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Water fluoridation is one of those things that always astounds me and reminds me how completely different the past was, politically and in terms of social cohesion and trust in science, experts and all that. The idea that a few scientists could run a few relatively short-term experiments (just a few years) and see a relatively minor benefit (tooth cavities hardly seems like an existential crisis) and based on this get the government to introduce a chemical to the water supply nationwide without facing widespread riots or resistance is just insane to me. I'm not trying to claim that fluoride is harmful or anything like that, just that the public seems to have had such complete trust in politicians, scientists, public health officials, bureaucrats and the media to accept it is an amazing demonstration of how different things are. It is an oft raised lament that "we don't build anything anymore" or that we aren't capable of the large-scale works of the past and I think this is directly related to that. I think there needs to be a certain level of blind trust in authorities to enable that which is a bit of a two edged sword.
It is becoming very hard for me personally to reconcile my lament that "we don't build anything anymore" with my own anti-conformist and stubborn opposition to things like covid lockdowns and covid vaccination as I think they are in direct opposition to some extent. As I've gotten older I have come to believe that public consensus and trust in institutions is more important than the actual content of that consensus or the 'correctness' of those experts and institutions, but at the same time I remain skeptical and stubborn. Does anyone else relate to this conflicted feeling?
Nothing was more "move fast and break things" than entire neighborhoods of kids riding their bike behind "the fog truck" spraying DDT everywhere.
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I've often thought, "If they just told us what the trade offs were and were honest about it, they'd get my vote," but I doubt that's a winning strategy.
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Just walking around a seeing the number of old people who don't have any teeth makes me think cavaties are actually a massive problem, still, despite water fluoridation. I'm sure it would be much worse without it.
Old people lose their teeth due to periodontitis, not cavities, usually.
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In the particular case of fluoridating water, the ruling elite had a good story. Scientists knew that naturally occurring levels of fluoride varied from place to place. Did it matter? They did the epidemiology thing and decided that less than one part per million made tooth decay noticeably worse. More than four parts per million caused dental fluorosis, but nothing else showed up strongly with natural levels of fluoridation. So topping up fluoride to bring low fluoride water up to one part per million seemed super safe; lots of people were already living with 1ppm. And had been for their entire lives. It was a rare case where we have data (albeit epidemiological) on all cause mortality, due to pre-existing "natural experiments".
Your confusion is the result of a garbled account of events. That is bad in itself, but I want to make the case that it is important to say that "topping up" and "adding" are different and that the claim that we "add" fluoride to the water supply is a lie.
First I will offer paradigms of "topping up" and "adding" and then make my case that things can go horribly wrong if we tolerate people confusing them.
Topping up Measure the level. If it comes in at 0.5 ppm, add enough to increase the level by 0.5 ppm. Measure again. If it is in the range 0.9 to 1.1 ppm declare victory. If outside that range, find out why, and adjust appropriately.
Adding Don't bother measuring, or if some-else has measured, just ignore it. Add enough to increase the level by 1 ppm. Continue to fail at measuring and be smug that the level is at least 1 ppm because our addition guarantees that out-come.
Now picture a town debating water fluoridation. Why? Well, Mr Bad Guy hopes to get kick backs from the contracts for fluoridation equipment and chemicals. He persuades his fellow citizens to top up fluoride levels at public expense. They vote for it. Mr Bad Guy sets it in motion. The measured natural level turns out to be 1.3 ppm. There is nothing to be done. No contracts, no kick backs. Mr Bad Guy looks around and notices that nobody is watching. He arranges contracts for equipment and chemicals to add enough fluoride to increase the levels by 1 ppm. He pockets his bribe money. Fluoride levels increase to 2.3 ppm. Mr Bad Guy feels safe. No-one will notice 2.3 ppm and if he falls under suspicion for corruption, he can always say that he misunderstood.
Later Dr Nerd measures the fluoride and checks the records of the old measurements. Dr Nerd is unhappy about the waste of public money, or about the dangers of fluoride, take your pick. He tries to "blow the whistle". But what language does he speak? If he uses the vernacular he complains that we are adding fluoride to the water supply and we shouldn't be doing that, we should instead be adding fluoride to the water supply [sic]. Nobody understands his point. So he switches to Nerd-speak and complains that we are adding fluoride to the water supply when we should be topping up; very different. Topping up is free! But the towns-folk don't speak Nerd-speak, so Dr Nerd still fails to make himself understood.
Talking about topping up fluoride levels using the word adding is bad. It covers up corruption and is why we cannot have nice things.
Is this an actual thing that happens with any regularity? And even if it is, I'm skeptical that trying to teach the public scientific jargon will fix it.
A much better solution for Dr. Nerd-boy here would be to use vernacular language like a normal person instead of like an idiot. "The town government is wasting money adding extra fluoride to the water supply, when our water already had enough fluoride in it naturally!" Boom, now everybody understands what he's talking about.
But the language of "adding" rather than "topping up" has erased the concept of already has enough fluoride in it naturally. The idea is missing from the discourse. Lots of ordinary people have naturally occurring fluoride in their drinking water and have no idea that it has always been like that. Dr Nerd's third attempt at making his point will make not make sense to those people and they will ignore him.
We can tell that the idea of already has enough fluoride in it naturally has been erased from the discourse, simply by listening out for the missing follow-up questions. When some-one is on the media, arguing against fluoridation on the grounds that the recommended level is a health hazard, the interviewer questions them. The obvious line of questioning is "What about places with naturally occurring fluoridation? Do you advocate removing it? How? Are the health problems actually showing up? There have been multiple life times for them to appear!" But the obvious questions don't occur to the interviewer. The concepts have somehow gotten erased :-(
Yes, it would be nice if reporters interviewing anti-flouride activists would ask about this. Genuine, hard-hitting reporting is a rare and valuable thing in all sorts of fields, alas.
I do continue to wonder, though, whether your scenario of a town official deliberately adding unnecessary extra fluoride in exchange for kickbacks from the fluoride company has ever actually happened anywhere, and if it did happen how the situation was handled once it became public knowledge.
And this is an extraordinarily bad idea. Any time you take a statement which is clearly true in vernacular speech, and try to tell normies it's false because Science(tm) has assigned a different definition to one or more of the component words, you are lowering the general public's respect for science and scientists.
You are right to press me on whether my corruption scenario has ever actually happened. My gut feeling is no, never. But the past few years have wrecked my world view, and I fear that I am old and have been left behind while the world changes.
Back in March 2021 I had the Astra-Zenaca mRNA vaccine for COVID. How dangerous could it be? I knew that the messenger RNA would cause my cells to produce the protein that the snippet coded for. Scary! But I knew that that is what happens in a viral infection, and what happens when you take a "weakened" vaccine. Indeed Edward Jenner's original cowpox vaccination for smallpox is doing the same thing; spoiling the host for the smallpox virus by getting host cells to produce a shared protein and getting the host to produce anti-bodies to it. I was a science enthusiast and marveled at the invention of mRNA vaccines.
I saw public health as a nerdy area, and took it for granted that traditional standards of safety and efficacy would be upheld. I was disappointed. The https://meaningness.com/geeks-mops-sociopaths dynamic had played out while I wasn't paying attention. The blot clots and myocarditis problems would have lead to the swift withdrawal of the vaccines when I was young; but the world had moved on.
My current understanding of how the world works goes something like this:
It is year N and Mr Blackpill has noticed that the incentives tend towards corruption. He claims that year N is already corrupt. It isn't. Mr Blackpill is undaunted; he claims that dynamics created by the incentives are fast acting and predicts that year N+10 will be corrupt. Nope. Mr Blackpill has complete faith in his reasoning and in human avarice. Year N+20 will definitely see a corruption scandal. Mr Blackpill is wrong again.
Eventually year N+30 arrives and with it a big corruption scandal. Mr Blackpill was right in the end. Worse, it turns out that the corruption is entrenched and hard to root out. It has been going on for fifteen years. Mr Blackpill was right about N+20. There are a variety of forces that tend to hide scandals and when they break out into the mainstream it turns out those in the know had been complaining, correctly, for many years.
Returning to adding versus topping up. I see the language here as one of those forces that tend to hide scandals. Ecbatic not telic. I don't know whether we are in year N, year N+10, or year N+20. Mostly I don't know because I'm not in the business. But I cannot know by reading the newspapers. People complain about fluoride being added to the water supply and I'm left to guess that they mean topping up. If there was a scandal of the kind that I speculate about, adding, not topping up the news reports would say much the same and the I wouldn't be any the wiser. It would be the year N+20 situation, where there is corruption but still ten years to go before the facts break into mainstream news.
At the end of the day, my guess is that there just isn't enough money in water treatment to attract the avaracious, and the potential for corruption goes unrealized. But the clumsy language, that stands ready to hide it if it ever happens, still give me the ick.
I'm aware that I completely lack the common touch, so it is best that I defer to your expertise here. I would be interested if you had any ideas on how to push back against the confusion of adding and topping up.
IMO the best thing to do to clear up fluoride confusion is to remind people that it is a naturally occurring mineral, and therefore many water sources naturally contain some, without any human intervention. I suspect most of the anti-flouride sentiment would go away if people understood that, and the language question of adding vs topping up wouldn't make much difference.
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Every damn day. I have an uncomfortable blend of paleoconservativism and libertarianism in my blood, and I've already resigned myself to the reality that I'll never be able to resolve the conflicts between the two. The best way I can cope with the conflict is to follow my gut moral intuition when I approach an issue where they conflict.
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Yes. The decay in the trust of institutions in the western world is already a massive problem , that will only get worse. You are exactly on point in my opinion. Trust might matter more then absolute truth . I am certain that lack of trust precludes substance and correctness in the long term. Lack of trust in each other and by extension in the institutions that govern us , renders us ineffective at best.
Is the problem a lack of trust or a lack of trustworthiness? Are they more trustworthy than we think? Or is it good for us to believe they're more trustworthy than they are?
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No. Reality matters. A consensus contrary to reality is a disaster in the making, and trust in untrustworthy institutions is foolish and counterproductive.
I have a big issue with your statement. It sounds correct but in my mind doesn't stand up to scrutiny. What is reality? Who decides that exactly? How can you decide whether an institution , whether that is the police or whoever , did their job correctly? Are you capable or even interested in judging each and every move they make ? And what do you do with that judgement? Do you just use your judgement ( whether right or wrong) to fuel hatred and distrust? Because you are probably not using it to make a a practical change. So what is it? What is the goal? The cornerstone of society is trust. Trust has to be blind up to a logical point.
Yes, but I'm not concerned about whether it stands up to scrutiny in your mind; I am only concerned about whether it stands up to scrutiny in reality.
Let us say the institutions claim there is definitely no train coming down a set of railroad tracks. Reality is what decides whether someone standing on the tracks when that train arrives gets crushed or not.
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That which does not go away when you stop believing in it.
No one decides it. It happens regardless. If you do a bad job planting your crops, people starve. If you do a bad job enforcing the law, chaos and violence reigns. If you do a bad job protecting your borders, foreign armies victimize your populace.
For the police, you derive a general understanding of what their job is by examining the laws they're supposed to enforce, and their actual enforcement of those laws, measure it versus the costs of maintaining them and the general realities that add friction to the system.
Random sampling and statistics help a great deal here.
That is certainly a thing people can do. For example, the BLM movement spun out of a coordinated attempt by Blue Tribe to generate hatred and distrust by pushing misinformation about the actual performance of law enforcement, resulting in a very large and quite partisan disconnect between public perception of police misconduct and actual rates of misconduct. And the result is that tens of thousands of additional black Americans are now dead, and hundreds of thousands of additional Black Americans have been victimized by serious crimes. That was a practical change of the sort you are describing.
Alternatively, one can do one's best to verify that trust, and to withdraw it when one perceives that it has been repeatedly violated. It is always possible that one has been deceived, though, so it's best to keep an open mind to new evidence when it arises.
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