Fluoride ... the Silent Killer
(or at least, that's what some article on the internet called it)
The city council of Portland, Oregon, where I live, has recently passed an ordinance to add fluoride to the water supply. My first thought on the matter was "it's about time." And I had no further thoughts about it.
That is, until recently. A few friends of mine are strongly opposed to fluoridation, and have been making anti-fluoridation posts on Facebook. They are motivated enough to spend their own valuable time creating signs to support the effort to put a measure on the ballot which would allow the city residents to block fluoridation.
They aren't the only ones. Outside of my local grocery store there are people with petitions accosting me as I head in to buy potatoes. Our local newspapers are buzzing with fluoridating talk, we've made big national news, with articles by NPR, the New York Times and the Huffington Post. It simply doesn't make sense to me. To me, this isn't even an issue worth talking about. It's a simple public health decision. Portland spends a small fraction of it's budget on maintaining a fluoridated water supply, and the oral health of it's 580,000 residents and the other 400,000 people who share the well have fewer cavities.
Naturally, I have a gut opinion. I grew up in Salem, where I spent the first 18 years of my life drinking fluoridated water. It (apparently) has not had any negative effects on me personally. A few years after I moved away, I had the pleasure of my first root canal. Does that mean that fluoride helped me while I lived in Salem, or does it mean that I didn't brush my teeth as much as I should have after I left?
I love a good debate. But, I really hate situations like this. I have a strong opinion that I trust without question. I don't even think about it. This debate has alerted me that I believe that fluoridation is beneficial, and that I have this belief without evidence. Unfounded beliefs are dangerous. They leave people open to manipulation and misinformation. So, when I discover that I believe something without question, I do my best to find out what the facts actually are and challenge my belief.
The arguments on the side of opposition are alarming. Fluoride is an industrial waste product. Fluoride is used as an insecticide. Fluoridation is a fraud. The evidence for fluoridation is dubios. Fluoride causes cancer. The majority of these arguments come from a non-mainstream organizations, which are easy to classify as junk science. Which, simply put, means they articles that use big, sciency-sounding words to convince people that of their particular truth. Junk science is deliberately designed to confuse and instill fear, usually motivated by a political objective or to simply help the authors gain wealth. You'll find junk science supporting instant weight loss pills, magic magnets, perpetual motion, and cold fusion.
After hunting down the actual Harvard study, I found it to be study of other studies. It concludes that there was a difference in IQ of less than half a point among populations with high fluoride exposure. In order to use this study make an argument that fluoride lowers IQ, you would first have to accept that a Chinese IQ test is a valid measure of intelligence, expose yourself to high levels of fluoride, and then believe that having an IQ score of 99.55 instead of 100 would have a noticeable effect on your life.
The arguments for fluoridation are actually pretty simple, and typical of scientific studies. You get such provocative supporting statements like "a systematic review found that water fluoridation was statistically associated with a decreased proportion of children with cavities and a decrease in decayed, missing, and filled primary teeth." The original idea for performing fluoridation in the first place began after 11-year study which showed 60% decrease in cavities among children. That is a highly statistically significant result, but not likely to cause someone to parade signs in front of city hall.
I can find a lot of anti-fluoridation literature which is pretty easy to poke holes in, and a lot of scientific literature which overwhelmingly shows that fluoridation improves oral health. I am quite satisfied in my position for fluoridation. And, I can rest comfortably knowing that I've done the research to confirm my belief that adding fluoride to water is a reasonable thing to do.
Oral hygiene is a major public health concern. I've had this drilled into my head as far back as I can remember. My father works in the dental health field, so I've picked up quite a bit of knowledge about dentistry and oral health concerns. I have listened to dentists tell me stories of people who come into their office with a tooth ache, and the dentist is afraid to even do the examination for fear that poking around will cause their highly diseased teeth to literally crumble. And the reason for this? Most of the time it's because they just didn't brush their teeth.
I also know that fluoride is important. Every dentist that I have ever talked to, either at a routine visit or informally, has always stressed the need for fluoride. Even strong opposers of fluoridation seem to consent that fluoride prevents cavities.
However, I am still left with the original question: why do people have such strong opposition on fluoridation? If the junk science is just a scare tactic to persuade me into agreeing with the anti-fluoridation position, then what's the underlying issue? What's the goal?
My original belief that fluoride was good is founded on a general trust of the scientific process. Despite the fact that science is performed by fallible humans, the process helps eliminate errors and bias. That trust was instilled in me over the course of my life and during my own science education. But what if I didn't have this trust? Would there be any reason to believe that any scientific analysis was correct? Would the guys in the white lab coats would just be agents trying to fool me? If I accepted that as a possibility, then I would have to question the motivations of those people. Why would they want to convince me that their truth was right? What do they have to gain? Without that trust it's pretty easy to fall into the conspiracy theory, and pretty easy to be prayed on by those with something to gain who would exploit that lack of trust.
I don't know why people oppose fluoridation with such vigor. The history of fluoridation has several examples of strong public opposition. However, although it is a curiosity, knowing the reasons behind the opposition really isn't that important.
Unfortunately, as is often the case, I fear the real loser in this debate are people who aren't so well off. They are the people who are in collection because they still don't have the money to pay for the emergency room visit that their child needed three years ago. The family who are so busy trying to decide between paying rent and buying food, that the decision to spend $5.00 on a tube of toothpaste falls by the wayside. These are the people who need the most help, and the people that I think about when I hear public policy debates. To me, if fluoridated water means their child will have one less painful cavity, that's all that matters.
