Robert F. Kennedy Jr. has been vocal about eliminating fluoride from America’s water supply in a manner akin to Israel’s action a decade ago. A noteworthy standpoint comes from Ilana Decker, an Israeli immigrant who relocated to New York three years prior. Decker rarely harmonizes with Kennedy’s perspective, fearing that advocating for governmental restrictions on health mandates links her to anti-vaccination groups, a viewpoint she does not support. However, the discourse on water fluoridation prompts her agreement with Kennedy, supporting plans presented by the upcoming secretary of health and human services aiming to discontinue the longstanding tradition of introducing fluoride into American drinking water.
Her endorsement of these prospective changes emerges from her personal encounters. Decker lived in Israel when the water fluoridation stopped a decade ago. Despite her unwillingness to associate with RFK Jr, she strongly believes in the necessity to omit fluoride from the drinking water. Such beliefs even led her to provide her 4-year-old child with fluoride-free toothpaste, but she did not entirely exclude the possibility of using fluoride. Dissatisfied with the governmental manipulation of individual health choices under the guise of public good, she noted that the absence of consent for consuming fluoride-tainted water is frustrating.
Kennedy’s nomination as a non-supporter of vaccination and open critic of health bodies heightens the controversy around government’s authority in public health issues and the extent to which skepticism towards science should influence policy. The fluoride debate serves as a perfect metric for these arguments. Data provided by the U.S. Centers for Disease Control and Prevention (CDC) suggest that fluoride in water reduces tooth cavities in both children and adults by approximately 25% over a lifetime, a feat that led to their designation of water fluoridation as ‘one of the 10 great public health achievements of the 20th century.’
Opponents of fluoride content, referring to studies that link developmental issues in children to high fluoride levels, question the government’s motives behind the usage of fluoride. Kennedy has condemned fluoride as harmful, likening it to industrial waste and a dangerous neurotoxin and has pledged to terminate water fluoridation immediately after assuming office, arguing that the decision to use fluoride should rest with individuals rather than the government. He has expressed assumptions about fluoride’s future dismissal during a television appearance following Trump’s election, opining that a faster eradication would be beneficial.
In 2013, Israel made headlines by discontinuing water fluoridation, a decision rooted in debates similar to those in America. This Israeli policy shift might provide useful implications for possible effects of defluoridation on Americans. Shlomo Zusman, a former chief dental officer in Israel for over two decades and a vocal opponent of the 2014 defluoridation policy, emphasized that the success of water fluoridation should serve as a reference for public health, warning that any opposition to it could pose risks.
Zusman also pointed at modern techniques of water purification that manipulate the water supply, making fluoridation only one of many changes. An interesting fact is that since 75% of Israel’s drinkable water undergoes desalination, it has no natural levels of fluoride. He dispelled the notion of ‘natural’ water without added fluoride like it’s sourced directly from a spring, claiming that all water is subject to manipulation. Fluoridation was enforced in nearly all Israeli municipalities for years, with the Israeli Health Ministry endorsing it as the most effective, easiest, cheapest, and fairest method of preventing oral diseases among the public.
In 2013, Israeli health minister Yael German pledged to stop mandatory fluoridation the following year, pointing to doctors who warned her about potential risks that fluoridation posed to pregnant women, individuals with thyroid complications, and the elderly. She emphasized the significance of individual choice. ‘Continued massive fluoridation of 100% of the water was an incorrect act,’ she wrote to a pediatric association that was among the numerous groups that protested against her plan. She even suggested that it might breach fundamental rights and freedom of choice.
Despite the subsequent government’s vows to reintroduce fluoride, the mandate has not been reinstated in Israel. Dentists in the country have reported a marked increase in children’s cavities since the abolition of fluoride in tap water, prompting calls for fluoride reinstatement. A recent study disclosed a significant surge in dental restorations and crowns among Israeli children aged 3-5, ascribing the increase to the absence of fluoride. These researchers from the Hebrew University-Hadassah School of Dental Medicine stressed the need for reintroducing community water fluoridation in Israel.
A second study, published in early 2022, analysed six years’ worth of data from dental clinics tied to an Israeli national healthcare network, revealing that children aged 3-12 required almost twice the number of restorative procedures compared to the period before the discontinuation of fluoridation. Despite Israel’s enhanced free dental care for all children, the deterioration in dental health was not remedied. Nevertheless, the topic of fluoridation is rife with continued research and widespread misinformation, illustrating that Israel isn’t unique in its evolving approach towards fluoride.
Following fluoride elimination in 2007, Juneau, Alaska, witnessed a decline in pediatric dental health, in accordance with a study that examined the cost and frequency of dental treatment for low-income children. Similarly, Calgary, Canada, recorded an escalation in cavity-related treatments conducted under general anesthesia among children after halting fluoride usage in the water supply in 2011. In response to these problems, Calgary has now elected to resume water fluoridation. That said, numerous municipalities across the U.S. and most of Europe, in contrast, have chosen to abandon fluoride or never introduced it in the water supply to begin with.
Not all Israelis are convinced about the benefits of reintroducing fluoride in water. Some Israeli mothers theorize that the rising cases of cavities have more to do with bad hygiene habits and an increase in children’s consumption of candy and sugary snacks rather than the lack of fluoride in the drinking water. According to a recent study from the National Institutes of Health’s National Toxicology Program, higher levels of fluoride exposure may be correlated to lower IQs in children, although this doesn’t contradict the dental benefits of fluoride. This report, following a review of over 500 studies conducted over a decade, expressed a ‘moderate confidence’ in the correlation between children’s impaired cognitive development and fluoride exposure levels above 1.5 parts per million.
However, it is worthy of note that this figure significantly surpasses the recommended fluoride concentration of 0.7 parts per million in U.S. drinking water. A recent study from May suggested a link between high prenatal exposure to fluoride and behavioral complications, with higher fluoride areas showing symptoms of autism, anxiety, and other disorders in children by the age of three. However, the authors did not establish a definitive cause-effect relationship. Zusman, dismissing the aforementioned health concerns as trendy, stated that if credible, comprehensive research provided evidence of harm, he would advocate for the abrupt end of water fluoridation, as he, too, has a personal interest with eight grandchildren to consider.