Comment by jdminhbg

The missing context here is that the science and established benefits of fluoride aren’t a culture war political football in those countries.

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.

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

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.

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.

[1] https://smile-365.com/what-countries-have-the-lowest-prevale...

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.

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.

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.

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.

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 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.

Sure, but they are also not fighting about it, this seems crucial.

Incisive comment, thanks for questioning the assumptions here.

How much natural fluoride does Europe have in their water?

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.

[dead]

Never interrupt your enemy when he is making a mistake. The whole "everyone else agrees on X" bit is such a reliable tell.

Most developed countries have stopped using fluoride. I think that’s the commenter’s point. The US and Australia are outliers here for sure.