Three years back, Ilana Decker relocated from Israel to New York and discovered herself in disagreement with Robert F. Kennedy, Jr. on several occasions. The idea of governments imposing healthcare directives didn’t resonate with her, as she didn’t want to appear as if she was in opposition to vaccinations. However, there was one area of alignment between her and Kennedy: they both shared apprehensions towards the new government-appointed health and human services secretary who proposed to cease the long-standing American policy of encouraging fluoride use in city water systems.
In the past Israel, Decker’s home country, had put an end to water fluoridation. Decker expressed her support for a similar change in the US, but she wanted to clarify that she didn’t identify with Kennedy’s political principles entirely. The only area where she did agree was on the issue of fluoride in tap water. Despite her broader understanding of the role government plays in public health, Decker actively chose fluoride-free toothpaste for her four-year-old, underlining her concerns about fluoride’s potential health risks.
Decker explained her stance over the contentious issue, ‘Although I can choose to use non-fluoride toothpaste, I don’t have control over what comes out of my faucet.’ Her concern centered mainly around the limitation of individual health choices by the government under the banner of common welfare. She believed that these decisions should be personal, not imposed by external agencies.
Kennedy, known for his opposition to vaccinations as well as his critiques of public health bodies, has brought nationwide attention to the controversial debate involving governmental roles in public health and the growing skepticism towards science. Water fluoridation came into the spotlight as an ideal case study for examining these debates.
On the other hand, the U.S. Centers for Disease Control and Prevention maintain that water fluoridation reduces dental decay in both children and adults by about 25%, considering it as ‘one of the ten significant public health achievements of the twentieth century.’ However, fluoride critics point to research indicating that excessively high fluoride levels, higher than what is typically found in fluoridated water, might lead to children’s developmental issues. These critics also entertain a plethora of conspiracy theories, some going as far as claiming governmental control over the populace through fluoride administration.
The new secretary of health, despite these evidence-backed health benefits, had labeled fluoride as ‘an industrial waste’ and a ‘dangerous neurotoxin.’ He pledged to discontinue water fluoridation on his first day in office. Such a move would depend on local agencies’ approval, as the water supply is usually managed at the local level. However, like Kennedy, he highlighted individual choice, indicating his likeness towards personal decisions over governmental dictates when it came to fluoride use.
As Kennedy expressed in a recent NBC interview, ‘Fluoride is approaching the end of its reign, and it’s better for it to disappear sooner rather than later.’ The discourse in Israel over the shift from mandatory water fluoridation to a fluoride-free policy could illustrate potential implications for the U.S., should it decide to follow suit.
Israel had initially mandated fluoride in nearly all local municipalities. Still, in 2013, the health minister, Yael German, decided against the mandatory fluoridation for the subsequent year. Her decision was backed by unnamed doctors who shared their concerns about potential risks related to water fluoridation for pregnant women, elderly individuals, and people with thyroid disorders.
Reflecting the sentiments of Kennedy and his supporters, German emphasized the significance of individual freedom of choice in health matters. However, since Israel discontinued fluoride in its tap water, dentists have reported an increase in dental cavities in children and are advocating for reinstating fluoride.
One study conducted in Israel found a significant surge in restorative dental procedures and crown implants in children aged between 3 to 5 years. The researchers attributed this rise to the absence of fluoride and concluded that Israel should consider resuming community water fluoridation.
Another study analyzing data spanning six years from dental clinics affiliated with a national health network revealed that the number of restorative treatments needed for children nearly doubled compared to before the discontinuation of fluoridation. Researchers commented that even with Israel’s efforts to provide free dental care for all children, the overall dental health seemed to worsen.
Adjustments in fluoridation policies, due to misinformation and continuous research, have been a global phenomenon. Cities such as Juneau in Alaska experienced a decline in pediatric dental health following the discontinuation of fluoride in 2007, as per a study. Similarly, Calgary in Canada observed higher rates of cavity-related treatments among children after it ceased fluoride enrichment in water in 2011. Consequently, Calgary has now reverted to its previous fluoridation policy.
Contrastingly, several municipalities across the U.S. ceased using fluoride in recent years. In Europe too, many countries never introduced it into their water supplies or have ended water fluoridation. Instead, these countries have introduced fluoride salt and milk to balance the potential health implications of not having the mineral in their water supply.
Back in Israel, there are contrasting opinions about the reintroduction of fluoride. Some women have attributed the increase in child cavities less to fluoride’s absence and more to inadequate oral hygiene and higher consumption of sweets and sugar-laden snacks by children. These groups reference a recent study from the National Institutes of Health’s National Toxicology Program that links high fluoride levels to lower IQ in children.
Despite these discussions, the report doesn’t question the dental health benefits of fluoride. Regardless, these trends highlight the ongoing examination of fluoride use, the balancing of its benefits and potential risks, and the crucial debate around individual health choices versus government-imposed public health measures.