Comment by 827a

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...