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Notes -
I did a deep dive a few weeks ago and thought about making an effort post of “Everything you wanted to know about Flouride”
But alas, I didn’t. Instead I’ll just drop this low effort summary:
Reasonable (according to me) responses:
Don’t panic about your current consumption. It’s probably fine.
IF YOU ARE PREGNANT, current evidence suggests it would be VERY WORTHWHILE TO TRY TO ELIMINATE FLUORIDE from your diet. Buy an appropriate water filter/purifier (not all remove it). Maybe even consider removing it from your toothpaste. 2a. If you have small children consider limiting their exposure.
The magnitude of the effect is insanely large if true. National healthcare systems should be urgently prioritizing studies on it. This should be the number one priority study. ( the most compelling reason is that this would be an easy intervention. It’s not like we would have to tear out our entire infrastructure like with lead pipes. It’s about as close to flipping a switch as any intervention could ever be)
Since your post didn’t mention it: even more concerning than the IQ drop is the effect on rates of severe emotional/mental illness. That LA (?) study had some insane rates (if true).
*posting from phone so probably lots of typos. Sorry.
Edited summary #3 to add "Even at relatively normal levels." The interesting question is not: "can extreme levels of fluoride cause issues?" The interesting question is "Are current levels extreme?"
Let's do the math on this. Toothpaste is about 0.1% fluoride. Typically you'll put about 1g of toothpaste on your toothbrush, so that's 1 mg of fluoride. If you ingest 10%, that's 0.1 mg. Fluoridated water is typically around 1 mg/L, so by using fluoridated toothpaste twice a day, you're probably ingesting about 10% of what you would get from two liters of fluoridated tap water. Not insignificant, but probably not a major concern.
On the other hand, if it's available in the US, hydroxyapatite toothpaste is a perfectly acceptable substitute, if a bit more expensive.
Agreed. Thanks for the note.
My inclusion of that line was intended to be more of a rhetorical flair to highlight how fluoride consumption is probably only relevant for the pregnant (and small children). Upon rereading I don't think I was successful at conveying that. The risk of using fluoridated toothpaste is likely to be zero or close to it.
My personal read of the evidence is something like:
If you are an adult in a 1st world country, don't sweat fluoride. If you are pregnant or have small children, maybe try to limit exposure when it's convenient. Don't freak out if your child drinks tap water at a friends house.
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Is it comparably well-studied? Devil you know and all that
hydroxyapatite is literally produced by your body. It's in your teeth and saliva.
Well if there's any point in putting it in toothpaste, it must be to increase the concentration way above that which is naturally-occuring. So I repeat the question.
Its functions appear to be neutralizing acids produced by mouth bacteria, and remineralizing enamel. Adding more mostly seems to counteract the higher acid levels generated by the modern diet. Fluoride apparently increases the effectiveness of both these functions better than just throwing morehydroxyapatite at the problem.
I expect it'd actually be a good idea for mothers anyway, since pregnancy makes it easier to lose teeth, but I'm going off anecdotes for that one.
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Hypothetically, lets say the optimal societal solution to fluoride is the government injects the water, but pregnant women and new borns drink bottled water. What is the chance that society actually converges on this solution given the past policy decisions. Even if there was no past commitment from the government to the fluoride policy i feel like this would go down like a ton of bricks. Making people pay extra when they are making babies is not a popular policy position. But given a bunch of bureaucrats have committed to the fluoride i can't see them admitting there might be flaws in their approach.
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Thanks for this.
Since you seem to know things, what's the mechanism for fluoride's prevention of dental decay? Can using fluoride toothpaste or mouthwash give us the positive benefits without causing the negative ones?
I wouldn't say I know things, or at least not these ones ;). It's not my area of expertise nor am I particularly interested in the question of "How does fluoride work?" (That being said... I think the current consensus on mechanism (https://en.wikipedia.org/wiki/Water_fluoridation#Mechanism) is pretty well supported - even the (smart) anti-fluoride folks agree. My, barely informed, take on the evidence is that topical applications can have the benefits with harms.)
My curiosity relates to the following three questions:
*Dangerous is shorthand for the belief that "Water flouridation has a significant negative impact on a significant number of people". Note: this does not mean net negative. Even IF the evidence emerges that it is "dangerous", there is a good chance the benefits could still outweigh the costs
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