin-Osteosarcoma study. 33) Fluoride may cause reproductive problems. 34) Some individuals are highly sensitive to low levels of fluoride as shown by case studies and double blind studies. 35) Other subsets of population are more vulnerable to fluoride’s toxicity. 36) There is no margin of safety for several health effects. 37) Low-income families penalized by fluoridation. 38) Black and Hispanic children are more vulnerable to fluoride’s toxicity. 39) Minorities are not being warned about their vulnerabilities to fluoride. 40) Tooth decay reflects low-income not low-fluoride intake. 41) The chemicals used to fluoridate water are not pharmaceutical grade. 42) The silicon fluorides have not been tested comprehensively. 43) The silicon fluorides may increase lead uptake into children’s blood. 44) Fluoride may leach lead from pipes, brass fittings and soldered joints. 45) Key health studies have not been done. 46) Endorsements do not represent scientific evidence. 47) Review panels hand-picked to deliver a pro-fluoridation result. 48) Many scientists oppose fluoridation. 49) Proponents usually refuse to defend fluoridation in open debate. 50) Proponents use very dubious tactics to promote fluoridation.
Also, dentists have no neuroscience background! So let's take recommendations by dentists to ingest a neurotoxin with deep deep skepticism, shall we?
Vitamin D is also quite toxic, would you celebrate banning that as well?
Not at the levels it is found in water in the USA. Those studies were done in countries with much higher levels of fluoride.
Anyway, lots of things in this world that are bad for people in high doses are beneficial in smaller doses. Water is a great example, as are salt and sugar.
With fluoride, relatively small amounts in the drinking water is known to cause lower IQ.
But somehow even smaller amounts are safer?
Do you just not see the problem here or are you purposely blinding yourself to the reality because of your political biases? Is it an unconscious thing for you?
You are simply not being rational. You are making excuses and excuses for holding a belief you have had and probably defended for years. And now you are too invested to left the belief go. Just let it go already.
> We know the biological mechanisms in the body that makes use of salt and sugar.
We also know it in fluoride: https://www.nidcr.nih.gov/health-info/fluoride/the-story-of-...
> But somehow even smaller amounts are safer
Yes, that's how nature works. Take a look at some typical prescription pharmaceutical doses sometime; many of them are awfully small. Like micrograms per kilogram.
The other thing to consider is that in life we balance risks and benefits with the aim of achieving a net positive. Most things that are good have some risks, and many things that are bad have some benefits. We know the benefit of water fluoridation, and the value to society is large. Meanwhile, we suspect there is a possible drawback of water fluoridation, though there is not a lot of data, and the risk is small at the amounts added to municipal water supplies. Nobody has been able to characterize the offsetting loss to any degree of certainty, so we cannot effectively recalculate the cost/benefit analysis.
To a degree, it becomes impossible for them on a subconscious level because of the social costs involved.
This is a mass psychology problem, not a scientific evidence problem.
It's too convenient to discount people who disagree with you as being "politically biased" and "blinded." A better explanation is that they observed the same input you do and concluded the benefit is still worth the risk.
And if it turns out that millions of Americans became stupid because of fluoride and not, say, bad parenting, phone addiction, and manipulative media, I won't be too proud to admit you were right.
For reference, adding lead to fuel was far, far worse.
I suspect it is hard to control for confounding correlations - specifically I would guess it is more likely that poorer areas are flouridated. HV electric power lines and nuclear stations have the issue that poorer people are more likely to live next to those, and poorer people have have worse health outcomes so it falsely appears that both of those cause the health problems.
It's kind of amazing to say something like that then be so inconsistent on things that will have real outcomes that make life better for kids. They're all for cutting school support and social services.
It also has among the happiest citizens: https://www.deseret.com/utah/2024/09/09/utah-mental-health-h...
It has the highest economic mobility in the country: https://www.forbes.com/sites/adammillsap/2023/12/22/utah-top...
Despite being filled with guns, it’s got a homicide rate only a little higher than Canada: https://en.wikipedia.org/wiki/List_of_countries_by_intention...
And it’s ranked in the top 10 states for life expectancy: https://www.axios.com/local/salt-lake-city/2022/08/24/utah-t...
Utah and Massachusetts are basically the steel-man versions of their respective ideologies. But Utah doesn’t have the benefit of Harvard and MIT, major Pharma companies, etc. It’s surrounded by desert and has no natural resources to speak of.
Then they redistribute to their poorest members in the form of free private education at all pre-college levels and highly subsidized college as well. And with food banks, free or subsidized medical services, and whole bunch of other things the government doesn't provide.
They've essentially traded one government for another, but theirs requires belief in their religion and only applies to their believers (who happen to concentrate in Utah).
Is that income before tax or after tax?
"After tax" seems like it should be obvious, but then wouldn't that require tax specialists to decide how to deal with tax exceptions (retirement taxation incentives, donations, etcetera).
If the 10% donation is tax deductible, doesn't that require some mathematics to work out the 10%?
Irrelevant aside: I think the efficient altruist 10% is "We're often asked how exactly to calculate income — should it be pre-tax or post-tax? Generally, we recommend choosing the option that makes most sense to you, though we think it makes sense to choose pre-tax if your donations are tax-deductible (for example, GiftAid counts towards your Pledge!) and post-tax if they're not.". https://www.givingwhatwecan.org/pledge
I presume there are guidelines that get complicated? Like Halakha or Sharia?
I can't speak to how enforcement was in the past (I haven't researched it enough to say), but the way it currently stands is there is a yearly "tithing settlement". No tax documents are requested, all that our church has is the amount I donate. The bishop asks if I'm a full tithe payer, and accepts my answer.
Social pressure perhaps? But at least where I've been it's appeal to morality as taught in our canon.
Membership is not rescinded for not paying tithing, but a temple recommend requires being a full tithe payer (as reported by me).
EDIT: link to the official handbook: https://www.churchofjesuschrist.org/study/manual/general-han...
The only tax form I can think of is a form they send me so I can deduct it from taxes (as it's legally a tax-deductible donation).
EDIT: Section 34.4, 34.5.2, and 34.5.6 are applicable.
34.4:
> Confidentiality of Tithing and Other Offerings
> The amount of tithing and other offerings paid by a donor is confidential. Only the bishop and those who are authorized to handle or view these contributions should have access to this information. Stake presidencies, bishoprics, and clerks should never inappropriately discuss a member’s tithing status. Nor should they discuss the total amount of tithing or other offerings received.
34.5.2:
> Receiving Tithing and Other Offerings
> The Lord has given bishops the sacred trust of receiving and accounting for the tithes and other offerings of the Saints (see Doctrine and Covenants 42:30–33; 119). Only the bishop and his counselors may receive tithes and other offerings. Under no circumstances should their wives, other members of their families, clerks, or other ward members receive these contributions. The only exception is when Aaronic Priesthood holders are assigned to collect fast offerings (see 34.3.2).
> Church leaders and members should not leave donations unattended.
34.5.6:
> Donation Statements
> Donor Statements of Contributions are available to all members at donations.ChurchofJesusChrist.org. Leaders should encourage members to regularly review their donor statements. Where applicable, official tax statements are also available at donations.ChurchofJesusChrist.org, from the local unit, or from the area office.
Also, there's no prescriptive guidance on pre-tax vs. post-tax, or how to handle many edge cases, such as capital gains, tax deductions, etc. The church's stance is that it's between you and God to figure out how to apply the "pay 10%" guidance.
Old, but still observed: https://www.churchofjesuschrist.org/study/ensign/1974/04/i-h...:
“...the simplest statement we know of is that statement of the Lord himself that the members of the Church should pay one-tenth of all their interest annually, which is understood to mean income. No one is justified in making any other statement than this. We feel that every member of the Church should be entitled to make his own decision as to what he thinks he owes the Lord, and to make payment accordingly.”
At the beginning of The Church of Jesus Christ, saints were asked to consecrate all that they had to the bishop. Legally they signed away all rights to their property and the bishop leased it back to them.
They found that that wasn't sustainable (due to debts and disputes) and switched to 10% of interest (see Section 119 in D&C, https://www.churchofjesuschrist.org/study/scriptures/dc-test...). While tithing was paid in the past with animals, food, etc, that just doesn't scale beyond local communities.
Yes, our church does use funds for advocacy, but it's hard to ascribe pure malice to a church that spends $1 billion annually on humanitarian aid every year, and is expanding affordable education to tens of thousands of people in developing countries.
Not all of us agree with how much money is being held in reserve, but it's important to understand that we don't have a testimony in the church because of what we get from it, or even agree with all policies, but rather because of a personal witness of its truth. It is true that some stay in our church because of social pressure, and I'm not going to defend that practice. But, that's not what our core doctrine teaches.
I understand that it's easy to think that we are all a homogenous group that all thinks the same, but peek under the surface and you'll find many of us who find the core doctrine so compelling that we are willing to stick with the church and to enact change in constructive instead of destructive ways.
Where did your number come from? I've just read "Globally, the church boasted that it had spent US$40m on humanitarian aid in one year (2015)" from https://businessdesk.co.nz/article/full-page/behind-the-nz-m... (seems like a good article)
Bing says as of 2023, the church's net worth is estimated to be around $265 billion which would be income of $16 billion (assuming a conservative 6% annual ROI). I'm unsure how correct those numbers are since the article says (US$15.7b land and US$100b investment fund).
The Mormon church earns $7 billion a year from tithing. Even if humanistic aid were $1 billion - it is a relatively poor percentage.
Let's consider healthcare to be humanitarian aid (yeah, obviously not external). Governments spend 30% of taxes on healthcare, and people pay 30% in taxes so we might estimate that people are paying appromx 10% on humanitarian aid via their government. Although perhaps that is just a form of insurance you've paid in and you get paid out. I'm unsure of the statistics but my guess is that most people pay a lot in and get a little out due to skewed distribution of sickness costs. With health insurance the best deal is to never get sick and never claim (and your premiums help the poor bastards that do get sick - the best outcome a society could hope for). Note that health insurance in New Zealand is wildly different from the US model.
I've had a little experience watching how the Mormon church acts in Samoa which is definitely not a wealthy country. I would be interested to know how much of that humanitarian aid was paid for by countries that needed the humanitarian aid? The equivalent to paying in and getting paid out (with the church claiming doing good with the paying out, but not talking about what it keeps).
I'm a little cynical that there's some dissimulation by the LDS church - they are not well known for frank openness.
A lot of money also goes towards subsidizing education (All the BYUs, including the online classes that are targeted towards developing countries), building churches and temples, supporting local congregation budgets, and supporting church members who are financially insecure (I'm not sure if they counted that last part in the 2024 summary though).
> I've had a little experience watching how the Mormon church acts in Samoa which is definitely not a wealthy country.
Looks like they have a summary here: https://www.churchofjesuschrist.org/serve/caring/annual-summ...
> I'm a little cynical that there's some dissimulation by the LDS church - they are not well known for frank openness.
Yeah, it would be nice if they were more transparent here. I understand the legal reasoning--essentially security by obscurity--but it's frustrating to only get peeks and glimpses. I don't blame you for some healthy cynicism.
[1] https://www.churchofjesuschrist.org/serve/caring/annual-summ...
It’s up to personal interpretation. Some do before tax, some do after. Some only pay tithing on their regular income (i.e. from a normal job) but not on “already tithed” income (e.g. birthday money from parents), while others do it differently.
The church’s stance is that they say you should pay 10% tithing on your income. They don’t define income. And all they do is ask “do you pay a full tithe?” And it’s up to you to decide if you do or not based on how you view what “income” means.
And in terms of aggregate outcomes, Utah’s results are impressive. The LDS apparently does a better job teaching kids to read than the government here in Maryland.
That's because you're not counting the money the church spends to replace government programs, which in Utah is significant.
Now that the internet has destroyed local community and trust in institutions, what will conservatism do?
You can get a lot done when you establish regressive control structures for enforcement. Generally speaking, most people usually don't want that trade-off.
Worth noting here that the church additionally spends north of $1 billion annually on humanitarian aid across the globe [1] (separate from the redistributions to the poor mentioned by OP). Aid is provided independent of religious affiliation.
[1] https://philanthropies.churchofjesuschrist.org/humanitarian-...
*: searches suggest the wealth of the church to be around $265 billion. So their members give 10% annually to the church and the church gives less than 0.5% of their total wealth to the poor (but mostly to other Mormons or prospective converts). If you're wondering why they keep this massive horde of wealth, it's because they think it'll be needed for the apocalypse. Yes, it's for the apocalypse.
You are incorrect saying that you have to be a member of The Church of Jesus Christ of Latter-day Saints (the actual name of the "Mormon church") to receive these benefits. In some cases there will be conditions, like if you want to attend one of the church universities you will need to promise to abstain from alcohol (one example), but becoming a baptized member of the church is not required
I would say it's very accurate. They are forced to share their wealth to get into the Kingdom of God. The only choice they have is to not go to heaven. I'd say that's being forced, just by a different power.
> but becoming a baptized member of the church is not required
You don't get the BYU discount unless you're baptized.
It is neither optional or excludable.
This is why the monopoly man choosing to share caviar with his family or paying dues to a yacht club does not make them a socialist. The monopoly man retains full agency over who they share with.
Even the non-member BYU tuition is subsidized and a much lower price than other comparable colleges. But really, BYU is not the best example of Mormon charity, it can only accommodate a limited number of students.
https://chatgpt.com/share/67e8572d-c5f4-8000-9393-c2e894c922...
https://www.wweek.com/portland/blog-30229-portland-voters-so...
To the extent this is a polarized left-right issue, it's only recently and only because everything is polarized right now.
The top 10 most fluoridated states went 5/5 Rep/Dem in 2008 and 6/4 Rep/Dem in 2024. These were Kentucky, Minnesota, Illinois, North Dakota, Virginia, Georgia, South Dakota, Maryland, Ohio, and South Carolina. Hardly a blue wall.
The bottom 10 least fluoridated states with 6/4 Rep/Dem in 2008 and 6/4 Rep/Dem in 2024. These were Hawaii, New Jersey, Oregon, Idaho, Montana, Louisiana, Alaska, Utah, New Hampshire, and Mississippi. Hardly a red wall.
The bottom three least fluoridated states are all hardcore blue: Hawaii, New Jersey, and Oregon.
I just don't see any evidence here that this has been a left-right polarized issue until this year. The distribution of fluoride by political leanings is just too random.
AFAIK, HFCS is one of the worst offenders.
HFCS is not worse than sugar unless you're consuming such an outrageous amount that the fructose leads to a fatty liver (which does happen). But if you're consuming that much HFCS, it's only a small amount more of sucrose to yield the same outcome, as of course both have loads of fructose.
The one viable argument to vilify HFCS is simply that it's so convenient and inexpensive (courtesy of massively subsidized corn production) that it led to many more products having added sugars. But people who carefully pour over ingredients looking for HFCS, but treat sugar as wholesome, are usually operating on ignorance.
In the body it's literally all the same with minor variations in ratios. Indeed, the revered Mexican coke with cane sugar...the sucrose is broken down to component glucose and fructose in the acidic environment [1], exactly as happens with HFCS variants, and it would have been the moment it hit your digestive tract anyways.
There is zero scientific justification for the weird focus on HFCS. Yes, glucose and grossly excessive amounts of fructose are a serious problem. Especially in forms that rapidly get absorbed and go off like a glucose bomb -- our bodies are not adapted to the extremely rapid intake of glucose forms of food we eat now, including ultra-processed foods fill with refined carbs.
The #1 source of glucose in most diets is white breads, rices and so on. White flour is 60-80% starch, while white rice pushes 90% starch. Starch is strings of glucose molecules, and indeed enzymes turn that starch to free glucose almost immediately when eaten. So from a glucose perspective flour is much worse than an equal amount of sugar.
And of course nutritive sweeteners in all their forms should be avoided. But table sugar isn't more wholesome or better than HFCS.
[1] - Fun video about the sucrose in Mexican coke - https://www.youtube.com/watch?v=NY66qpMFOYo
I live in New Zealand and my town doesn't put fluoride in the water but it seems like they'll be made to do so fairly soon. I don't really care one way or the other from the point of view of ingesting the stuff, but I do consider it a bit of a waste of money. People who brush with toothpaste don't need this and people who don't are probably drinking too much soda. A more useful thing to do might be to subsidize toothpaste for people who can't / won't buy it for their kids.
I think every person in my social circles with any kind of illness or disability would be incredibly grateful for fluoridation, and it's not because of drinking too much soda
Is this real?
As an American, I wish we didn't do this, but it's a collective action problem that's very hard to solve.
The reason I wish we didn't tip is because I think the list price should reflect the true cost of whatever I'm buying. I think that is more honest, encourages healthy competition, and is a pleasant consumer experience.
I was really glad when the DOT forced airlines to include taxes and fees in ticket prices in 2012, and wish there were a similar law/regulation that applied to all commerce. (And yes, I realize this is hard, given the incredible complexity of U.S. tax laws in a bazillion different—and often overlapping—jurisdictions.)
> $2.65/hr+
Bottom line, if your business can't afford to pay its people a living wage, then it can't afford to operate.
(Well, they also make espresso drinks and made-to-order deli sandwiches, so I guess it's appropriate to tip if you order those.)
I disagree. I tip for delivery, and for table service. Not for a service that does not require leaving the counter.
In my area, pizza delivery drivers (read: not DoorDashers, etc. I am not sure what they make since I refuse to use those services) make about $12 - $15/hour and get paid for mileage (usually between $0.50 - $0.62 per mile.) I'm not seeing a reason to tip them. They are making well above minimum wage in my State, unlike the restaurant servers/bartenders that only just barely crested $4/hour as of 2025. The latter is in a position to rely on tips, the former is far from it.
I ask because we don't seem to have an established "hard line" on when tipping is appropriate in the United States, and when it is not. This extremely fuzzy understanding is allowing companies like DoorDash, coffee shops, etc to under pay their staff by off-loading part of the cost to the customer, which makes your $7 latte cost $10, or whatever. It's steamy bullshit and needs to be shoveled into the bin.
If we had a hard line on when tipping is justified, we'd quickly see a change in the other direction. I've always felt that the hard line should be "if you are making less than minimum wage, then tipping is justified." That's it. No soft maybes, no washy-washy justifications.
That being the case, if a barista (avg $15/hour in the US) is not happy _without_ the tips, then they have two options: demand more from their employer, or find a different job that pays better. Either way, the employer is left to consider either raising wages to keep people satisfied, or doing the same just to keep people in the door and stay in business. The barista is, in essence, the face of the company. They do the work the customer sees, which makes them important to the sustainability of the company. Ergo, the company needs to put more resources in the barista's pocket to ensure quality work.
It sort of blows my mind why everyone else in the US does not think this way, but I have tried to dissect my own stance on tipping (from the standpoint of having spent nearly a decade working front-of-the-house in restaurants), and I'm really having trouble poking holes in my own logic. So, I'm always interested to hear other people's takes on why they tip the way they do.
This is the problem. You basically said "we do it like this because that's the way we've always done it," which is the weakest form of justification for anything.
Rain, snow, etc...do you tip the person who delivers your mail? They do it in an LLV (a rather treacherous vehicle with little to no climate control) or on foot, but nobody tips them. When the pizza delivery person applied for the job, they did so knowing they would have to deliver in bad weather, but somehow we reach the conclusion that the responsibility of making sure that driver is being paid adequately for their risk and efforts is shifted to the customer, rather than than their employer.
Now, I should clarify that despite my years of restaurant service where my $2.65/hour paycheck existed nominally for the sole purpose of covering taxes (hence, my "take home" pay coming directly from the customers to my pocket), that I am in the camp of abolishing tipping altogether. Raise the wages of all service workers to a livable wage, which all these companies can certainly afford, and we'd be done with it. But I know that's a huge leap, so we need to take baby steps to get there.
Having a well-defined notion of which positions should be tip-based and which should not is the first baby step.
I guess what I am getting at with my other comments is that we do not have a clear understanding of said appropriateness, and thus, we, the consumer, along side the food service worker, are generally taken advantage of by the companies that perpetuate the idea while said companies are off the hook for labor costs.
Now, before someone (if anyone is still following this thread) chimes in with "but if the restaurants pay the bartenders/servers a full wage, the food and drinks would be way more expensive!" I am here to tell you "travel more." I have been to many other countries where tipping is not at all a thing, and the food costs about the same as it does in the US.
When you walk into a restaurant in the US, you're getting ripped off. The dish you just paid $16US for cost them about $3 to make, including wage. It's not like the cooks are prepping one dish at a time, or the servers are only taking one table at a time...not to mention most restaurants in the US are using frozen, prepared ingredients that they are really just heating up or re-hydrating. Overhead costs like electricity and rent? A drop in the bucket compared to what small businesses have to deal with. The staff is making bare-minimum wages as it is while the parent companies and investors are making bank. That money from your $16US meal goes up, but very little of it actually comes back down.
Tipping exists because greed at the top exists and its unfair to both food service workers and the customers, but we've been at it so long that it's been normalized. And now it's spreading to other industries, like retail and online sales.
It's pretty nice to go to a cafe, pay a fair price, and not be guilted into 20% extra by a PoS machine.
Are you worried the machine will think less of you if you don't tip? Where does guilt come into it?
The idea is to remove fluoride from water and advise pregnant women to use fluoride-free toothpaste.
Everyone else can get enough fluoride from modern toothpastes, or regular dentist treatments.
The logic is that fluoride in tap water made sense in the era before toothpaste had it, but now it is “overmedicating” a vulnerable fraction of the population.
In the actual research the main "risk" posed by flouridated water is actually fluorosis. This causes minerals in your enamel to be replaced with flouride which can cause them to be brittle in the long term. It's pretty uncommon but the thought is that now that flouride toothpaste are commonplace, the benefit of flouridated water is also way less. Which changes the calculus.
A not insignificant number of researchers are advocating for the view that flouridating water just isn't worth it anymore and the (slight) risk of flourosis is more significant than the (slight) benefit of decreased dental caries.
Multiple such studies have been done, globally, over many decades.
There are two Cochrane reviews that I saw on community water fluoridation:
https://pubmed.ncbi.nlm.nih.gov/26092033/
https://pubmed.ncbi.nlm.nih.gov/39362658/
There is limited modern evidence (ie. in a world where everyone is brushing their teeth with fluoride toothpaste) of some reduction in tooth decay in children. There were no studies on adults that met the review criteria.
Overall it seems like we just don't really know how much impact CWF currently has.
https://www.cdc.gov/oral-health/data-research/facts-stats/fa...
However:
Once ingested, the fluoride has a systemic affect on teeth before they erupt, incorporating into the matrix of developing teeth to increase the mineralization content and decrease the solubility of enamel. [1]
[1] https://www.uspharmacist.com/article/current-fluoride-recomm...
My city started fluoridating a few years ago. The crazy was off the chart, they’re still active. NYC has fluoridated for 60 years, you’d think someone would have figured out that the entire city is dumber.
And companies that adulterate, misrepresent and obfuscate what they put in food as well. No-one is putting corn syrup or brominated vegetable oil in food with any intention other than money money money.
In fact, if I were an evil subgenius and really actively wanted to damage the IQs of the nation for some nefarious purpose, and it has to be substance-based, I'd avoid things with annoying oversight like public drinking water and vaccines and focus on food and pollution as a vector. If challenged, I just say "why do you hate my freedom to make a profit and provide jobs". Sure, the FDA and EPA exist, but even then you can get away with far, far more in those areas. Food wise, HFCS, BVO, etc, pollution wise, almost everything to with plastics or polymers, oil, coal, gas the list goes on and on.
Or do you mean that your opinion should trump that of any doctor or expert in any field when the issue pertains to your person? If that's the case, I wonder why you choose to participate in society at all, given that you're uncomfortable with the idea that other people might know more than you.
No. When decisions I take could affect others, that can, in a limited way, justify overriding bodily autonomy. E.g. preventing someone with an infectious disease from spreading it by quarantining them. Or when they can't make their own decisions, e.g. if they're children, suffering dementia, or are unconscious and time is critical.
> Believe it or not, a doctor won't amputate a limb
I struggle to understand how this is a reasonable, much less charitable, interpretation of my words. Bodily autonomy does not include commanding others. But people can refuse care, even when it is medically sound. Except in very limited circumstances, doctors may not force procedures or medicine on unwilling patients.
> Or do you mean that your opinion should trump that of any doctor or expert in any field when the issue pertains to your person? If that's the case, I wonder why you choose to participate in society at all, given that you're uncomfortable with the idea that other people might know more than you.
One does not at all follow from the other. Experts in the field will tell me excessive sweets are bad for me (and I believe them) - should they get to put a block my credit card so it cannot be used to buy unhealthy snacks, only healthy food?
I have humored your post, now please explain to me: How does believing people have a right to refuse medical treatment imply I am uncomfortable with others being more knowledgeable?
Maybe that’s why they haven’t?
But being serious if it’s relatively low and the negative effects only occur during pregnancy it’s not that easy to measure it.
Obviously there is no conclusive evidence (even if the studies from China seem somewhat credible) but IMHO even if the likelihood of this being true is e.g. only 5-10%, risk of a population wide loss of 1-2 IQ points seems like a massively too high price to pay just to slightly reduce cavity rates.
Also dismissing all credible (albeit weak) scientific evidence out of hand just because crazy people hold similar beliefs is a about as stupid as what they are doing..
The Flynn Effect was the observation that real IQ scores were increasing over time. But sometime around 1990 this seems to have stopped in pretty much the entire developed world, including the US. I'm not implying that this is solely due to fluoridation, though it's certainly a plausible contributing factor. But as for your snark about 'someone would have figured out people are getting dumber' - well, they have, and we don't know why.
[1] (pop media coverage of study) - https://www.popularmechanics.com/science/a43469569/american-...
[1] (study - no paywall!) - https://www.sciencedirect.com/science/article/pii/S016028962...
And lower IQ scores don't necessarily say much about pure intelligence directly, a worsening education system could also contribute and that's not exactly far fetched. And your linked source says:
> The steepest slopes occurred for ages 18–22 and lower levels of education
But it's relevant here because most people don't know that general intelligence levels (so far as IQ can measure) have begun to decrease, to the point that the GP here was overtly mocking the mere possibility of such as a [implied] practical impossibility.
Diagnoses for them started to skyrocket. Important difference.
I’m no expert, but I have seen the public education system attacked and defunded for decades, at home and abroad. Even libraries are being shut down in places with enough anti-intellectual sentiment. This goes much deeper than the fluoride in water.
If you can point to IQ values of New York specifically, going down more significantly starting with the introduction of fluoride into the water system, then you might have something there.
Until then, policy discussions like this will continue to take focus from the things that actually have an impact on IQ, like public education, healthcare/nutrition, and poverty.
And I'm certain one could trivially dig up data correlating the decline of IQ in New York to fluoridation. The Flynn Effect reversal began in the 90s, and New York began fluoridating their water in 1965, so there's an excellent age correlation there. But that correlation does not necessarily mean causation. What matters are more controlled studies determining definitively whether fluoride is intellectually harmful by using fluoride levels in urine to control for various confounding variables (people in the same regions getting fluoride from multiple sources, consuming more/less products with fluoride, etc). And we do have those studies, and the answer is yes it is.
That certainly doesn't mean it's the sole cause for the reversal of the Flynn Effect as its seen across the developed world, and many countries do not add fluoride to their water. But it is likely a contributing factor. In recent decades we have begun moving far faster than we're capable of evaluating the consequences of, and long-term consequences may well be stacking from multiple sources of mistakes.
[1] - https://nces.ed.gov/programs/coe/indicator/cmd/education-exp...
This is disingenuous, and itself a political talking point.
> In reality US education spending per student has continually increased and is always near the top of the world.
It is much more nuanced than “money in equals IQ out”.
Where does the money end up? Not in classrooms, unfortunately.
What is the average ratio of teachers to students? Is this number going up, up, up?
Now do counselors, nurses, etc.
How much are teachers spending out of pocket for classroom supplies? Has this number gone down, down, down?
By "most" metrics the US should be having phenomenal educational outcomes. The one variable that's not controlled for is the quality of students. Also, I put "most" in quotes because it's a weasel word - to my knowledge we outperform on every single typical educational metric, except result.
[1] - https://usafacts.org/data/topics/people-society/education/k-...
It was probably much more effective 50 years ago when fluoride was not in everyone's toothpaste.
On the other hand, the society you live in probably has some sort of document establishing who does have the authority, and how it devolves to the actual policy-makers. Google “$YOUR_LOCATION government” and you’ll have some good starting points. If you’re lucky, you might even get to participate in the process; “$YOUR_LOCATION elections” will give you good pointers in that case.
When you drink from publicly supplied water, you accept risks that can be much worse than fluoride in your water. If you want to avoid that, you need to procure your own drinking water.
So for $15/mo, “problem” solved.
Are you doing that?
I'd love to give it a go for my family
Was that intentional? (https://en.wiktionary.org/wiki/dental_calculus for those who didn't get the reference.)
Not really: https://jamanetwork.com/journals/jamapediatrics/fullarticle/...
https://news.ycombinator.com/item?id=43523900
I can only assume once you see those very valid criticisms, you will update your references
No, this is the original claim:
> but it turns out that there are a decent amount of good studies showing a link between fluoride in water and (slightly) lower IQ when pregnant mothers ingest the fluoride.
Then the parent replied that this IQ link is lacking evidence, which it's not, per the meta-analysis I cited.
Which is not a claim that was being discussed in this subthread, since the original claim being refuted specify any such qualification.
This was a real problem in the San Jose school district until recently. They started fluoridation of water in the last ten years, and were the biggest US city that didn’t fluoridate. The evidence of the above is clear according to SJ dentists I have talked to.
[1] - https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
> It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ.
---
"Since 1945, the use of fluoride has been a successful public health initiative for reducing dental cavities and improving general oral health of adults and children. There is a concern, however, that some pregnant women and children may be getting more fluoride than they need because they now get fluoride from many sources including treated public water, water-added foods and beverages, teas, toothpaste, floss, and mouthwash, and the combined total intake of fluoride may exceed safe amounts."
---
So the issue is trying to isolate the exact amount and source of fluoride people are getting. And that probably has no answer because it's going to vary dependent on how much fluoridated water somebody drinks, the rest of their diet, their other dental hygiene composition, and more. So levels that would be safe for one percent of the population, will be dangerous for another percent of it.
https://theunbiasedscipod.substack.com/p/the-well-runs-deep-...
The NTP report is flawed and likely biased.
Makes sense, but the intention also is that many people do not brush their teeth, or at least do not brush them as often as they should, and so fluoride is added to drinking water to compensate so people's teeth don't start to fall out at an alarming rate.
Good job ignoring absolutely everything in the comment except the part that offended you. Nothing more American than having a hard-on for being judgemental and then defending the right instead of actually trying to solve the underlying problem.
But the "soda" category these days is also pretty overloaded: full sugar coke vs Coke zero is a very different calory intake.
That's why SNAP money is restricted to particular categories. So caring about how it's spent is already a foregone conclusion, and rightly so.
If someone wants to spend money however they like, they'll have to earn it themselves. Even inherited money carries a sense of obligation to honor the family with how it's used (like not blowing it all in a week of lavish partying in Vegas, as an extreme example).
You know on a serious note, it occurred to me that Liquid Death's slogan "Murder your thirst" isn't far off. Wonder if it's a not-so-subtle nod.
If you're replacing sweat, wouldn't you want sports drinks?
https://www.gocomics.com/peanuts/1969/03/27
But anyway, in most cases, the fact that drinking milk doubles as a source of food is clearly a benefit. It's hard to explain a common behavior by reference to a rare circumstance.
Water has zero calories, is reasonably filling, neutral-tasting, and gives me what my body needs, without any other junk. What's not to like?
Also, what you think cheese consists of.
One can enjoy something without it being good for you. I like cheese. I'm under no illusion that it is healthy
When I had to fly to NY for work I felt like I couldn't get water anywhere that was worth drinking.
I’ve travelled and lived across the country during my high school and college years; and I’ve travelled my extensively within Upstate very (Adirondacks, Catskills, and Finger Lakes) and the taste of local water is the first thing I notice.
Bad building pipes aside, I have not tasted any water that exceeds NYC’s tap water in taste.
I’m not the only person who’s expressed this, and guests from other regions have also admitted the same consistently over the years.
Countries where the tap water is drinkable without chlorination have quality that exceeds bottled water, and it might even be sourced from the same aquifers.
many? (!!!)
Googling it all I found was one dentist website that said 2%, but didn't seem that reliable
I have no doubt most people brush their teeth in one capacity or another, but do you really think 98% of people brush them regularly and sufficiently? I reckon that drops down quite a few double digits at that point, and since we're talking about populations here that's quite a lot of people.
Even if the fluoride somehow manages to overcome all that and prevent you from getting cavities, the gum disease will eventually cause all your teeth to fall out.
Given that everyone gets enough in toothpaste I just don’t see the reason to keep doing it, too much can go wrong. It’s kind of a strange mass medication that I’m not sure the government needs to be involved in.
The advantage of putting it in water is that it ensures all children get it, not just the children whose parents can and do make sure they brush their teeth and go to the dentist.
Bad parents are gonna be bad parents.
They banned it as part of the culture war. That's 100% of the reason. "The libs" want it, so it must be banned.
My understanding also is that if you’re a dentist wanting to get rich, move somewhere that has unfluoridated water.
There is also a host of things we use water for from cooking to preserving, distilling and cooling.. i wonder if any of these things could concentrate the fluoride.
Also since fluoride has a lower boiling point any studies tracked what breathing in fluoride gas over long periods cause?
What most people don't understand here are the levels of fluoride being ingested. You can very easily remove all fluoride from your water with a relatively cheap RO system. But the recommendation to use "fluoride-free toothpaste" is just plain misinformation.
The reason is that you don't eat toothpaste. And even when adults ingest small amounts of toothpaste, again, the amount of fluoride is basically beyond negligible. Fluoride can both be applied to teeth as a varnish and/or consumed in drinking water. Using a flouride-free toothpaste can oftentimes do more damage than good because of SLS in those alternatives and because those alternatives often have abrasives that do far more harm than good. It's amazing people will recommend a product that may likely be worse because they have no domain expertise. So, yes, people should talk to their Dentist about these things and ask questions of them vs the Internet.
Really the downside to removing fluoride from city water is that low income families will be worse off with respect to dental related issues compared to more well off families that spend time instilling dental hygiene and preventative care for their kids. As you mentioned most people who have decent oral hygiene get enough flouride.
Where we live we have well water. Fluoride in the water isn't a concern, and if it was in our drinking water it generally wouldn't be consumed because of the water filtration anyway.
Source: spouse is a DDS.
Dismissing things out of hand like this is a category of stupid in itself.
Look at the current research, listen to people who devoted their careers to studying this, make up your own mind. If you're on HN, then you're qualified enough to at least figure out who the genuine experts are and read what they recommend.
Putting any science-based debate into a "category" to dismiss is turning yourself into one of the stupid people.
> Look at the current research, listen to people who devoted their careers to studying this, make up your own mind.
Do you honestly do this with every single belief you have? Even every single controversial belief? Have you looked, yourself, into whether the world is flat? Whether the 9/11 conspiracy theories are true? Whether crop circles were created by aliens? These are all absurd conspiracy theories, but I assume most people don't know the "up to date" research on any of them, or what people who have "devote their careers" to research them say.
And those are incredibly common and well known to be false theories.
You have to take some things on faith to at least some degree - though to be clear, by "on faith" I mean "on faith of people you trust", which should really start with professional scientists etc. Also, it's totally fine to just say "I have no actual idea" about most things, and just go with what your current understanding of the status-quo position is.
Yes.
> Have you looked, yourself, into whether the world is flat? Whether the 9/11 conspiracy theories are true? Whether crop circles were created by aliens?
Yes.
But having a healthy mouth is far from the end goal, imo. If your mouth is full of cavities you’re more likely to build up bacteria that cause downstream effects as serious as heart disease. Also if your mouth is routinely uncomfortable you may gravitate towards soft processed foods and away from healthy whole foods like fresh fruits and vegetables.
I know water is not the only way to get fluoride into people. But these politicians who are trying to take it out of the water are just saying basically “it’s fine, let’s do nothing”. They’re not going to fluoridate the salt. They’re not going to run public health campaigns stressing the importance of regular brushing. They’re just willing to let people’s teeth rot to score points.
It’s disgusting, and no matter how you feel about the water you should be able to see that these people are not on your side.
https://www.mayoclinic.org/healthy-lifestyle/adult-health/in...
I'd actually just like to see more money put into public dental assistance. And education.
I would want to see that in anti fluoride campaigns and laws as well, but have not see that happen in the laws and campaigns I have followed. Or in the HN comments I have responded to on the subject, most focus on banning and provide no follow, or no structured follow up like - free toothpaste, required educations, and follow up studies, reassess in X years.
Do you really think there are sizable native born populations that are not aware of tooth brushing?
There’s plenty of people that don’t bother with it, but I don’t see a PR campaign being particularly effective at changing that.
I think there are lots of adults who don’t realize that poor dental health can cause heart failure and worsen basically every chronic condition.
I think there are lots of goobers who don’t realize that there’s no reason that United and Elevance and the rest couldn’t be forced to cover dental care via regulation.
I get your point, but big picture there are a lot of impactful education campaigns that should be possible.
I don't know that you have the causality here correct.
I drink tap water now with fluoride so its not like I care strongly, but its a bit weird that many people buy only non-fluoridated water themselves and are confused when other people show a preference for non-fluoridated water in their own taps.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/...
Suddenly everything was up for debate.
https://en.m.wikipedia.org/wiki/Lancet_MMR_autism_fraud
They are experts in this field, and, unlike “random person on the internet who spent 2 minutes on google”, have informed opinions on this topic.
If you want a serious discussion on why fluoride is good or bad, that’s where you need to go.
Random person on the internet is very easy to disagree with, because we’re all idiots right? It’s a very easy lazy way of self confirmation.
…but if you are serious about critically considering the issue and facing your own biases, talk to an actual topic expert.
My dentist told me he had carefully reviewed the literature and determined to his satisfaction that public fluoridated water was in the best interests of public health, currently. He offered to share some reading that he was convinced by.
You can’t really ask for more that that.
Discussing this here is a bit like protesting by posting on social media; yes, I suppose it’s better than doing nothing and not engaging with the topic at all… but only barely, and not in any meaningful way.
Why do almost no other countries fluoridate drinking water?
Even if it does turn out to be unambiguously good, people have a basic right to make their own medical decisions.
Recent systematic reviews suggest an association between higher fluoride exposure and lower IQ in children. - https://en.wikipedia.org/wiki/Water_fluoridation
At some point, you have to accept that your random wikipedia page and 5 minutes on google is not a convincing argument.
This is right up there in the conspiracy theory territory.
Rational discussion means listening to experts and admitting that you are not an expert.
What do you want me to say?
You aren't a qualified expert on this topic. If you want an expert opinion, talk to an expert, not some dubious fucking provenance wikipedia page.
Who do you think conducted those peer-reviewed systematic reviews? I'm sorry if I don't take the word of some random guy's dentist over multiple meta analyses in major medical journals.
And I don't need an expert to tell me people should have the right to make their own medical decisions.
And finally, I live in a country where public health experts have decided against water fluoridation. This is represents the vast majority of countries. What now? Should I pick some other experts to listen to?
> Should I pick some other experts to listen to?
I think it's reasonably clear that you haven't spoken to an expert in this field.
> I'm sorry if I don't take the word of some random guy's dentist over multiple meta analyses in major medical journals.
Are you certain you're competent to review and understand the literature on the topic? It takes a lot of time and effort; that's what dentists do as a job. That's why they have to go to school. That's why random people on the internet do not do dentistry.
If you don't trust my dentist, then talk to your dentist.
This is literally my point: I'm not telling you how it is; I'm telling you, talk to someone who knows what they're talking about; and, don't believe that you are an expert because you put some trivial amount of effort into investigating it yourself.
You can't be an expert at everything. No one can.
As some point, you have to trust other people.
My previous dentist pushed these $80 (not covered by insurance) fluoride treatments on every cleaning visit. There's no research that shows much of anything about their effectiveness (good or bad). Yet they push them anyway, because it (their words) might help and probably won't harm. That doesn't give me a good feeling about their competence to have an expert opinion on this sort of thing.
I would, however, trust the opinion of someone who is doing medical/dental research, and holds a doctorate in a relevant field.
I don’t understand what you mean here. Are you just wholly rejecting the concept of expert knowledge, trials, meta analyses, basically the foundations of science, just because in order to participate in it you have to have tainted yourself by rigorously studying it?
I am embracing expert knowledge in trusting meta-analyses and the decisions of EU health experts.
If you’re this deep on the appeal to authority train, the NIH released a report in the last year linking fluoride exposure to moderate drops in IQ with moderate confidence.
It’s probably not the worst thing in the world, but is definitely not inert.
I’d say that’s a reasonable sign of someone qualified to have an opinion.
I think you’re getting confused with a dental technician.
Your dentist is well qualified to have an opinion on the effects of fluoride on your teeth.
They are poorly qualified to have an opinion on whether it should be added to the water supply at source.
Generally it's multi-discipline, but a good start here would be an epidemiologist with a focus on dental issues.
Chemists who work in fluorine chemistry on the other hand have to become experts on the biological effects of fluorine exposure. Small and seemingly innocuous exposures can do a lot of damage and kill you, though not in a way that lends any support to the idea that municipal fluoridation will harm you. If you do understand how it kills you (basically by being exceptionally narrowly focused on making free calcium ions and to a lesser extent magnesium ions biologically unavailable), it is hard to describe a chemically plausible scenario that somehow avoids this basic fact of chemistry. Fluoride behaves the same way outside the body.
Municipal water exposure is far below the noise floor for fluoride. Food has far higher levels of fluoride than municipal water and the body has ample excess calcium and magnesium to absorb the loss of bioavailability of a microscopic amount of those minerals. Humans consume calcium measured in grams per day, multiple orders of magnitude more than can be lost via municipal fluoridation. Natural dietary variation will have a far larger effect.
There is a very serious mechanism of action problem. Fluorine poisoning is a thing that happens. The observed effects and empirical evidence, as well as the mechanisms of action that cause them, are incompatible with any mechanism of action that supports the hypothesis that it causes brain damage. Basically, it would invalidate the entire history of actual fluoride exposure.
The other serious problem is that people are exposed to far more fluorine through what they eat than through water. What is special about trace levels in municipal water? And many parts of the world have far higher natural fluoride levels in their water than any municipal water supply with no evidence of adverse consequences. This has been studied many times in many countries! In fact, the only consistent correlation with naturally high fluoride levels is better cardiovascular health (for which there is a known mechanism of action).
This notion that trace levels of fluoride in some municipal water is adversely impacting IQ based on thin evidence from the developing world is just the public health version of “faster than light neutrinos”. Someone thinks they measured it but it contradicts everything we know about the subject. The rational approach isn’t to discard everything we know without a hell of a lot more evidence.
I don’t think adding fluoride to municipal water does much these days but it also isn’t harming anyone.
That debate is framed around being vaccinated vs the scare of "vaccine caused autism" (or myocarditis), but that frame is missing the risk of things like measles.
Likewise tooth decay is not only expensive, but it can have dreadful health consequences if left unaddressed. Missing teeth is also socially costly. Being poor or "ugly" or poor looking is a serious adverse health consequence. Imagine parents barely making ends meet or working multiple jobs. It's easy to imagine disadvantaged kids missing out on dental care.
I also explicitly remember reading multiple reports of poor tooth health correlating with dementia development. I've also read that serious infections of any sort can harm IQ.
The bigger issue is that we have vast amounts of scientific data and empirical evidence around fluoride toxicity. People are injured and die due to fluorine exposure, we understand how it interacts with biology. Any mechanism of action that can support the hypothesis that fluorine causes brain damage necessarily invalidates all of this evidence and is difficult to explain as a matter of basic chemistry.
And then we have to explain why fluoride in water has this effect but the much higher levels of fluoride in food does not.
Fluoridating municipal water may not offer much benefit but there is no credible science that it is actually harmful. Large regions of the world have water that naturally has far higher fluorine content than municipal water and there is no evidence of IQ reduction in these regions either.
The vast majority of dentists are not public health experts, and will have little to offer other than “exposing your teeth to fluoride regularly is good”.
No they are not. The are experts are filling cavities and treatment. They have no additional knowledge of fluoride in water vs any other interested person.
For that you need to talk to someone in research, which is not someone seeing patients.
It's not a debate everywhere else because adding fluoride to the water is objectively an unusual thing to do that they just... don't. Presumably they get fluoride other ways.
I'm skeptical of results showing IQ loss but I also think fluoridation should be phased out as fluoride toothpaste and mouthwash are now widely available. Banning it seems like the wrong move to me...states should simply decide to continue adding it or not.
Isn't that exactly what's happening here? A state deciding to not continue adding it?
Did OP mean that municipalities should simply decide to keep adding or not? If so, how do we decide (from our various armchairs in most cases far away from Utah) what the appropriate level of government for making this call is?
I think the bigger complication though is going to be - depending on the state - how water districts are apportioned. I think even many counties (let alone municipalities) will share water infrastructure so it’s not really clear who has the jurisdiction to make that decision other than the state.
By having official country-level guidelines by the health ministries or similar for people to brush their teeth with toothpaste containing fluoride, and specific guidelines around it for kids, as trivial as it may sound. Along with experts' reviews providing more details on these decisions, and explaining tradeoffs properly.
Fluoride containing toothpaste is the main recommendation, even in places that fluoridate the water (which are the minority). There is not much to add to this apart from refining these guidelines. Eg in the EU where some countries fluoridate water, most don't, there is no huge debate about it overall. Most eu countries that fluoridated the water stopped doing it some point mostly because it was no longer needed in preventing cavities, and prob largely due to logistics/costs than possible risks.
Your second paragraph reflects my personal views on it, too. The "banning" is weird, esp since, according to the article, it comes from people that seem to advocate against use of fluoride in general in toothpastes etc. The discussion should be around best policies to prevent cavities etc, but it does not seem to be around that. I see nothing wrong with local communities deciding if they want to put fluoride or not in their water, based on their own opinions but also general situation. Maybe in some much poorer areas fluoridation of water could be beneficial until some other measures take place, for example.
How have other countries solved it?
Adding fluoride into tap water always sounds borderline insane to me. The only benefit is to protect your teeth, which, to me, strongly suggests that the correct approach is to put it into toothpaste or other oral hygiene products instead of water.
We're either bigger, or denser, or less dense, or ... essentially whatever suits the argument.
https://www.airportthai.co.th/en/aot-reiterates-the-guidelin...
edit: But I will say it works both ways. Most countries do not know what it takes to keep hundreds of millions of people of various backgrounds together under a common way of life with a certain risk vs entitlement balance. Americans as a whole are more risk tolerant AND accepting of failure and reinventing yourself. In most cultures it's a great shame to quit your job with benefits, start a business and not succeed. In the states it's not shameful. You tried? Awesome.
I have to assume many, maybe most, people that give reasons like you mention just flat out don't want the policy and reach for a reason to justify it.
I can say I don't want gun control laws. Not because it doesn't work elsewhere or couldn't work here. I just fundamentally disagree with it and don't want to live in a place where the only ones with guns are state officials.
It's baffling how despite numerous other countries outperforming the US in educational outcomes we do not even look at other approaches!
(If we had patriotic songs worth remembering im sure i would have)
The problem is this, hoe do you fix something you are proud of? It seems a contradiction?
Speaking as an American, though, I can both be proud of something and recognize its faults. I'm proud of the core principles that America was based upon, for example, but very much recognize how far we've deviated from them and how much we need to fix.
I think there's never much to gain in being proud of things you have nothing to do with or control over. If you like some principles you would be proud when you uphold them personally. It is when we start feeling proud in the abstract that we start having issues.
"Pride goeth before a fall" is a time-worn saying for good reason.
Hell, in some countries even the national anthem has no lyrics but is purely an instrumental track (Spain being a notable example).
Mexico's Pledge of Allegiance celebrated every Monday in schools.
https://en.wikipedia.org/wiki/Pledge_of_Allegiance_to_the_Me...
But even that was once-in-a-lifetime event to emphasise the importance of the first day at school at age 7, it did not happen every Monday.
Needless to say, it wasn't very effective. As evidenced by history, some of our parents definitely broke that pledge later in their life.
Claiming to be the best (at anything) is just tacky and arrogant. Especially with something as impossible to quantify as "best country". There's no such thing as the best country in the world. Every one has strengths and weaknesses, and you can't really balance and rank them.
[1] https://en.wikipedia.org/wiki/List_of_countries_by_incarcera...
[2] https://www.statista.com/statistics/262962/countries-with-th...
It’s kind of amazing that the left has forgotten that fact.
Poland,
https://georgewbush-whitehouse.archives.gov/national-anthem/...
Netherlands,
https://www.classicfm.com/discover-music/periods-genres/nati...
The difference between America the Beautiful and other anthems is how much it does, for how long, and making sure it gets everything it can possibly cram in there. It's like a bunch of people standing on a stand at a sporting match shouting "America, America, America" unremittingly, whereas most people might be satisfied to shout "Go {my country}" and be done with it.
And oh, that people used to talk about us and that despite they don't anymore we are still a pretty nice place to live.
https://www.tiktok.com/@guinnessworldrecords/video/747057742...
ha-ha f....
The cultural difference is that our rich people are too rich, our media is too centralized, and none of those in power want to enrich and empower the country, when they could enrich and empower themselves.
(For now, at least? How long until that gets cracked down on as dangerous?)
There is no person in the world who cannot have a toothbrush and toothpaste if they want to. And if you find one such person, they won't have access to any centrally treated water.
Considering that the number of such people is very low it would be very cheap to solve this issue.
> really?
Yes, really.
> So why are they poor?
Why is anything the way that it is?
It was referring to the comment where you said “less cynical”.
> Why is anything the way that it is?
America big? America different?
It’s more challenging to find non-cynical reasons for people being poor and suffering.
It's not perfect by any means, but it's definitely much better than nothing. So the US should absolutely be able to at the very least match that, but really most likely it should be able to do much better. That it doesn't is very much a choice.
I think the US would prefer a UHC if we were starting from a blank slate. The difficulty is mapping a path from what we have now to that.
Do you remember when Republicans went on and on about how "Democrats rammed through the ACA without a single Republican vote"? As if that represented a problem on the Democratic Party side, and not the Republican one? Despite the similarities to models proposed by Republicans in the past, and the relative conservative step it represented from "Byzantine kludge of often poor-to-no-coverage" to "something with a higher floor"? That's how hard it would be to find a Republican to "prefer a UHC if we were starting from a blank slate."
It's important not to underestimate the distrust of government services and regulation of any sort of the Republican base. The conservative media - talk-radio, then cable, then social/podcasts - has been intentionally undermining the credibility of government services at every opportunity for 40 years. And the politicians hamstring and sabotage whenever they get a chance to try to make sure that services offered in the US are sub-par compared to elsewhere.
It's a well-oiled machine running a cycle that keeps people focused on anything else but the services they actually use all the time so that cognitive dissonance can't creep in. (Granted, sometimes, when necessary to acknowledge those things, they'll fall back to making it clear that YOU earned/paid for the things you use, but those other gross poor people are just freeloaders.)
It's like with abortion - for decades "overturning Roe V Wade" was what Republicans said they wanted to do. And people kept trying to convince themselves "oh they don't really mean that, they wouldn't do that actually anymore." Take their word on it about wanting to tear down government services.
This is partly what I was getting at when I said the culture of the US is different and the scale is much larger than European countries. It's not just geographically larger, but it's politically and ideologically broader too. If you have a wonderful idea like UHC, you need to make it work with liberals, conservatives, and everyone in between. Like it or not, a universal healthcare or Medicare for all plan is either going to be DoA in Congress, or a considerably watered-down and Americanized version if it has any hope at all of getting enough senators to pass it without first seeing massive electoral college reform in this country first.
That is the scale of the US. You can't assume that an idea that's well-liked and popular in another country is going to be popular and well-liked here.
And the various countries in Europe do have different healthcare systems, sometimes significantly different.
It's difficult, but not as difficult as it's often presented to be, as long as you're okay with giving the finger to a relatively small number of wealthy health industry executives.
And that, is the difficulty. Sure, I agree that it wouldn't be too logistically difficult to implement universal healthcare in the US. But that doesn't matter when more than half the country has been propaganda'd into not even wanting it in the first place.
Hell, I expect that there are a ton of Medicaid and Medicare recipients in the US who would tell you that they think government-provided, single-payer healthcare is a bad idea, when that's essentially what they have, to some degree.
That's what it still has.
The current healthcare system is working perfectly (and by that I mean lucratively) for the 0.01% in control of the political system.
If you want to make that argument, actually make it, because if you try, 99% of the time its not actually true, its simply ignorance.
> US states used to be offered much more independence.
But even in your own example with the EU, the EU still mandates many health policies for its member countries: food safety; air and water quality; tobacco, sugar and alcohol regulations; and so on. That's not at all dissimilar to what the federal government does in the US, except our states don't implement those policies/directives themselves because the feds enforce it all.
The comment I was replying to pointed out that the US isn't several countries put together. As you describe, the EU is several countries put together and yet the US actually pushes more power to the states.
Doesn’t their comment claim the opposite?
Unlike the US Federal government EU has very limited direct means of imposing any if its laws or regulations on member states of they chose not to comply with them.
And are those conditions manmade? If so, would we be better off reversing the proximal issues rather than adding fluoride to try to fix it?
let alone the precautionary principle in a complex system with a gazillion variables... (i.e. things we don't know we don't know)
https://news.ycombinator.com/item?id=43521734
And this is known by people who do professional advocacy work, on topic I am familiarly with, such as city design and transportation. They take great care to make sure all the examples are from the US, even if those examples aren't nearly as good as others. Because they know, when speaking to American audiences, you lose the audience if you suggest in X town, they should do Y that is done in Europe. In the US selling something as domestic innovation is usually the best, "if people in Indiana can do it, you can do it even better".
To just ignore any explanation that points out that culture matters, and believing that only 'hard' factors matter, is incredibly foolish. Cultural believes, such as exceptionalism absolutely do a play a huge role in determining what happens in the real world. To point that out, is not cynical or lazy.
And this does not just apply to the US, it many countries have different forms of that.
I really don't buy it, at least not as a general statement.
As to rail, both the first-gen and second-gen Acela is based on the French TGV.
The comparison to the Dutch healthcare system is not apt. While the Heritage foundation may used ideas from the Dutch system our system is quite a bit more Byzantine and inefficient. We spend twice as much per capita on healthcare and have worse outcomes and fewer people covered. Our citizens have far more per capita medical debt than the Dutch.
We didn’t really implement the Dutch system and we didn’t really learn from the French how to build and maintain high speed rail. Saying we learned healthcare from the Dutch because we have doctors like they do makes as much sense as your argument.
Why does the US execution not match that of the countries it looks into? I think it's because talented people in the US disproportionately go into the private sector, leading to an incompetent public sector. American distrust of their government is arguably justified.
IMO the most distinct parts of the Swiss health insurance system is that (1) copay is obligatory but limited (i.e. healthcare isn’t free but it’s not expensive either), and (2) it’s individual, companies cannot pay for it, so there’s no US-like extreme benefit of having a good job.
It isn’t really bargaining power of the pool, but the risk assessment of the pool you are in. Being in a hodge lodge personal pool means you are sharing risk with people who will have more expenses. That’s why Switzerland throws everyone into the same pool, so no crème low risk can be siphoned away.
Due to the regulations it is not a big run to the bottom
> The average Obamacare plan costs $483 monthly for a 30-year-old, $544 for a 40-year-old and $760 for a 50-year-old.
> The bronze plan covers 60% of the costs associated with care.
I feel like they missed the most important parts of the Dutch health insurance system…
> While more than 90 per cent of Australians have access to fluoridated water, that figure is significantly lagging in the sunshine state, where local councils have ultimate authority over whether it is adopted.
> A decade after the Newman government handed responsibility for fluoridated drinking water to local governments, 51 out of 77 have opted out. That means about 28 per cent of Queenslanders do not have fluoridated drinking water
https://www.abc.net.au/news/2023-11-24/fluoride-dental-care-...
There’s evidence that despite widespread availability of fluoride toothpaste and mouthwash, fluoridated drinking water improves dental outcomes at the population level.
There’s also evidence that at high levels (not the normal levels it is added at, but at higher levels which can happen on accident) fluoride may reduce IQ.
I’m ok with either trade off but the “solved” phrasing makes it sound like there is an obviously superior choice.
Meanwhile, back here on Earth-1, there's no right thing, and countries all over the world have "by and large solved" the issue by doing completely different things: https://en.wikipedia.org/wiki/Water_fluoridation_by_country
> Water fluoridation is considered very common in the United States, Canada, Ireland, Chile and Australia where over 50% of the population drinks fluoridated water.
> Most European countries including Italy, France, Finland, Germany, Sweden, Netherlands, Austria, Poland, Hungary and Switzerland do not fluoridate water.
Unfortunate that the color scheme is confusing, but not any weird borders.
You can see the uncolored map here: https://en.m.wikipedia.org/wiki/File:BlankMap-World6-Equirec...
These countries largely publicly recognise the benefits of fluoride, but don’t add it because:
- Some countries opt for intake via supplementation.
- Some have a naturally sufficient supply in drinking water via natural processes.
- Some even need to reduce the abundance of fluoride in their water due to over supply.
I think you are kinda misusing science/not science arguments.
This is indeed the scientific reason why there is flouride in the water. It is also scientific reason why some countries removed it.
In some countries people take care of their teeth on average and in other countries not so much. So there is science for why fluoridation happens. You can read many articles about the fluoride benefits for teeth and what is the impact of teeth for overall health.
Yet it is supported by science.
Indeed even the discovery of this property of fluoride came about from the observation of people who naturally consumed fluoride had fewer dental caries and tooth decay.
Further studies cemented the benefits of the passive inclusion of fluoride in drinking water versus control groups. So no, the science you speak of is almost certainly politics dressed up as science.
There have been countless studies that show that communities with flouride in the water have consistently lower rates of tooth decay than communities without fluoride in the water. In fact, community water fluoridation has been recognized as one of the great public health achievements of the 20th century.
Systematic reviews and meta-analyses have shown repeatedly that water fluoridation reduces tooth decay in both children and adults by approximately 25-30%.
I think you can pretty easily infer his opinion about toothpaste containing a "dangerous neurotoxin".
The latest report from the National Toxicology Program has found a causal reduction of ~1.63 IQ per additional mg/L concentration of fluoride in their urine [2], which would seem sufficient to also call it a neurotoxin, though the NTP under extensive pressure chose to avoid any particular label after having previously declared it a "presumed neurotoxin."
Notably the study from NTP also mentioned something most people here seem to be missing: "There is a concern, however, that some pregnant women and children may be getting more fluoride than they need because they now get fluoride from many sources including treated public water, water-added foods and beverages, teas, toothpaste, floss, and mouthwash, and the combined total intake of fluoride may exceed safe amounts."
Fluoride being seen as desirable at safe levels, may have drove excessive multi-domain inputs of it, which can combine to drive it to unsafe levels.
[1] - https://en.wikipedia.org/wiki/Fluoride_toxicity
[2] - https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
No it is not. It is sensational and intentionally inflammatory. It is especially damming coming from someone in his position.
Vitamin A, vitamin D, vitamin B, iron, and caffeine are all deadly at that level. The first 4 are mandatory for life, shall we call them dangerous too? Or perhaps we have some nuance and acknowledge the co spirit oriel background (and other beliefs) of the people pushing the anti-fluoride message.
But with fluoride we're talking about extremely low doses, well below the lethal level, being able to potentially permanently damage the mind's of children. Such an extreme risk justifies an abundance of caution, especially when the reason we're doing it is for some relatively modest dental gains, which are likely increasingly obsolete with fluoride being in tooth paste and many other sources besides water. In fact, as per the study I linked to up above, this is precisely the problem!
"Since 1945, the use of fluoride has been a successful public health initiative for reducing dental cavities and improving general oral health of adults and children. There is a concern, however, that some pregnant women and children may be getting more fluoride than they need because they now get fluoride from many sources including treated public water, water-added foods and beverages, teas, toothpaste, floss, and mouthwash, and the combined total intake of fluoride may exceed safe amounts."
[1] - https://pubchem.ncbi.nlm.nih.gov/compound/Retinol
See the rest of this thread. If you think the group (at RFK doing so in an official government capacity) using such inflammatory language is going to stop at removing fluoride from just water I don't know what to tell you.
Tooth paste, and other commercial products, are opt-in systems. And indeed there are already numerous unfluoridated options available.
EDIT: I checked. It is possible to buy salt with added fluoride in Germany but it comes with the health note "Zusätzliche fluoridhaltige Präparate sollten nur auf ärztliche Empfehlung eingenommen werden.", which means you should only use it on recommendation by your MD.
I can't find any information on this, do you have a source? According to Wikipedia fluoride toothpaste is recommended by health officials in Germany for children(https://en.m.wikipedia.org/wiki/Water_fluoridation_by_countr...)
Tooth paste with more than one per mille of fluoride has either to be marked as unsuitable for children or has to have a note that children have to be supervised using it and a doctor or dentist has to be consulted in case the child swallows more than a pea-sized amount.
So, not quite prohibited, but far from recommended.
In France, for example, the limit is 1.5 mg/L in tap water. https://www.anses.fr/en/system/files/NUT2007sa0315q.pdf
Supplementation mainly concerns iodine for non-marine salts. Sea salt naturally contains iodine and fluorine. Salt from salt mines contains much less. For this reason, iodine deficiency was relatively common in the Alps until the beginning of the twentieth century.
To my knowledge, there is no debate or controversy on the subject. Endemic goiters are exceedingly rare and are linked to behavioral and eating disorders.
> In England, approximately 10% of the population, or around 6 million people, receive fluoridated water, either naturally or through water fluoridation schemes, mainly in the West Midlands and the North East.
Uh oh. I know it is better now but in 1978 a third of people in the UK didn’t have their natural teeth.
You saw it too in Canada when the Inuit went on food stamps and went from eating mostly meat to mostly plants: their teeth went all over the place and full of holes within a single generation.
We also saw that with the advent of agriculture in general, along with a massive decline in average height.
https://www.yongeeglintondental.com/blog/healthy-primary-tee...
That, of course, is not quite the same thing as perfectly white, perfectly aligned teeth.
No, not really. There are a couple municipalities (Portland, OR, e.g.) that have famously not fluoridated their water forever, but for the most part this is not something most places argue about. UT is an exception.
I think most cities manage their own utilities. So, Portland has to make some decision on this issue. Utah doesn’t, it was an active choice to intervene.
downplayed? you judge.
The British abolished slavery with a vote of parliament. The Russian emperor signed a decree, and freed the serfs. Compromised were made, compensation provided and people were made free. But for some reason, Americans felt the matter is important enough to start a civil war around it.
People complain about America being divided and both sides there being unable to compromise, but if anything, that's been the defining feature of the nation since it's creation. "Y'all should take a chill pill, this ain't that important" is a perfectly valid position to have.
It sure is bizarre for the parts of the world where people are born to do as they're told and shut up.
What's rare is for a nation to have a civil war between sides that agree on almost everything, from the structure of the government to the economic system.
The situation was fundamentally different. Colonies that allowed slavery had no representation in parliament and the slave owners received massive “compensation” that the British people had to spend decades paying off..
Also AFAIK most slaveholders were living in Britain and just viewed their plantations as just another investment. There was very little ideological/“way of life”/racial supremacy stuff involved. So if some Liberals wanted to buyout their not necessarily very liquid “property” with cash they didn’t really have much reason to oppose it.
And then there were 5x more slaves in the US in 1864 while the population was only ~30% higher than that of Britain in 1830 (only if we don’t count the colonies).
Not sure how excited would the inhabitants of New England and other free states would have been if they were forced to buy out all the slaves in the country (if that was even an option).
Slavery for the British was a side note at that point while it was a fundamental component of the US economy.
The idea that no compromise was possible sounds somewhat absurd since America did end the civil war with a compromise. "You can free the slaves, but then we oppress them for 100 or so years." Not that it was a good compromise or anything, but it does show that the civil war was fundamentally pointless.
So it’s hardly applicable to the US (or Britain)
> end the civil war with a compromise
I’m not sure it’s was a compromise per se.
Most people in the north didn’t really actively support country wide abolition before the war (neither did Lincoln) nor were they necessarily particularly concerned about the treatment of the African-American population.
Opposing slavery is a very low bar. Most people in the free states were still deeply racist and segregation was effectively (while not necessarily legally) still a thing there. It only became a major issue in the mid 1900s.
The answer was the same then as it is now: big business. Slave labor cash crops were central to the economy of the South. Great Britain was not dependent on it in the same way.
Even more so the economy of Wall Street.
For one, we’re literally making everyone slightly less intelligent. While it’s a very small factor, I sure as hell wouldn’t want that for my daughters.
For two, IQ is easy to measure. Through that, we know it’s affecting the brain during development. How else is it affecting it? We don’t know.
Weighed against potentially higher risk of cavities pretty much only during childhood and the math seems incredibly clear to me. I feel like the only reason we haven’t banned adding it to water supplies is because people have a knee jerk reaction to anything that sounds even vaguely anti-vax nowadays.
The fact that until 10 years ago the US allowed significantly higher levels should be a really big deal to people.
I’m on reverse osmosis well water so it doesn’t matter to me personally, for what it’s worth.
Almost all fluoride from the drinking water does not have any effect on tooth enamel, because it has contact with it only for a few seconds, except for an infinitesimal fraction that may exit again the body in saliva.
On the other hand, the harmful effects of fluoride in drinking water are certain and it cannot be predicted exactly how much water will be ingested by someone, i.e. which will be the harmful dose of ingested fluoride.
The only argument of those who support water fluoridation is that most people must be morons who cannot be taught to wash their teeth. I do not believe that this theory can be right.
it always surprises me how willing people are to just make something up and be confident in doing so. We've know for almost 75 years that water fluoridation reduces tooth decay[1] and yet here you are straight up denying that.
Do you just not care if you are correct? or do you know you aren't but are driven by the beliefs you already hold?
[1] https://www.cdc.gov/oral-health/data-research/facts-stats/fa...
The contact via toothpaste or mouth wash isn’t all that much longer, so why would they be effective if fluoridated water isn’t? People intentionally wash out toothpaste and mouthwash after this short contact.
I put in a spelling error in the above paragraph of 215 characters, you still understand it but what was your perception of me from this very small error?
Of course it comes down to whether the relationship actually exists. But picking a slightly higher risk of cavities when the other option is potential mental impairment (however mild) seems like a no-brainer..
I don't think it's such a no brainer if every health org is recommending fluoride, and some people think it's scary.
Also you are not supposed to eat toothpaste…
> don't think it's such a no brainer
Well obviously only if the relationship actually exists and there is enough evidence for it. How else could you interpret my comment?
> brainer if every health org is recommending fluoride
Is that true? e.g. throughout entire Europe for instance?
having to resort to childish attempts like this essentially invalidates anything "insightful" you might want to say. if you can't see that manually adding safety-unproven chemicals to water without people's consent is a weird and unethical thing to do, then that's fine, but don't embarrass yourself and everyone else like this
Nobody is doing that, so maybe don't embarrass yourself like that?
> without people's consent
Also not happening. Consent was established when it was voted on, and if people want to change their local policies they are always free to do so. People that object against majority are also free to drink alternative water from the free market instead of relying on socialist handouts
If you want to have an actual, good faith debate about the pros/cons of a specific additive that's wonderful. But you didn't, you reduced the entire thing to "chemicals bad because chemicals". But, more significantly, so too has the US's administration which Utah is following suit on. The US is full on "feels not reals" government mode.
when was it voted on and by who? tell me.
you're also aware that people pay for water, it's not free? quite an odd thing for an adult to not know
"good faith debate". from someone who started making mocking autism noises in the middle of a normal conversation? that's what I suggested was embarrassing, you simply didn't read my comment because you yourself have no interest in having a good faith discussion and you're just blindly throwing terms like that as a way of dismissing an opinion you disagree with.
"chemicals bad because chemicals" I never said anything of the sort, this is a strawman you invented to strengthen your struggling argument. there have quite literally been studies linking increased fluoride to toxicity. it's not "chemicals bad because chemicals" it's "there have been studies suggesting this chemical may be toxic so why are we putting it in drinking water without a public consultation in the last 70 years?"
>The US is full on "feels not reals" government mode.
okay and here we have your real motivation. 90% likely you quite obviously don't give a fuck about fluoridated water or human rights, you are pissed about the current executive branch and you're looking to take it out somewhere. this "debate" is over.
The general idea of the government medicating the people writ large isn't low stakes.
In the US there are a lot of people who are of the opinion the government should just let people be.
I have a feeling it's not about "letting people be". It's about "let me be and screw over those I don't like"
Anyone who thinks this is a straightforward issue is dumb, frankly.
How can the issue people are concerned with be government overreach if they don't care about the government overreaching into others backyards?
If you think all the people advocating for small government must be fools or hypocrites, you don't understand the issues an any depth.
I'm curious, what rights are "granted" by making it illegal for doctors to prescribe puberty blocks when they as a medical professional and a child's parents as their guardian agree they're the best medical course of action for a child?
Saying "it's about granting and taking away" like rights are some zero-sum game feels like it's ignoring the complexity of these issues more than what I'm saying.
So it's not an issue of trampled rights if it's just trans rights, yet you can't come up with a reason that trans rights need to be restricted to ensure freedom of others. And it's being disingenuous to call you out for saying trans rights don't matter when you say this...
You knew the example. You know why society restricts people below 18 from all kinds of things. You are the very definition of disingenuous.
I don't mind being called "the very definition of disingenuous" by you.
Here's some interesting data (2003 I believe, so pretty old) [1]: It reports that most of Europe, Canada, Australia, and South America experiences cavities at rates higher than the United States. However: Many of these countries have public health care; the US does not. Is the US under-reporting? (I didn't dig much deeper into the underlying data; may not be a relevant concern).
Three things I think are likely to be true: (1) Fluoridated toothpaste is widely available and cheap. (2) Cavity rates are significant even in countries with high rates of fluoridation. (3) Fluoridating the water supply carries with it a non-zero monetary cost. I tend to believe that these three realities, at the very least, justify the conversation as being one we should have. It could be the case that water fluoridation made a ton of sense in a world where people didn't have as much access to fluoridated toothpaste, but nowadays the typical person has hit the limit on what it can do for them, and ingesting more is, at best, doing nothing.
Here's another way I like to think about it: Put the science aside for a second (I know, hard, not ideal, but bear with me). You've got two people who are low income. Person A believes, for their own health and in the expression of their own personal liberties, they want access to fluoride; but the Government is not fluoridating their water. They can spend $5 a month to buy fluoridated toothpaste; possibly not even more expensive than the toothpaste they were already buying. Person B is living in the opposite world: They believe that they do not want to ingest fluoride, but the government is fluoridating their water. They would have to spend many dozens to hundreds of dollars a month buying water bottled somewhere more natural. From a personal liberty and economics perspective: Its pretty clear-cut.
[1] https://smile-365.com/what-countries-have-the-lowest-prevale...
Direct monetary cost is entirely insignificant, though. Potential risk of mental impairment (of course there is no conclusive evidence of that) seems like a much bigger issue.
If one out of a hundred people don't want fluoride, can't they can spend slightly more on bottled water? Why require the other 99 to be up-to-date on research to get the best personal medical outcome?
Flouride should be put in the toothpaste. Then people can make a choice on whether they want it, but most importantly, its in the only product that is actually used for brushing teeth
It's basically a waste product and water naturally has fluoride in it at the same levels, or more, that fluoridated water has, and the environment has been just fine in those places.
If it's harmful as you imply, lots of water would need defluoridation.
Sounds like it's not important to address fluorine reduction if a casual relationship can be established.
I do wonder how they compensated properly for fluoride being added in poorer areas. Will dig it out when I get chance.
Meanwhile growing up in Poland in the 90s as kids we had these fluoridation sessions in school, for which everyone had to bring their toothbrush and brush their teeth with some kind of sour tasting fluid that contained fluorine.
We had the same in Sweden up until the early 90s, and it's apparently doing sort of a revival in some schools.
https://sv.wikipedia.org/wiki/Fluortant
And regardless of whether the water is fluoridated or not, there is no big debate elsewhere about it, nobody cares that much about it, because all the evidence is that in smaller amounts prob it is does not matter much either way, in the presence of people brushing their teeth. A lot of countries stopped it due to logistic purposes. In netherlands they tried fluoride in the water, a court said they should actually pass a law in order to be able to do it, and they did not even bother with that and dropped it. The fact that some countries may not use fluoride in the water is not due to some deeply-held conviction about how destructive fluoride is for the iq of the kids. In terms of risks of fluoride, fluorosis is what is mostly discussed anyway, and to a degree, unless it is too serious, this may just be an aesthetic issue.
From the perspective of one that watches this craziness from outside, the whole debate is non-sense, and whether some european countries use water fluoridation or not is not very important, it does not cause any heated debate in the EU. The debate in the US is not because the US considers some things that others do not consider. There is no actual truthseeking mentality from the current administration or anybody on this to actually find for sure if fluoride decreases iq, or if fluoride in the water is absolutely essential for dental health even if people are brushing their teeth.
But beyond Europe there’s still no global consensus.
I do agree that the US is an outlier with fluoride being nearly universal.
Some countries no longer add it (but their water still has naturally occurring fluoride that they don't remove).
> Maybe the US should look into how other countries have solved it?
I mean Utah is trying, sorry it took a while. I know Germany and Sweden don't fluoridate its water, I assume you mean Western Europe by the "world" (sorry if I am interpreting too much here, but that's usually what's popular to compare US to and bash US on how bad it is), so US is getting "with the program", finally I suppose. States having individual laws here is a benefit, one state doesn't have to wait for the Federal Government to act.
> This is one of these US-specific polarised debates I find really bizarre,
I don't think it's that polarizing? Unless 1) you're listening to US media more and 2) you're not getting many non-polarizing issues in the news, because those are well are just boring and don't sell ads.
This isn't a sensible way to think about it. Every contentious conversation I've ever had has gone this way:
It's irrational to complain about 'both sides' when only one side is insisting on making it into an issue. I generally just try to disegnage from people as soon as they start freaking out about fluoride/ chemtrails/ vaccinations etc, but people like this frequently treat skepticism as a personal attack. Increasingly they occupy positions of political power (see eg RFK) having acquired them by public displays of conviction rather than any objective criteria.Some place do it. Others partially, many not at all.
This is not obvious. Some water has high levels of fluoride, which can cause harm (fluoride added for public health reasons is not the highest level of fluoride you will find [in the UK]).
Fluoridation could be done by mixing of naturally high fluoride water sources into other water.
(To be fair, though, many [most?] Western countries do not fluoridate their water. The US is actually not doing the common thing here.)
It's honestly not clear if water fluoridation in the US is necessary or all that useful here anymore, as we started doing it when fluoride toothpaste wasn't really a thing. Now pretty much all(?) toothpaste in the US has fluoride in it. If someone can't afford toothpaste, then they probably can't afford regular dental care either, and fluoridated water isn't going to make much of an impact anyway.
https://www.uk-water-filters.co.uk/pages/areas-with-fluoride...
For context... some people think statins should be put in the water. Maybe they should. But were does mass medication of the people stop?
Because I live in a small township that delivers well water to you tap. It tastes horrible, shortens the life of pipes and appliances, and smells like sulfur.
Every year they mail a flyer that explains how the lead levels are dangerously above the national standard and you should run the tap before you drink from it.
Like, sorry there's nothing we can do about it. =(
Also those dinky little TDS meters don't even measure TDS. They measure electrical conductivity and with a little math they use the EC as a proxy for TDS. It's typically only calibrated to one specific ion, others will be off by some factor. Also keep in mind TDS is expressed in PPM as CaCO3.
Oh man, I used to live in a place like this. You could smell if a restaurant served filtered water (lots filter for the soda machine, to keep mineralization in it down I assume, and use the same water to serve) or straight from the tap, without taking a drink. Like with your nose six inches above the cup, you could smell it. Luckily, almost all served filtered.
Turns out that carbon filters do filter fluoride, but only on the first few X litres of water, where X is in the first 0.01% or so of their expected lifespan. So, they do, but not really usefully in any sense.
My filter that I wanted to know about (so that my kid is getting fluoride) is a 2-stage filter, with the other stage being a particle filter, but fluoride is very small and unaffected.
Your filter might be different of course.
FWIW, in my city, the water has essentially zero fluoride if it isn't added, and it has been a great intervention.
https://cascadefamily.com/images/WaterFluoridationLevelsUtah...
Or, toothpaste has enough extra fluoride, adding it to water is just a waste of money.
This is not that. This is the US health system being lead by a bunch of woo-woo people who don’t understand how research works.
The majority of the developed world does not fluoridate their water supply. The US has one of the highest rates of fluoridation in the developed world. Within America, fluoridation rates are highest on the East Coast and in the South, and lowest on the Left Coast.
https://www.acffglobal.org/salt-fluoridation/
Ultimately, the woo woo people are the ones who rely on someone in a labcoat to tell them whether ingesting government approved (there's your first red flag) synthetic fluoride from industrial byproducts is "necessary".
If it's useful, brushing it onto your teeth and into your gums 56,000 times in your life is probably sufficient, particularly given that we don't know with absolute certainty beyond any shadow of a doubt that the industrial waste options are totally without health consequences. I'll literally just take care of my teeth and cross my fingers over listening to modern medical consensus on a range of topics where I simply trust intuition and common sense more.
In the USA, dental care is not covered by public insurance, and is an optional add-on to insurance through one’s employer.
So without addressing at all whether fluoridation is effective or safe, there doesn’t seem to be any compelling need to fluoridate public water, and there’s no economic down side for the public if governments choose not to do so.
Given this, why not just leave people alone to make their own choices? If the citizens in a city or state want to fluoridate the public water supply, then do so; if they choose not to, then leave them alone. It’s a free country and voters are grownups; let them choose for themselves.
If you live in a place that chooses the choice you dislike but for some reason fluoridated public water supply is a critical issue for you, either campaign to change it or vote with your feet.
This issue just doesn’t seem important enough to me to spend any effort arguing either way.
I wonder how many people really brush their teeth on a regular basis.
> either campaign to change it or vote with your feet.
I imagine that campaigning to change it requires notifying people there is a problem, and getting it into the news and spreading that news.
Whatever the number is it's not appropriate for the state to medically intervene on their behalf.
In countries with some form of universal health care, simple proactive health interventions can save the State large amounts of money.
Why is it appropriate especially in light of many people actively opposing the intervention?
These are questions about what is the proper relationship between the state and the citizen.
And they are a litmus test for current political belief bifurcation in the US.
You talked about dental care not being covered by public insurance — is it not worth considering that some basic level of dental care is already being applied to the country via fluoridation? It's a minimal, cost-effective way to prevent tooth decay at scale. Fluoridated water is one of the few dental protections available to everyone regardless of their income.
I'm completely sure that any people that don't brush their teeth is just because they are too lazy to even bother.
This trope of justifying everything with "but there are millions of poor people in the USA" is really tiresome.
Your comment is well-stated, and in the spirit of a free and liberal society. The problem—not with your argument, but with the world—is that today there seems to be literally no issue unimportant enough not to argue about, or use as the battlefield for an unending ideological proxy war. My guess is that few of the people arguing this issue on HN have strong feelings about flouride qua flouride, but have strong feelings about the kinds of people they believe oppose or support the use of flouride in water, and this notion is what they're really railing against.
So my instinct is to really be afraid of this anti-fluoride wave, even tho practically I don’t care one way or another.
I’m not sure what your anecdote proves because I’m wholly in support of a polity being able to make that decision.
Presumably when they voted to get rid of fluoride in the water in Calgary, they didn't do so expecting the outcome would be that people in their town would be less healthy overall. Nonetheless, that was the outcome of their vote.
The anecdote shows that it's not trivial, because when the fluoride in the water went away, people were not able to trivially replace it, leading to worse health outcomes. Ultimately people found too high of a cost, seeing as that they reversed the decision.
Sadly it took a decade for them to realize their mistake. I worry people today are making the same mistake, and we will reverse it in a decade after health outcomes are shown to have worsened.
Flouride in Water: Ingest away.
I do not understand how these two can co-exist.
Radioactive isotopes in banana: consume away.
Understand now? I'm not even defending anything other than how two things that vaguely appear contradictory, are in fact, not.
Because your banana example doesn’t have additives meant to be reactive — so is unlike adding fluoride to water at levels which impact dental health.
That is why I do not understand how the two can co-exist. Either the concentration is so low that drinking it for dental health is pointless, or it is not something people should be drinking. If there was a middle ground, we would have a 1 a day pill for this and not bother brushing our teeth or putting fluoride in water.
We do; fluoride tablets are common.
> and not bother brushing our teeth
Brushing your teeth does a lot of things besides applying fluoride to the surface. It's mostly about getting stuff that's already there off the surface.
No, I don't. Does that matter?
Chlorine for water treatment in the backcountry when applied to a liter of water: Ingest.
Chlorine straight from a household bleach bottle: Do not ingest.
At higher dosages, every dietary mineral becomes harmful, then (generally) lethal.
Without iron, humans die. Yet accidental (over-)ingestion of iron supplements is a leading cause of poisoning in small children.
Sorry, that was the John Birch Society from the 1960's.
[1] https://en.wikipedia.org/wiki/Opposition_to_water_fluoridati...
(I'm having some fun, but it is in fact the first thing that comes to mind when I hear objections to fluoridated water. Since we're talking about RFK and Utah, I kind of assume it more or less stems from the same fears.)
The idea that the conspiracy theorists are winning the public policy debate enrages me. There's rock solid proof of the benefits of fluoridation extending decades, and there is little to no proof of any adverse side effects.
Oh well, good luck Utah. I'm glad I don't live there, but if I were a young dentist, I know where I'd set up my new practice.
https://www.oregonlive.com/portland/2013/05/portland_fluorid...
Portland is a bit odd when it comes to water; they drained an entire (uncovered, open to the elements) city reservoir because a guy peed in it. True story. I assume they have signs for the birds flying aloft to not defecate over the reservoir.
Edit: It appears many posts all over this thread are being brigaded with downvotes. Why? Is Big Fluoride in trouble? Grow up. You people are brain damaged (possibly from fluoride).
The US has had water fluoridation for 65 years, affecting 346 million people. That's a pretty big god damn sample size and long amount of time in which to observe effects. If we still have no proof of significant negative health effects, it's probably not bad for you.
That said: you can always lower the amount of fluoride if it turns out the local area already gets a lot of fluoride from other sources. You don't need to ban it, you can just lower the levels.
So please don't defend this decision by Utah. They're being children.
2. A 1.5-3 IQ level difference is not noticeable in any practical way. Things like birth order have a more significant impact on IQ.
3. Comparing Canadian children to Mexican is pretty dramatic, like comparing rich kids to poor kids; you will always see a marked difference between the two, in intelligence, in health, in crime, in all sorts of things. Mexican communities often over-fluoridate their water (I know because I grew up in Mexico and my teeth are stained because of it). Again, this is no reason to ban it, just lower it.
This finding is a suggestion of a link, it's not empirical proof. The methods and findings have many questionable aspects. You can always find some paper that suggests something random like vegetables are bad for you or something. One paper does not a water-tight case make.
The problem is there will have been a lot of confounders.
E.g. despite huge sample sizes, isolating the cause of the obesity crisis is too hard because so many different things changed at once.
The answer to the obesity crisis wasn't to ban Pizza. We don't we ban sodas and junk food at schools, which we know would have a positive impact on health. But we do ban fluoride, without proof that it will help? With actually the only scientific proof being that it would be detrimental to remove?
If people's concern is really that it might slightly lower IQ, consider that 1) IQ has been steadily increasing since the 40's, and 2) you can get better IQ by investing in education, something that we do an embarrassing job of already and need to improve on.
The other concern touted is that it might cause cancer. As we well know by now, nearly everything causes cancer.
Banning fluoride is just a move by politicians to take advantage of ignorant scared people to drum up more votes/support. It's like every other action they take to vilify something scary or unknown and then claim victory over the evil thing they purged. This isn't new, either - this clearly partisan stance was being pointed out in the 1950's when it was first being considered for nationwide use.
"After more than 70 years of investigation, there are still questions about how effective water fluoridation is at preventing dental decay and whether the possible risks are worth the benefits. Although water fluoridation undoubtedly did improve the dental health of many children in the 1960s and 1970s, fluoride proponents were perhaps too hasty in declaring that community water fluoridation was the best (or only) solution for dental decay. A less fractious debate might have encouraged a more open discussion in which the possible harms could have been more fully discussed and other options, such as providing fluoridated toothpaste, more fully considered." - https://pmc.ncbi.nlm.nih.gov/articles/PMC4504307/
You got a cite for this? I keep hearing that the education interventions tried in the West have universally failed to raise IQ.