Should fluoride be in our water?

Summary

The video by Vox examines the controversial topic of water fluoridation, highlighting that 63% of Americans consume fluoridated water. Originally introduced to prevent tooth decay, this practice is now under scrutiny as emerging science questions its necessity and safety. Critics are concerned about fluoride's impact on developing brains, with recent studies indicating a potential link to lower IQ scores. Despite these findings, the science is inconclusive, leaving many unsure about the future of water fluoridation. The video explores the balance between dental health benefits and the possible risks of continued fluoridation.

Highlights

• Fluoride in water protects teeth but recent studies bring up new safety questions. 🤔
• Widespread use of fluoride in toothpaste reduces the need for water fluoridation. 🪥
• Some researchers argue that high fluoride levels could potentially impact developing brains. 🍼
• New meta-analyses provide mixed results, keeping the debate on fluoridation alive. 🌊
• Guidelines suggest caution for pregnant women and infants regarding fluoride intake. 👶

Key Takeaways

• Fluoridated water was introduced to prevent tooth decay, but its necessity is now questioned due to modern widespread topical fluoride use. 🦷
• Some recent studies suggest a possible link between fluoride in water and lower IQ in children, sparking concern among scientists. 🧠
• The debate on water fluoridation remains inconclusive, balancing between dental benefits and potential neurological risks. ⚖️

Overview

The video by Vox revisits the long-standing debate on the fluoridation of drinking water. Initially meant to combat tooth decay, this practice has faced renewed scrutiny as recent scientific studies suggest potential risks. Some of these studies have found a link between water fluoride levels and reduced IQ in children, raising public health concerns.

Historically, water fluoridation was a straightforward method to ensure access to fluoride's dental benefits, especially when topical fluoride wasn't as widespread. However, with today's availability of fluoridated toothpaste and mouthwash, the necessity of fluoride in water is being reevaluated, particularly given the emerging potential neurological impacts.

Despite these concerns, the scientific community remains divided, with no conclusive evidence to entirely support or refute the need for water fluoridation. The precautionary principle is often cited, suggesting that action should be taken when there is evidence of potential harm, even if not fully proven. This reveals the complexity and ongoing nature of the debate over water fluoridation policies.

Chapters

• 00:00 - 00:30: Introduction to NYC Tap Water and Fluoride This chapter introduces the topic of New York City's tap water, specifically focusing on the presence of fluoride. It is noted that NYC tap water contains 8 mg of fluoride per liter. Fluoride is highlighted as being essential for oral health, providing protection against cavities. This is why fluoride is commonly found in toothpaste, mouthwash, and dental treatments. It is also why around 63% of Americans have fluoride in their drinking water. The chapter mentions someone with views on public health that are not supported by science, implying a discussion on differing opinions regarding fluoride in drinking water.
• 00:30 - 01:00: Public Health Leadership and Fluoride Debate The chapter discusses a public health debate surrounding water fluoridation in the United States. A potential new leader of a major public health agency advocates for the removal of fluoride from the public water supply. Historically, the addition of fluoride to water has been controversial and fueled conspiracy theories. However, evolving scientific evidence has prompted some scientists to reevaluate the necessity and safety of this practice, questioning the need for continued water fluoridation and what levels, if any, are appropriate.
• 01:00 - 01:30: Fluoride's Role in Oral Health The chapter 'Fluoride's Role in Oral Health' explains how fluoride protects against cavities by remineralizing tooth enamel and creating a protective barrier against acids produced by oral bacteria. It details how fluoride from water consumption is partly retained in the body, adhering to bones and contributing to dental health through saliva. Additionally, it notes the natural occurrence of fluoride in soil and air.
• 01:30 - 02:00: History of Water Fluoridation Almost a century ago, dentists discovered that high natural fluoride levels in water stained children's teeth but prevented decay. In 1945, Grand Rapids, Michigan, and Newberg, New York, began artificial water fluoridation. In Grand Rapids, a 15-year study with about 30,000 school children showed a significant decrease in tooth decay rates.
• 02:00 - 02:30: Effectiveness of Fluoride in Water This chapter discusses the widespread adoption of fluoride in water, highlighting that 60% of communities adopted the practice leading to its inclusion in toothpaste for topical use. The primary aim of water fluoridation was to ensure widespread access to fluoride's dental protection, regardless of individual access to dental care or fluoridated products. The chapter addresses evaluating the effectiveness of fluoride in water by examining communities that have ceased its use, mentioning studies cited by supporters of water fluoridation to underscore its benefits.
• 02:30 - 03:00: Fluoride Dosage Recommendations The chapter "Fluoride Dosage Recommendations" discusses the impact of adding or removing fluoride from water supplies on dental health, specifically tooth decay. A case is presented from Calgary, Canada, where the removal of fluoride from the water in 2011 resulted in a significant increase in tooth decay among children's baby teeth. However, a review in 2024, which considered 21 studies of communities that added fluoride, found only a slight reduction in tooth decay. The chapter also mentions that prior to 1975, the benefits of water fluoridation in preventing tooth decay were more pronounced.
• 03:00 - 04:00: Fluoride and Neurological Impact The chapter 'Fluoride and Neurological Impact' discusses the historical and current effects of water fluoridation on tooth decay prevention in children. It notes that while water fluoridation led to healthier teeth in the past, its impact might not be as significant today due to the widespread use of fluoride in toothpaste. The chapter hints at emerging scientific inquiries into the neurological effects of fluoride, suggesting a fresh avenue of research into its broader impacts beyond dental health.
• 04:00 - 05:00: Analysis of IQ Studies This chapter, titled 'Analysis of IQ Studies,' begins with a discussion on the safety of fluoride, particularly its use as a water additive. It is noted that fluoride is typically added to water as liquid fluosilicic acid. The World Health Organization recommends a fluoride dosage of no more than 1.5 mg per liter of water, which is equivalent to approximately 1 gallon for an Olympic-sized swimming pool. In contrast, the CDC recommends a higher dosage of 7 mg per liter, translating to slightly less than half a gallon per swimming pool. It is highlighted that municipalities have the authority to set their own fluoride dosages.
• 05:00 - 06:00: Fluoride in Diet and Environment The chapter discusses the presence of fluoride in the diet and environment, particularly focusing on water fluoridation practices like those in New York City. The CDC's recommendation aims to protect against tooth decay while minimizing the risk of dental fluorosis, which was first noted in places with high natural fluoridation. Researchers are now exploring fluoride's impact on brain development, particularly during pregnancy and in young children, using IQ as a key measure.
• 06:00 - 07:00: Concerns for Pregnant Women and Infants The chapter discusses the sensitivity of the brain to toxins, emphasizing its role as an indicator of toxicity. Professor Bruce Lamere from Simon Fraser University, an expert in environmental neurotoxins such as lead, pesticides, and mercury, is mentioned. The text also references early studies from the late 1980s to the 2000s that investigated the impact of fluoride on IQ, particularly in Chinese villages with naturally high fluoride levels. These studies focused on children who grew up in these regions with fluoride-rich water.
• 07:00 - 09:00: Conclusion on Fluoridation Debate The study compared villages with high levels of fluoride to those without, measuring fluoride levels up to 2.3 gallons per swimming pool of water. Despite methodological issues, the studies raised concerns as they noticed a difference of about 5-7 IQ points between high and low fluoride-exposed populations. For the average person, a few IQ points difference may not seem significant, but it underlines the importance of further examination in public health contexts.

Should fluoride be in our water? Transcription

• 00:00 - 00:30 this is the New York City tap water that I drink and for every liter of it there is8 mg of fluoride in it fluoride is essential for our oral health it protects us from cavities which is why it's also in lots of toothpaste and mouthwash and in treatments we get at the dentist and for about 63% of Americans it's also why it's in our drinking water now someone with a lot of views on public health not supported by science
• 00:30 - 01:00 is being considered to lead one of the country's top Public Health agencies and one thing he believes is that we should advise all us Water Systems to remove fluoride from public water putting fluoride in the water has long fueled conspiracy theories but it turns out the science is still evolving and some of it emerged even as we made this video and it's causing some scientists to take another look at this practice and wonder do we still need fluoride in our water and if so how much
• 01:00 - 01:30 is safe fluoride protects us from cavities by remineralizing enamel on our teeth it acts as a protective barrier against the acid that bacteria in our mouths produce when we drink fluoride in water about half of it sticks around in our bodies some of it binds to our bones and some reaches our teeth through our saliva fluoride occurs naturally in soil and air and some regions have naturally
• 01:30 - 02:00 occurring fluoride levels in their water almost 100 years ago dentists figured out that high naturally occurring levels of fluoride in the water was staining children's teeth but it was also preventing tooth decay in 1945 Grand Rapids Michigan and Newberg New York were among the first communities to start fluoridating water artificially in Grand Rapids researchers monitored roughly 30,000 school children over 15 years and observed that the rate of tooth decay declined by more than
• 02:00 - 02:30 60% so other communities started adopting the practice too and eventually it got added to toothpaste which works topically the goal of adding it to water was to make sure that everyone had access to fluoride's protection regardless of whether they used fluoridated products or had access to dental care one way to figure out how well the fluoride in our water is still working is to look at what happens in communities who have stopped adding it supporters of water fluoridation point to studies like this one
• 02:30 - 03:00 that looked at what happened in Calgary Canada after they stopped fluoridating their water in 2011 the rate of tooth decay in children's baby teeth was already on the rise but after they took the fluoride out of the water that rate spiked but this 2024 review looked across 21 studies of communities that added fluoride to their water and could only determine that it may have led to a slight reduction in tooth decay the study authors found that prior to 1975 there was was a clear and important
• 03:00 - 03:30 effect on prevention of tooth decay in children due to water fluoridation but because of the increased availability of fluoride in toothpast since then it is unlikely that we will see this effect in all populations today so fluoride in the water did help us have healthier teeth in the past and it still might in some communities but because of how widespread topical fluoride is the effect might not be as dramatic as it was historically and in recent years a handful of scientists have been looking at into another question how much
• 03:30 - 04:00 fluoride is safe fluoride as an additive to water is usually in the form of liquid fluosilicic acid and the World Health Organization recommends a dosage no higher than 1.5 mg per liter of water to put that in perspective that's about 1 gallon for an Olympic swimming pool amount of water the CDC recommends 7 Mig per liter of water or a little less than a half gallon per swimming pool municipalities set their own fluoride Doses and most
• 04:00 - 04:30 set it around this amount like my New York City tap water this CDC recommendation is solely based on an amount that balances the protection from tooth decay while limiting the risk of dental fosis the mostly harmless tee staining first observed in communities with high natural fluoridation but scientists studying these dosages today are looking at how fluoride affects developing brains both in utero and as young children primarily by measuring IQ what we've learned about the developing
• 04:30 - 05:00 brain is it's probably one of the most sensitive indicators of toxicity and so we typically begin there Bruce Lamere is a professor of Health Sciences at Simon Frasier University in Canada and studies environmental neurotoxins like lead pesticides and Mercury some of the first studies to show a link between fluoride intake and IQ were from villages in China with high natural amounts of fluoride starting in 1989 through the 2000s some of them looked at children who grew up in a village where the water
• 05:00 - 05:30 had high levels of fluoride and compared them to Villages without high levels of fluoride they measured levels as high as 2.3 Gall per swimming pool of water these early studies had plenty of issues but they did raise a big red flag and what they found is comparing the High versus the low populations they saw about a s IQ Point difference but when it's that large it's hard to sort of just dismiss for the average person a few points difference in IQ doesn't have a huge impact and it might not even be
• 05:30 - 06:00 measurable the former director of the National Institute of Environmental Health Sciences explained this to me using lead as an example you know Laura if you'd had less blood lead maybe you'd have three more IQ points you can't prove that in an individual but you look at a population and we know that if you shift the population's IQ you have more people needing special services you have fewer Geniuses the results of those early studies inspired some researchers to try
• 06:00 - 06:30 and find out whether the neurological risk from high fluoride levels could also occur at lower levels like the who maximum of 1.5 mg per liter or even at the lower levels we fluoridate our water in the US over the years some Studies have found an association between IQ and lower fluoride levels some haven't leaving scientists particularly in the dental and epidemiological communities divided on the issue but while we were working on this video
• 06:30 - 07:00 US Federal scientists published a rigorous analysis of 74 of the studies on childhood IQ and fluoride in it a small number of highquality studies from outside the US found an association between lower IQ and water fluoride levels below 1.5 mg per liter but the small number of studies meant that they weren't able to draw conclusions about the levels that we fluoridate water in the US I called Bruce Lamere back up to make sense of the results hello again
• 07:00 - 07:30 hello the metaanalysis is really a way to synthesize and quantify the high quality studies and the low quality studies and try to make sense of it right because otherwise what you're left with is well these studies which are my favorite studies said this and that confirms my belief and these studies uh which did that don't confirm my belief and clearly they're wrong what this new metaanalysis was able to conclude is that urinary fluoride levels below 1.5
• 07:30 - 08:00 mg per liter were associated with lower IQ translating to a loss of 1.6 IQ points per 1 millgram per liter of fluoride in urine urine which captures the totality of exposure that people have and that's how we measure risk from Total exposure not from one isolated Source Bruce explained that the fluoride we put in our water is just the minimum amount of fluoride we all consume black and green tea leaves have high fluoride
• 08:00 - 08:30 content a variety of food like potatoes and canned shellfish has fluoride in it the pesticides on our food can have fluoride in it too we consume fluoride if we accidentally swallow toothpaste or mouthwash and the levels of fluoride we add to water also doesn't capture the roughly 3 million Americans primarily in the southwest that use groundwater that has natural fluoride concentrations even higher than 1.5 mg per liter experts were particularly concerned about infants who drink formula almost their
• 08:30 - 09:00 entire diet is fluoridated water and dry formula that can have fluoride in it too and about pregnant people who can pass all of this fluoride intake to a fetus we often times see exposures that exceed 1.5 and in some cases in pregnant women during the third trimester we saw levels much higher so what do we make of all of this information first of all topical fluoride is essential for keeping our teeth healthy and for non-pregnant adults there is no evidence that
• 09:00 - 09:30 ingesting fluoride is harmful there is some evidence that pregnant people babies and young children should be aware of their overall fluoride intake right now we could be encouraging pregnant women to drink bottled water if their tap water is fluoridated and we could be encouraging women who are using formula to feed their babies to make it with water that doesn't have fluoride on it but if we're trying to figure out whether we still need to keep fluoridating our water or whether it's
• 09:30 - 10:00 safe to do so as is the science still isn't conclusive so it's a confusing time for understanding these risks and benefits I am a believer in the precautionary principle which does not say you act in the absence of evidence it says you act in the presence of concerning evidence and my reading of the literature is that there is enough data to say there is concern
• 10:00 - 10:30 [Music]