Severe cases of fluorosis are crippling; most victims are elderly. As a result, fluoridation advocates and people in government must thread a needle: enough fluoride to protect against tooth decay in children, but not enough to cause problems in the long term. The Atlantic, Is There Still a Good Case for Water Fluoridation?, Charles C. Mann 2020

On a tooth-cleaning visit not long ago, Barbara told me that in the late 1970s, when she attended dental school, her professors expected that most middle-class patients would lose a lot of their teeth and need dentures by the time they were in their 60s. Today, she said, most middle-class people keep their teeth until they are 80. The main reason for this, Barbara explained, was fluoridation—the practice of putting fluoride compounds in community drinking water to combat tooth decay.

For reasons I can’t now recall, I mentioned this remark on social media. The inevitable but somehow surprising response: People I did not know troubled themselves to tell me that I was an idiot, and that fluoridation was terrible. Their skepticism made an impression. I found myself staring suspiciously, as I brushed, at my Colgate toothpaste. strengthens teeth with active fluoride, the label promised. A thought popped into my head: I am now rubbing fluoride directly onto my teeth. So why is my town also dumping it into my drinking water?

Surely applying Colgate’s meticulously packaged fluoride paste directly onto my teeth, where it bonds with the surface to create a protective layer, was better than the more indirect method of pouring fluoride into reservoirs so that people drinking the water can absorb the fluoride, some of which then makes its way into their saliva.

Then I wondered: How much fluoride is in my water, and how did public-health officials set the dose? Fluoride in large quantities is bad news. Potential side effects, I quickly discovered, include joint pain, bone fractures, sperm decline, dementia, premature puberty, gastrointestinal distress, immune-system dysfunction, (possibly) cancer, and (also possibly) lower IQ in children. Children have smaller bodies than adults and thus are at risk of relatively greater exposure when they drink. In calculating the dose, I thought, the authorities must have taken into account the weird thirsty kid who guzzles water by the quart. But if they lower the dose to avoid harming that child, where would that leave my mother-in-law, who for some reason has decided she no longer wants to drink much water at all? Is she getting shortchanged?



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