Fluoride

[HeliX]

2 minutes ago, wrighty said:

Well according to that WHO article there is a benefit for both children and adults in having fluoride in water, so your benefit is also non-zero.  Overall, I think the evidence for fluoride is positive.  

Are there any additives to the water supply you'd tolerate? Stuff to make it safe for example.  You might personally not need any of course, but if for the greater good...

Sorry, more precisely there is no benefit to me because I use fluoridated toothpaste and my teeth are in good health. There is no probable metric by which fluoridation would improve the health of my teeth.

I'm not against water additives, I'm against unnecessary water additives that are better delivered in an alternative way (i.e. toothpaste). The efficacy of fluoride in toothpaste utterly obliterates the efficacy of fluoride in water. It seems mad to dose the whole population for minor benefit and uncertain risk when a very good alternative exists and doesn't involve big outlay.

[wrighty]

36 minutes ago, HeliX said:

Sorry, more precisely there is no benefit to me because I use fluoridated toothpaste and my teeth are in good health. There is no probable metric by which fluoridation would improve the health of my teeth.

 

Do you accept that it's been demonstrated to help improve rates of dental health at a population level?

On a personal level, if you consider the risk of adding fluoride to tap water to be non-zero, have you considered your risk of using fluoridated toothpaste? Almost certainly negligible, as it is in tap water at the stated concentrations, but probably non-zero.

I hope you don't think I'm trolling you here - I'm not.  I'm trying to debate the pros and cons of a public vs personal health approach.  It's been suggested, semi-seriously I think, that statins (drugs to lower serum cholesterol) should be put in tap water to improve population rates of heart disease.  I'd be dead against that, but fluoride I support.  Probably because fluoride is a natural substance that is present in some areas that have the right bedrock or whatever.  And not everyone needs statins. Just like not everyone needs fluoride, so am I arguing against myself here????

I think we do have evidence that fluoride works, and we have no evidence that it harms. It's natural in many areas in the water supply anyway, so what's the problem.

[HeliX]

6 minutes ago, wrighty said:

Do you accept that it's been demonstrated to help improve rates of dental health at a population level?

I think that's not as clear as has previously been suggested. i.e. this Harvard review which suggests that the rate of dental problems reduced at similar rates in countries that didn't fluoridate water over similar time frames: https://www.hsph.harvard.edu/magazine/magazine_article/fluoridated-drinking-water/

It is, obviously, a very difficult thing to control the other immensely important factors for when studying.

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On a personal level, if you consider the risk of adding fluoride to tap water to be non-zero, have you considered your risk of using fluoridated toothpaste? Almost certainly negligible, as it is in tap water at the stated concentrations, but probably non-zero.

Yes. I don't swallow it. It's applied topically (where it's most effective), instead of briefly being somewhere near my teeth and then swallowed, like water is. The dosage is also very easily controlled, not so much with water. In that application the benefit is very obvious, and very good, and massively outweighs the risk. Hopefully!

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I hope you don't think I'm trolling you here - I'm not.  I'm trying to debate the pros and cons of a public vs personal health approach.  It's been suggested, semi-seriously I think, that statins (drugs to lower serum cholesterol) should be put in tap water to improve population rates of heart disease.  I'd be dead against that, but fluoride I support.  Probably because fluoride is a natural substance that is present in some areas that have the right bedrock or whatever.  And not everyone needs statins. Just like not everyone needs fluoride, so am I arguing against myself here????

I don't, I'm always happy to have a reasonable conversation. Statins in water sound daft too, but at least their benefits are mostly gained via ingestion, unlike fluoride... I just think fluoridating water is a really rubbish way to achieve what we're trying to achieve. Providing schoolkids with subsidised good quality toothpaste, and education on healthy teeth (and eating) habits is likely to be so outrageously better that fluoridation seems like a daft thing to contemplate in comparison.

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I think we do have evidence that fluoride works, and we have no evidence that it harms. It's natural in many areas in the water supply anyway, so what's the problem.

See above - I think the evidence is questionable, the risk is plausible, and therefore it's difficult for me to support dosing the entire population with random dosages based on their water intake.

[Jarndyce]

8 minutes ago, wrighty said:

It's natural in many areas in the water supply anyway

This.   If fluoride is as harmful as is being suggested, presumably these areas must take steps to actively remove it from the water supply.   Any evidence anywhere that this is carried out?

If not, is there any evidence of harm in these areas, attributed to high naturally occurring fluoride level in the water, when compared with other areas with low (or no) naturally occurring fluoride?

That might be a worthwhile study…so I’m guessing it’s already been done.

[Dirty Buggane]

2 hours ago, Happier diner said:

How do you work this one out. Where does the water hide for years? Surely it would be gone in a day.

You try using a diesel can for water, see how long it takes for the taste to go.😛

 

 

[HeliX]

3 minutes ago, Jarndyce said:

This.   If fluoride is as harmful as is being suggested, presumably these areas must take steps to actively remove it from the water supply.   Any evidence anywhere that this is carried out?

If not, is there any evidence of harm in these areas, attributed to high naturally occurring fluoride level in the water, when compared with other areas with low (or no) naturally occurring fluoride?

That might be a worthwhile study…so I’m guessing it’s already been done.

Yes, some places have harmful levels of fluoride in water naturally.

https://www.sciencedirect.com/science/article/pii/S2666765722000369

EDIT: Also "If fluoride is as harmful as is being suggested" - I don't think I'm suggesting it's very harmful. I'm suggesting it's potentially some level of harmful.

To counter, if fluoride is as safe as being suggested, why do many health bodies say not to use fluoridated water when making up infant formula?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913880/

Edited May 15, 2023 by HeliX

[wrighty]

3 minutes ago, Jarndyce said:

This.   If fluoride is as harmful as is being suggested, presumably these areas must take steps to actively remove it from the water supply.   Any evidence anywhere that this is carried out?

If not, is there any evidence of harm in these areas, attributed to high naturally occurring fluoride level in the water, when compared with other areas with low (or no) naturally occurring fluoride?

That might be a worthwhile study…so I’m guessing it’s already been done.

See the WHO report I linked to earlier - it covers this.  High levels of fluoride in water are bad - dental and skeletal fluorosis, increased fracture risk, potential neurological complications in the developing brain etc.

Arsenic is a well known poison.  Do people also realise it's an essential 'mineral'?

[wrighty]

2 minutes ago, HeliX said:

 

To counter, if fluoride is as safe as being suggested, why do many health bodies say not to use fluoridated water when making up infant formula?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913880/

One way to encourage breast feeding, and we all know 'breast is best'

[HeliX]

Just now, wrighty said:

One way to encourage breast feeding, and we all know 'breast is best'

I think it's probably the effect on childhood development rather than a fairly poor way to encourage breastfeeding!

[Jarndyce]

2 minutes ago, HeliX said:

Yes, some places have harmful levels of fluoride in water naturally.

https://www.sciencedirect.com/science/article/pii/S2666765722000369

I’m not a civil engineer, but I’m guessing that if your main source of drinking water is “ground water”, then the opportunity for concentration of minerals is much higher than in a running water source.   Also, from the same paper, it seems that fluoride in ground water can be concentrated through other mechanisms, eg

“In addition to the geogenic sources, fluoride can also be derived from anthropogenic sources such as chemical fertilizers, industrial effluents, sewage plant discharge, deposition from combustion sources, landfill leachate, and excessive groundwater pumping can also cause significant fluoride enrichment in groundwater (Iqbal et al., 2021; Podgorski et al., 2018; Rasool et al., 2017; Talpur et al., 2020).”.

I’m not sure this paper provides a valid comparison, unless IOM plans to reclaim and drink concentrated ground water.

[HeliX]

Just now, Jarndyce said:

I’m not a civil engineer, but I’m guessing that if your main source of drinking water is “ground water”, then the opportunity for concentration of minerals is much higher than in a running water source.   Also, from the same paper, it seems that fluoride in ground water can be concentrated through other mechanisms, eg

“In addition to the geogenic sources, fluoride can also be derived from anthropogenic sources such as chemical fertilizers, industrial effluents, sewage plant discharge, deposition from combustion sources, landfill leachate, and excessive groundwater pumping can also cause significant fluoride enrichment in groundwater (Iqbal et al., 2021; Podgorski et al., 2018; Rasool et al., 2017; Talpur et al., 2020).”.

I’m not sure this paper provides a valid comparison, unless IOM plans to reclaim and drink concentrated ground water.

You asked for evidence of harms from areas with high levels of naturally-occuring fluoride in the water supply, I wasn't suggesting it was a comparison with artificial fluoridation. I was answering your request!

[Jarndyce]

6 minutes ago, wrighty said:

Arsenic is a well known poison.  Do people also realise it's an essential 'mineral'?

That’s the point though, isn’t it?   Potassium and sodium are necessary for life, but too much of either can kill you - use of the word “poison” when discussing fluoride is emotive.   Chlorine can kill you - but I don’t hear many calls for stopping its use in water treatment.   Presumably somebody got the dose right.   Why is fluoride different?

[Happier diner]

19 minutes ago, Dirty Buggane said:

 

Dissolved fluoride has nothing in common with diesel. It has no taste or smell and its only dosed at 1 part per million

[wrighty]

2 minutes ago, Jarndyce said:

That’s the point though, isn’t it?   Potassium and sodium are necessary for life, but too much of either can kill you - use of the word “poison” when discussing fluoride is emotive.   Chlorine can kill you - but I don’t hear many calls for stopping its use in water treatment.   Presumably somebody got the dose right.   Why is fluoride different?

Fluoride is different because it's being used as mass-medication rather than treatment to keep the water safe from things like cholera infection.  I'm comfortable with that, given that it's a natural part of drinking water in many places, whereas I wouldn't be if it was suggested we put prozac in the water to make everybody happy.

I can see it's a nuanced subject, and Helix makes some good points about why we shouldn't.  From a personal perspective I agree with him - I don't need it for me or my kids - but from an evidence and public health perspective it's a good idea, with little downside in my view.

[HeliX]

7 minutes ago, Jarndyce said:

That’s the point though, isn’t it?   Potassium and sodium are necessary for life, but too much of either can kill you - use of the word “poison” when discussing fluoride is emotive.   Chlorine can kill you - but I don’t hear many calls for stopping its use in water treatment.   Presumably somebody got the dose right.   Why is fluoride different?

The amount of chlorine used is by volume of water - it's the amount required to make the volume of water you're drinking safe. It's also fairly necessary.

The fluoride is not targeted at the volume of water - it's irrespective of it (EDIT: To clarify this because I've worded it badly, it's applied per volume of course, but the intended treatment is not per volume, it's per-person). It's unknown how much the end-user will consume. It also targets exactly the wrong people - the people who need it most are kids who are primarily drinking juice and pop. The people who need it least are adults who are drinking primarily water. But the dosing targets the absolute opposite of that - unavoidably. I can't think of any other medication we'd apply in such a topsy-turvy and arbitrary way. Though perhaps wrighty can

Edited May 15, 2023 by HeliX