Okay, I get it. So in the same vein, or rather, gastrointestinal tract, allow me to add to the conversation. Since fluoride is a good thing, preventing cavities and destroying dentists’ livelihood, I think even more drugs should be added to the water supply, in a location-specific manner.
The most urgent need is in blue states, notably California. In those states, the addition of Thorazine and/or haloperidol would be a godsend for the schizophrenics that keep voting for Democrats. In Los Angeles, it should probably be switched to Clozaril, which is best for treatment-resistant schizophrenia. In Washington, DC, leuprolide in the water supply would suppress sexual urges and fantasies that are so prevalent in Congress, not to mention congressmen proclaiming they’re “Spartacus” and feeble ex-presidents wanting to beat up reporters.
In red states, a different kind of chemical add-in would be required. Parathyroid hormones should be added to the water supply to build bone mass and help Republicans grow a spine.
While we’re at it, water supplies everywhere can be laced with THC to help everyone chill out. /s
Why is no one on here treating this as a matter of Informed Consent? People can, and have, argued until they are blue in the face about all sorts of medical interventions and whether or not their benefits outweighed their risks. There are always good arguments for both sides, and always plenty of supporting evidence for both sides depending on which studies one wants to pull from. At the end of the day, the individual gets to weigh the evidence and decide whether or not the intervention is right for them.
On the other hand, the matter of "informed consent" has been settled in a pretty one-sided fashion for much of the 21st century, except for some outliers (such as fluoridated water supply). The desire to bring informed consent back into the topic of mass water fluoridation should not be shrugged off as a bunch of simpletons demanding the right to bad teeth and cholera.
Myself, along with 43 million other Americans, are on well water. If you all care so strongly about Fluoride being in drinking water, why are you not petitioning that the government come and inject Fluoride into my well water? Do my teeth not matter to you? If Fluoridated water is so essential, why doesn't the government provide vouchers to the 43 million Americans on well water to purchase Fluoridated water or Fluoride water drops? These questions are worth thinking about.
Your desire to force a medical intervention on someone because you believe your data to be superior to their data should not be tolerated.
The benefits far, far outweigh the risks, which is the cosmetic issue of mild dental fluorosis, not usually detectable. Children and the elderly are most affected by failure to fluoridate, and children for the longest time. Children and people with dementia don't consent. We look after them whilst not harming others. Beneficence is the operative ethical principle here.
Just so everyone is aware, before editing her last sentence it said:
"Beneficence is the operative ethical principle here, not autonomy".
She should have left her original sentiments intact; it helps paint a clearer picture that people like her do not care about your autonomy as long as they feel just in what is being done to you.
"Children and people with dementia don't consent. We look after them whilst not harming others."... Juliet - do you make medical decisions for my children, or do I? Or will you not grant me autonomy over my family unit?
And why no comments about the 43 million Americans that are on well water? Surely you care about them, too? When will you start your Go-Fund-Me to provide fluoridated water to all these people who aren't getting it?
As a last note, "intellectuals" such as yourself made endless claims that the Covid-19 vaccines' benefits "far, far outweigh the risks" and used that as a justification to declare once again things like "beneficence is the operative ethical principle, not autonomy". If I were to take a deep dive into your interaction history on social media and Substack, would I see you making these similar claims at any point in time? If so, would you still be so bold as to repeat this now in 2025?
I agree that the matter is political in the sense that voters or their elected officials decide. The four ethical principles typically used to make decisions vary in their importance depending upon the situation. Autonomy is the driver in individual health decision making, beneficence, non-maleficience and justice in public health decision making.
Th author writes, "I cite only one piece of data to establish equipoise in the public health decision to add fluoride to drinking water. And that is that most Western European countries have stopped or never started water fluoridation. This includes Germany, France, Italy, Spain, Netherlands, Belgium, Austria, Switzerland, Sweden, Norway, Denmark, and Finland."
Equipoise is about uncertainty in the peer reviewed literature about the value of an intervention. There is no equipoise about the 80 year old practice of water fluoridation.
Citing inability to put the validated public health measure into practice does not establish equipoise. People in Europe know that fluoridation is valuable. But their infrastructure is much older than that in North America. For example, Vancouver (2.4 million people) has two water treatment plants. Brussels (same population size) has 26 water treatment plants. Fluoridation is not cost effective in Brussels, so the salt is fluoridated.
There is much mis- and disinformation about water fluoridation. The "Europe doesn't have it" trope ought not to be repeated in an allegedly scientific blog.
There are only 11 countries in the world that have >50% of their population drink artificially fluoridated water. There are more Americans that drink fluoridated water than the rest of the world combined.
Of the 28 western European countries, fourteen never started the practice and 11 started and then decided to stop.
In summary, your assertion that it is primarily due to infrastructure is just plain wrong.
I like the inclusion of a diverse array of perspectives, and condescension or whatever tone is fine too. If the tone is too snarky, I don't have to finish reading! In short I support whatever the opposite of an echo chamber is.
The author appears to have gone lemming about Europe.
The author may be thinking of Europe of the 19th century. But now the population's embrace of science has waned. It loves homeopathy and has anti-vaxers galore. (The US had under 300 cases of measles last year; Europe had over 35,000.)
Europe is a patchwork of approaches to fluoride. Much of Europe depends on well water or have communities too small to make fluoridation financially viable. Some countries have enough or too much fluoride in ground water. A number of countries in Europe and Latin American put fluoride in table salt or milk to get that all important systemic effect. (See link to maps below)
Six million (out of 68 million) in the UK now have fluoridated water, which explains why British teeth have never been something to write home about. I recommend the British Fluoridation Society for info: https://bfsweb.org
Despite my amalgam filled mouth (product of a misspent and mis-brushed youth) I feel compelled to defend King and country.
You seem to be better versed on these topics than me, but I understand that the UK scores either 4th or 5th best in the world on DMFT (Decayed, Missing, Filled Tooth) scores.
Denmark is routinely number 1.
The reputation for Austin-Powers-like smiles was always more about the lack of cosmetic orthodontics as well as the tea, beer and cigarette stains from stimulants vital to keeping us functional in the bloody weather.
I'm comfortable with opposing views, and I am a fan of Sensible Medicine. My negative reaction to that article was primarily because of its ridiculously snarky, arrogant, and condescending presentation, not its content. It reminds me why time and time again science has been held back by establishment critics who are so utterly convinced that they were right that they spent more time on ad hominen attacks than engaging in scientific discourse.
Spot on John. As far as fluoride is concerned there is no need to have it in drinking water. After all most toothpastes have fluoride, and a dentist will put a concentrate fluoride gel (not ingested) on a child’s teeth. So why bother contaminating the drinking water with fluoride whose long term consequences may not be so great.
Toothpaste only remineralizes teeth for about 2 hours. Ingesting fluoridated water and food made with that water provides remineralizing round the clock.
"Contaminating" drinking water? What nonsense. Fluoride is a nutrient mineral, like calcium and iron. It is a very common mineral; it is everywhere and in all ground water. But some ground water doesn't have enough to be helpful in making teeth and bones stronger. Fluoridation simply adds more fluoride ions.
Fluoridation has been studied continually for 80 years – that's several generations. There is nothing that has been studied as much as fluoride. At least 5 systematic reviews found it safe and beneficial.
Your question isn't clear. I have given no reason why European countries don't fluoridate community water.
But Europe largely fluoridates salt to get a continual amount of fluoride ions in the saliva. Fluoridating water is not always practical; a lot of Europe uses well water. And there's fear-mongering; a lot of Europeans are anti-vax, as well.
Dr. M., keep up the good work. Controversy and disagreement is a great way to learn. May I add that, although I appreciate the many research studies that you review, I would like to see more case reviews with differing opinions and the resulting outcomes.
Bottom line: historically there were 3 College Administrators per 100 students, and student debt was for the most part, non existent.
Today, colleges have almost 14 Administrators per 100 student and everyone knows the college/student debt situation.
That in turn forces everyone to choose a career in mediocrity working for a State/Federal/etc. organization that will relieve the debt after 10 years of credited service.
Thus, Canada as an example, now has 40 government employees for every 100 workers.
What could 40 workers per 100 produce that clearly benefits themselves and the remaining 60 taxpaying citizens supporting their lavish (mediocre) lifestyle of included healthcare, pension, salary, vacations/holidays, retirement benefits, etc.??
Back to water and clean water and Trump reducing the annual budget by $2.48 billion.
The 'Ratchet Effect" supports that this is impossible, because it actually might cause the reduction of workers, not the quality of water.
But those workers will clearly destroy the quality of water in an effort to cling to their job.
Charles coined it as 'cutting muscle to maintain fat'.
We're going to see a lot more of this going forward.
If we hit 40 gov't employees per 100 workers USA, who prey=tell, might those 40 workers vote for next election cycle?
Thank you, JMM, for reminding everyone that disagreement is often healthy, and that throwing money at a problem does not correlate with solutions. I give you the state of California as Exhibit A... :)
We have fluoride toothpaste. An Engineer friend who has worked in a water treatment plant did not want fluoride in his drinking water mainly because of people possibly making errors and putting in too much fluoride.
Toothpaste is topical and remineralizes teeth for about 2 hours. Fluoridated water is systemic and provides continual remineralization for teeth and bones.
American "experts" have pushed this chemical lobotomy onto our country. We fight against our govt to remove it but they are blackmailed by america to keep poisoning us and retarding our children KNOWINGLY. This is just one more example of AMERICAN CORPORATE TERRORISM. Makes me VOMIT when i hear yanks chanting "WE ARE THE GREATEST COUNTRY IN THE WORLD"..... Greatest WHAT country? Greatest terrorist country? Greatest satanic country? Greatest WEAPONISED PSYOP country? YOUR killshots are destroying OUR people GROOMERICA.... YOUR KILLSHOTS. Just like Germans killed all those jews, we are told. THIS IS THE AMERICAN CORPORATE HOLICAUST...
Fascinating! I’m Harrison, an ex fine dining line cook. My stack "The Secret Ingredient" adapts hit restaurant recipes for easy home cooking.
check us out:
https://thesecretingredient.substack.com
Okay, I get it. So in the same vein, or rather, gastrointestinal tract, allow me to add to the conversation. Since fluoride is a good thing, preventing cavities and destroying dentists’ livelihood, I think even more drugs should be added to the water supply, in a location-specific manner.
The most urgent need is in blue states, notably California. In those states, the addition of Thorazine and/or haloperidol would be a godsend for the schizophrenics that keep voting for Democrats. In Los Angeles, it should probably be switched to Clozaril, which is best for treatment-resistant schizophrenia. In Washington, DC, leuprolide in the water supply would suppress sexual urges and fantasies that are so prevalent in Congress, not to mention congressmen proclaiming they’re “Spartacus” and feeble ex-presidents wanting to beat up reporters.
In red states, a different kind of chemical add-in would be required. Parathyroid hormones should be added to the water supply to build bone mass and help Republicans grow a spine.
While we’re at it, water supplies everywhere can be laced with THC to help everyone chill out. /s
I prefer that Sensible Medicine focus on clinical topics and leave politics aside.
Why is no one on here treating this as a matter of Informed Consent? People can, and have, argued until they are blue in the face about all sorts of medical interventions and whether or not their benefits outweighed their risks. There are always good arguments for both sides, and always plenty of supporting evidence for both sides depending on which studies one wants to pull from. At the end of the day, the individual gets to weigh the evidence and decide whether or not the intervention is right for them.
On the other hand, the matter of "informed consent" has been settled in a pretty one-sided fashion for much of the 21st century, except for some outliers (such as fluoridated water supply). The desire to bring informed consent back into the topic of mass water fluoridation should not be shrugged off as a bunch of simpletons demanding the right to bad teeth and cholera.
Myself, along with 43 million other Americans, are on well water. If you all care so strongly about Fluoride being in drinking water, why are you not petitioning that the government come and inject Fluoride into my well water? Do my teeth not matter to you? If Fluoridated water is so essential, why doesn't the government provide vouchers to the 43 million Americans on well water to purchase Fluoridated water or Fluoride water drops? These questions are worth thinking about.
Your desire to force a medical intervention on someone because you believe your data to be superior to their data should not be tolerated.
The benefits far, far outweigh the risks, which is the cosmetic issue of mild dental fluorosis, not usually detectable. Children and the elderly are most affected by failure to fluoridate, and children for the longest time. Children and people with dementia don't consent. We look after them whilst not harming others. Beneficence is the operative ethical principle here.
Just so everyone is aware, before editing her last sentence it said:
"Beneficence is the operative ethical principle here, not autonomy".
She should have left her original sentiments intact; it helps paint a clearer picture that people like her do not care about your autonomy as long as they feel just in what is being done to you.
"Children and people with dementia don't consent. We look after them whilst not harming others."... Juliet - do you make medical decisions for my children, or do I? Or will you not grant me autonomy over my family unit?
And why no comments about the 43 million Americans that are on well water? Surely you care about them, too? When will you start your Go-Fund-Me to provide fluoridated water to all these people who aren't getting it?
As a last note, "intellectuals" such as yourself made endless claims that the Covid-19 vaccines' benefits "far, far outweigh the risks" and used that as a justification to declare once again things like "beneficence is the operative ethical principle, not autonomy". If I were to take a deep dive into your interaction history on social media and Substack, would I see you making these similar claims at any point in time? If so, would you still be so bold as to repeat this now in 2025?
I agree that the matter is political in the sense that voters or their elected officials decide. The four ethical principles typically used to make decisions vary in their importance depending upon the situation. Autonomy is the driver in individual health decision making, beneficence, non-maleficience and justice in public health decision making.
Th author writes, "I cite only one piece of data to establish equipoise in the public health decision to add fluoride to drinking water. And that is that most Western European countries have stopped or never started water fluoridation. This includes Germany, France, Italy, Spain, Netherlands, Belgium, Austria, Switzerland, Sweden, Norway, Denmark, and Finland."
Equipoise is about uncertainty in the peer reviewed literature about the value of an intervention. There is no equipoise about the 80 year old practice of water fluoridation.
Citing inability to put the validated public health measure into practice does not establish equipoise. People in Europe know that fluoridation is valuable. But their infrastructure is much older than that in North America. For example, Vancouver (2.4 million people) has two water treatment plants. Brussels (same population size) has 26 water treatment plants. Fluoridation is not cost effective in Brussels, so the salt is fluoridated.
There is much mis- and disinformation about water fluoridation. The "Europe doesn't have it" trope ought not to be repeated in an allegedly scientific blog.
There are only 11 countries in the world that have >50% of their population drink artificially fluoridated water. There are more Americans that drink fluoridated water than the rest of the world combined.
Of the 28 western European countries, fourteen never started the practice and 11 started and then decided to stop.
In summary, your assertion that it is primarily due to infrastructure is just plain wrong.
I like the inclusion of a diverse array of perspectives, and condescension or whatever tone is fine too. If the tone is too snarky, I don't have to finish reading! In short I support whatever the opposite of an echo chamber is.
The author appears to have gone lemming about Europe.
The author may be thinking of Europe of the 19th century. But now the population's embrace of science has waned. It loves homeopathy and has anti-vaxers galore. (The US had under 300 cases of measles last year; Europe had over 35,000.)
Europe is a patchwork of approaches to fluoride. Much of Europe depends on well water or have communities too small to make fluoridation financially viable. Some countries have enough or too much fluoride in ground water. A number of countries in Europe and Latin American put fluoride in table salt or milk to get that all important systemic effect. (See link to maps below)
Six million (out of 68 million) in the UK now have fluoridated water, which explains why British teeth have never been something to write home about. I recommend the British Fluoridation Society for info: https://bfsweb.org
I also recommend the author check out the ADA on fluoride and also what happened to Calgary when it stopped fluoridation for ten years. (https://adanews.ada.org/ada-news/2021/august/community-water-fluoridation-prevents-caries/)
Maps here:
https://s3-us-west-2.amazonaws.com/cdhp-fluoridation/Marthaler+(2011)+Salt+Fluoridation.pdf#:~:text=Europe%20and%20Latin%20America%20are%20currently%20the,with%20implemented%20successful%20programs%20of%20salt%20fluoridation.&text=Nowadays%20in%20eight%20European%20countries%20national%20legal,Republic%2C%20France%2C%20Germany%2C%20Greece%2C%20Netherlands%2C%20Spain%2C%20Switzerland.
Ahem.
Despite my amalgam filled mouth (product of a misspent and mis-brushed youth) I feel compelled to defend King and country.
You seem to be better versed on these topics than me, but I understand that the UK scores either 4th or 5th best in the world on DMFT (Decayed, Missing, Filled Tooth) scores.
Denmark is routinely number 1.
The reputation for Austin-Powers-like smiles was always more about the lack of cosmetic orthodontics as well as the tea, beer and cigarette stains from stimulants vital to keeping us functional in the bloody weather.
[ https://mau.se/en/about-us/faculties-and-departments/faculty-of-odontology/oral-health-countryarea-profile-project--capp ]
I'm comfortable with opposing views, and I am a fan of Sensible Medicine. My negative reaction to that article was primarily because of its ridiculously snarky, arrogant, and condescending presentation, not its content. It reminds me why time and time again science has been held back by establishment critics who are so utterly convinced that they were right that they spent more time on ad hominen attacks than engaging in scientific discourse.
I share this completely.
100%
This reminded me of the movie "Love in the Afternoon." Sorry to digress but... her comment about Americans was and still is hysterical.
Spot on John. As far as fluoride is concerned there is no need to have it in drinking water. After all most toothpastes have fluoride, and a dentist will put a concentrate fluoride gel (not ingested) on a child’s teeth. So why bother contaminating the drinking water with fluoride whose long term consequences may not be so great.
Toothpaste only remineralizes teeth for about 2 hours. Ingesting fluoridated water and food made with that water provides remineralizing round the clock.
"Contaminating" drinking water? What nonsense. Fluoride is a nutrient mineral, like calcium and iron. It is a very common mineral; it is everywhere and in all ground water. But some ground water doesn't have enough to be helpful in making teeth and bones stronger. Fluoridation simply adds more fluoride ions.
Fluoridation has been studied continually for 80 years – that's several generations. There is nothing that has been studied as much as fluoride. At least 5 systematic reviews found it safe and beneficial.
But don't trust me. Talk to your dentist.
Is that why so many European countries no longer fluoridate their water?
Your question isn't clear. I have given no reason why European countries don't fluoridate community water.
But Europe largely fluoridates salt to get a continual amount of fluoride ions in the saliva. Fluoridating water is not always practical; a lot of Europe uses well water. And there's fear-mongering; a lot of Europeans are anti-vax, as well.
https://s3-us-west-2.amazonaws.com/cdhp-fluoridation/Marthaler+(2011)+Salt+Fluoridation.pdf#:~:text=Europe%20and%20Latin%20America%20are%20currently%20the,with%20implemented%20successful%20programs%20of%20salt%20fluoridation.&text=Nowadays%20in%20eight%20European%20countries%20national%20legal,Republic%2C%20France%2C%20Germany%2C%20Greece%2C%20Netherlands%2C%20Spain%2C%20Switzerland.
Dr. M., keep up the good work. Controversy and disagreement is a great way to learn. May I add that, although I appreciate the many research studies that you review, I would like to see more case reviews with differing opinions and the resulting outcomes.
Switzerland fluoridates it's salt not its water. Read the BBC article : These countries dont fluoridate their water heres why.
Dr. Mandrola,
Thanks for your writings and attempt to clarify the obvious.
One side note, but relevant point to add, is the need for governments to continually grow and take more control of their dominions.
Charles Hugh Smith wrote an interesting article titled "The Ratchet Effect".
https://charleshughsmith.substack.com/p/the-ratchet-effect-easy-to-spend
Bottom line: historically there were 3 College Administrators per 100 students, and student debt was for the most part, non existent.
Today, colleges have almost 14 Administrators per 100 student and everyone knows the college/student debt situation.
That in turn forces everyone to choose a career in mediocrity working for a State/Federal/etc. organization that will relieve the debt after 10 years of credited service.
Thus, Canada as an example, now has 40 government employees for every 100 workers.
What could 40 workers per 100 produce that clearly benefits themselves and the remaining 60 taxpaying citizens supporting their lavish (mediocre) lifestyle of included healthcare, pension, salary, vacations/holidays, retirement benefits, etc.??
Back to water and clean water and Trump reducing the annual budget by $2.48 billion.
The 'Ratchet Effect" supports that this is impossible, because it actually might cause the reduction of workers, not the quality of water.
But those workers will clearly destroy the quality of water in an effort to cling to their job.
Charles coined it as 'cutting muscle to maintain fat'.
We're going to see a lot more of this going forward.
If we hit 40 gov't employees per 100 workers USA, who prey=tell, might those 40 workers vote for next election cycle?
Keynesian Economics or Austrian?
The answer will be in your ballot box soon.
Thank you, JMM, for reminding everyone that disagreement is often healthy, and that throwing money at a problem does not correlate with solutions. I give you the state of California as Exhibit A... :)
Yes!
We have fluoride toothpaste. An Engineer friend who has worked in a water treatment plant did not want fluoride in his drinking water mainly because of people possibly making errors and putting in too much fluoride.
Toothpaste is topical and remineralizes teeth for about 2 hours. Fluoridated water is systemic and provides continual remineralization for teeth and bones.
American "experts" have pushed this chemical lobotomy onto our country. We fight against our govt to remove it but they are blackmailed by america to keep poisoning us and retarding our children KNOWINGLY. This is just one more example of AMERICAN CORPORATE TERRORISM. Makes me VOMIT when i hear yanks chanting "WE ARE THE GREATEST COUNTRY IN THE WORLD"..... Greatest WHAT country? Greatest terrorist country? Greatest satanic country? Greatest WEAPONISED PSYOP country? YOUR killshots are destroying OUR people GROOMERICA.... YOUR KILLSHOTS. Just like Germans killed all those jews, we are told. THIS IS THE AMERICAN CORPORATE HOLICAUST...