Who knew? What was once arguably the most benign, and successful public health measure of the 20th century has now come under scrutiny and skepticism. Throughout our state and indeed the nation, people are raising concerns about potential health risks associated with water fluoridation. While there have always been those who turn a cautious or conspiratorial eye towards socialized anything, the 21st century has without a doubt been marked by an increased skepticism in this regard. Perhaps this is a result of the greater access and availability of (dis)information that the internet makes possible, perhaps of the growing (uncomfortable) realization that neither government nor doctors nor scientists are perfect. But I’ve got to say that this one really surprised me.

I’m a fluoride child. Water in my home-town has been fluoridated since before my birth. In schools, we would “swish” in homeroom once every few months, our school nurse handing each of us a small paper cup and a foil packet of some fluoride super-solution. Indeed, fluoride was so imbedded within my culture during childhood that it is not until now that I realize how pervasive and aggressive its administration was. So you can imagine that when I first started seeing toothpastes on supermarket shelves sans the wonder-element, and reading stories about public agitation against its addition to the water supply, I reacted with disbelief, relegating the phenomenon to ignorance at best and fanaticism at worst. Surely we have more pressing matters to attend; one perhaps that despite an unprecedented epidemic of childhood obesity, our government continues to subsidize the production of high fructose corn syrup. Still, as a responsible anthropologist I could not help but recognize the influence of my own enculturation, so in proper scientific fashion, I set about developing a legitimate position on the matter. I have reviewed the literature, the popular, the scientific, even the aggressively activist, and have come to a conclusion.

But how best to present my findings? I could list the many medical associations in support of, versus those in opposition to, fluoridation, but that would be logically unsound (an appeal to authority). Or, I could dedicate a great many future articles to reviewing each and every criticism that has been levied, which range from the benign (white-spots on our teeth), to the severe (bone cancer), to the absurd (causing criminal behavior). Frankly, this doesn’t appeal to me (nor can I imagine it would appeal to my editor). Instead, I will talk about fluoride in the way I know best – in relationship to food.

Our nation’s food system is aligned such that the cheapest foods contain the highest proportion of refined and simple sugars: white flour, high fructose corn syrup, etc. Among other health issues, these ingredients put great stress on dental health. The poorest families, who rely on welfare, food stamps, food banks and soup kitchens, and survive on a diet almost entirely composed of these simple sugars, are therefore at the greatest risk for dental caries and other oral health issues. Given the healthcare insurance crisis in this country, these families are also the least likely to carry dental insurance. Thus, to discontinue fluoridation from the water supply would be to discontinue a public health measure that is very likely the only thing standing in the way of an oral health epidemic - one that would hit the poorest families the hardest.

We need only look to the history of water fluoridation, one of the largest (albeit informal) clinical studies in US history, to support this argument, and I need to look no further than my own life for an example. Not only I am a fluoride child, but as a child my mother and I relied for a time on welfare and foodstamps. My mother did not grow up with water fluoridation. By no fault of her own, the foods we could afford were not necessarly those that promoted exceptional dental health. Would you care to venture a guess how my dental history compares to hers? Sure, I had my share of cavities (more the result of my own refusal to floss, i think!), but my mother often suffered painful tooth problems.

To the best of our scientific knowledge, fluoride is a safe and successful public health measure. The known risks stem from intake at toxic levels. Iron and selenium, both vitally important to health, are also toxic when over-consumed. Anything, by definition, is unsafe at toxic levels, even water. However, do not mistake this for an argument against using precaution. Rather, I am very much arguing for it. If there are valid concerns about fluoride then we should pursue them. But we also need to consider what it does do, not just what it might. And if we indeed value equity in our society, then we must first find a way to ensure equitable access to better food and health services, before we pull the safety net out from beneath our most disadvantaged neighbors.

This entry was posted on Wednesday, May 14th, 2008 at 3:14 am by Philip Loring and is filed under Food, Research. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.