Perhaps more could be done. The situation is complex because of several compounding factors for sure. There are European countries that have no water fluoridation and better oral health outcomes than in North America.
Regardless, there’s 10 years where a city in North America turned off water fluoridation and we have results of that decision to study.
I'm skimming the results, but it looks like adult teeth had less cavities when they turned the fluoride off...and that was not observed in Edmonton where they left the fluoride on the whole time.
"For all tooth surfaces among permanent teeth (Table 1a), there was a statistically significant decrease in Calgary, for the overall mean DMFS, which was not observed in Edmonton."
Based on their data, you could argue that fluoride increases cavities in adults... I'm not making that argument. I agree with you in that I think confounders are at play and the difference attributed to fluorinated water isn't as large.
People will use this study to take about the rampant tooth decay in Calgary, ignoring that there is roughly as much decay in Edmonton which had the fluoride on the whole time.
Before calling them "anti science wackos", why not review the evidence or cite some of your own. Ironic that the "wackos" seem to be the only ones providing any evidence for their claims.
There is high quality evidence that fluoride at levels contained in some US water supplies is associated with lower childhood intelligence. For lower levels, the conclusion is "we don't know", not that there is no harm.
There is also high quality evidence that in the age of fluorinated toothpaste, fluorinated water "may slightly" improve dental health.
“The evidence suggests that water fluoridation may slightly reduce tooth decay in children,” says co-author Dr Lucy O’Malley, Senior Lecturer in Health Services Research at the University of Manchester. “Given that the benefit has reduced over time, before introducing a new fluoridation scheme, careful thought needs to be given to costs, acceptability, feasibility and ongoing monitoring."
The literally bold-faced conclusion of your article is that no evidence exists that community water fluoridation affects childhood IQ.
We have a natural experiment running for 80 years where each arm of the experiment has N > 100e6. If there was going to be evidence of community water fluoridation lowering IQ, it would have emerged by now.
"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".
They found drinking water with levels that lowered IQ. The actual conclusion was that higher levels (that were found in drinking water) lower IQ.
For lower levels the conclusion is we don't know how it effects IQ. The actual bold face conclusion is "More research is needed to better understand if there are health risks associated with low fluoride exposures".
The National Toxicology Program’s monograph failed peer review by the prestigious and independent National Academies of Science Engineering and Medicine. In fact, the document failed peer review twice:
It seems that this team found what they wanted to find. Are they scientists or ideologues? Were they creating the 'evidence' for the San Francisco trail?
Please define appropriate levels and then cite some evidence that proves with high certainty that level is safe.
For the sake of argument, assume that only 1% of the US has levels that harm IQ. Would it not be worth it to remove fluoride from the water to improve the intelligence of 1% of the population? Especially when you consider we can get fluoride from toothpaste?
"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"
They found fluoride in drinking water concentrations was associated with lower IQ, the opposite of your claim of "proven safe".
Show us some evidence that is proven safe, so far as I can tell all evidence points to unsafe or "we're not sure".
> What needs to stop happening is people ignoring objective reality just because the results happen to align with the other "team's" position on something.
I couldn't agree more. The study that is cited above started when Obama was president by the way.
Why did you omit the sentence immediately after the one you quoted?
> 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.
…or the following sentence, which they bolded to ensure the reader wouldn't miss it?
> 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.
So no, they very explicitly did not find that fluoride in drinking water concentrations was associated with lower IQ.
I see the goalposts are moving from "fluoride in drinking water concentrations" (implication: concentrations commonly found in municipal drinking water) to "fluoride in drinking water at certain concentrations" (i.e. any arbitrary number that could support your position).
Anyway, there's a pretty obvious definition of "drinking water concentrations": the recommended amount for US drinking water. Again, the authors of the study bolded this sentence to ensure you wouldn't miss it:
> 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.
My first sentence in my original post was " The conclusion from the largest and strongest studies is that there is a certain level of fluoride that harms IQ." I did not move the goal posts from there.
I was replying to a comment that said "fluoride in the drinking water concentrations is proven safe" (there is actually no proof of this).
I never claimed that all fluoride levels harm IQ.
It's great that the US recommends that fluoride doesn't exceed levels that are proven to harm children's IQ, instead they only recommend levels for which there is "insufficient data".
I suppose we will ignore the people who are still drinking water with levels above what is known to be harmful.
To be clear, about whom exactly are we talking here? Who are the actual people drinking water with known harmful levels of fluoride that we’re ignoring?
If we take the known harmful level of fluoride as being >1.5mg/L then the NTP monograph itself has some information ():
> areas including central Australia, eastern Brazil, sub-Saharan Africa, the southern Arabian Peninsula, south and east Asia, and western North America (Podgorski and Berg 2022). Regions of the United States where CWS and private wells contain natural fluoride concentrations of more than 1.5 mg/L serve over 2.9 million U.S. residents (Hefferon et al. 2024). The U.S. Geological Survey estimates that 172,000 U.S. residents are served by domestic wells that
exceed EPA’s enforceable standard of 4.0 mg/L fluoride in drinking water, and 522,000 are served by domestic wells that exceed EPA’s non-enforceable standard of 2.0 mg/L fluoride in drinking water (USGS 2020).
[https://ntp.niehs.nih.gov/sites/default/files/2024-08/fluori... Page 2 or Page 22 of the PDF]
Note in the US this is almost all people drinking well water. So if we take the known harmful level at 1.5mg/L, then there are lots of people known to be drinking water above these concentrations. I'm not sure I would say we're necessarily ignoring them, but could argue regulations aren't up to date: the current EPA MCL is 4.0mg/L and secondary MCL is 2.0mg/L.
For more in depth data, we can take the EPA's Review of Fluoride Occurrence for the Fourth Six-Year Review (2024) [https://www.epa.gov/system/files/documents/2024-04/syr4_fluo...]. Page 15 of the PDF shows artificially fluoridated water nowadays has fluoride concentrations between 0.6mg/L and 1.2mg/L. Page 18 shows that ~4.7 million are being served with concentrations of fluoride >1.5mg/L. This is higher than the Hefferon et al figure but it seems this figure is based on data from 2006-2011 (where the population was lower, but also the recommended fluoride concentration was higher, with the max at 1.2mg/L pre-2015). I also am not convinced Hefferon et al has any figures on private wells (although maybe I misread the paper).
Anyone who talks about who was President when a study was done is immediately clarifying for you that they have a political agenda.
If there’s a problem with a study, or a study is particularly strong, that should be due to something about the study itself (methodology, significance of results, etc), not its political environment.
To emphasize your point, I don't think anyone will notice if someone's alzheimers is 2.3% better.
These rating scales like CDR-SB (invented by drug companies or researchers who are funded by drug companies) are very good at making the tiniest improvement sound significant.
Im guessing English isn't your first language? Fistel is not a commonly used term.