I think certain topics in healthcare deserve the serious and honest approach necessary. In a time when health literacy is low due to widespread misinformation a satirical piece like this may create more resentment and confusion. Though I know the intent is good. I read the piece hoping for a scientific discussion but find that as many other health topics online it's clouded by political statements. Which is a shame given what we all went through not too long ago.
I really don't believe there is a push from dentists to remove fluoride based on loss of income. There is a shortage of dentists in the US. They are not in need of more patients.
Why are there less cavities in Western countries? It’s a complex picture. Dental care with fluoride products helps; foods made with fluoridated water can be consumed in unfluoridated areas. And as I said, some countries ingest fluoridated salt or milk.
You seem to be assuming that ingested fluoride is not absorbed in the gut. It is. That’s how it gets in saliva and to bones.
Studies found that fluoridated water, has the effect, on average, of preventing one cavity every 3 years. That is an effect in addition to using fluoride toothpaste, etc.
Let's set your red herrings aside (cholera, typhoid, lead, etc.) and get down to the crux of your argument, which is your defense of fluoride in public water systems. Perusing publications that support your point of view (there are many), it's impossible not to notice that they almost always begin and end their argument with words like "consensus" and "safe and effective." Where else have we been bludgeoned over the head with these words recently? And in the spirit of junk science, they also never address the competing hypotheses relative to both dental disease and fluoride administered systemically.
There seems to be no question that fluoride is a neurotoxin, only debate about what levels are safe. Nearly all research on this topic begins and ends with words like "limited data," effects unknown." and "more research needed." The consensus belief seems to be that certain levels - i.e., those added to public water supplies - are safe. Yet "more research is needed." It is known that fluoride from water ingested by a pregnant woman is found throughout every part of her reproductive system, including the fetus, amniotic fluid, placenta and umbilical cord. Through the mother, the fetus is ingesting and excreting fluoride. The impact on its development is unknown. Are you comfortable with that?
Fluoride is also added to a whole array of commonly used products such as toothpaste, mouthwash, dental flosses, products applied by dentists, not to mention all the food products made with fluoridated water. Is the cumulative amount safe? "More research is needed."
You can save your sarcasm. These are legitimate questions. Fluoride added to the water system does nothing to address the root causes of dental disease, namely diet. Rather, it lulls the public into believing they can continue to eat the cavity causing garbage that they do. See the reference below to Weston Price's research. Below is some data that counters your argument.
Lastly, anyone really interested in this subject will want to read Weston Price's compelling study Nutrition and Physical Degeneration. It gets to the heart of the matter of the dietary roots of dental disease. That's the place to start.
I suspect that most people don't know the full history of the fluoridation movement. An observational study comparing the water supply in two towns in upstate New York showed that the residents of one that had naturally fluoridated water had fewer dental cavities than the one that did not have it. This difference wasn't extremely large and only occurred in children aged 5-9. Children older than 12 actually had more cavities in the town with the naturally fluoridated water. A followup study was initiated in Michigan comparing fluoridated and non-fluoridated water. The plan was to compare the dental statistics over a 15 year period but was terminated after a short time due to an increased demand for the fluoridation that was being heavily pushed by public health authorities. Fluorides are toxic byproducts of a number of industrial processes and disposing of these waste products was a difficult and expensive matter. Aluminum production generates a lot of sodium fluoride as a waste product and this is what was first used in fluoridation of water supplies. The big push for fluoridation began at the end of World War II when President Truman appointed Oscar R. Ewing to head up the Federal Security Agency which contained the Public Health Service as one of its divisions. Ewing then contracted with Edward Bernays to promote the idea of fluoridation to the general public. Bernays was known as the "father of public relations" and wrote textbooks on the methods of propaganda. Bernays was also the nephew of Sigmund Freud. Once the concept of fluoridation was sold to the public, Oscar Ewing retired from "public service" and resumed his lucrative legal practice which included his being Chief Counsel for the Alcoa aluminum company which now had a market for the sodium fluoride that had previously been a troublesome waste product generated by the production of aluminum. Some wondered why calcium fluoride was not used to fluoridate water since that was the fluoride that was found in naturally fluoridated water that started the whole business. But, of course, calcium fluoride is not a byproduct of aluminum production.
Here's where I'm at. Anytime the gov't has XYZ BILLION in something, it's never about XYZ. It's about some politician, some NGO getting a cut. So I'm at the slash/cut/burn EVERYTHING mentality. Also, a good litmus test is, what are other European countries doing? Do they have fluoride in their water?
Hard to continue to support this platform with dumb articles like this. Why not have a nuanced approach to the topic if you want to encourage critical appraisal of important issues. I can watch The View if I’m interested in the mood for gratuitous ramblings.
People's cognitive biases around fluoridation are interesting. I bet if it was added to the air, instead of the water, by crop dusters flying over people's houses, or if it turned the water grey when it was added, we would have very different reactions towards it.
Anyway, after my road to Damascus moment with the media in 2020, I try and show much more goodwill to people whenever they are being shouted down with "studies have shown" or "scientists agree" totalizing messages from the news media. I've usually found that they're not wild fantasists, but have reasoned arguments, even if I ultimately disagree with them.
In the spirit of this I looked into JFK's position on fluoridation and discovered that there's a body of literature, by reasonable people, showing an association between fluoridation and IQ drops in children.
Indeed the government's own National Toxicology Program of HHS did a thorough review of the evidence and found "the results from 18 of the 19 high-quality (low risk-of-bias) studies (3 prospective cohort studies from 2 different study populations and 15 cross-sectional studies from 13 different study populations) that evaluated IQ in children provide consistent evidence of an inverse association between estimated fluoride exposure and IQ scores"
The same group's findings were extended in a JAMA Pediatrics article in January of 2025 where they found a clear does/response relationship. "Among the subset of low risk-of-bias studies, there were inverse associations when exposed groups were restricted to less than 4 mg/L, less than 2 mg/L, and less than 1.5 mg/L [ crucially 1.5 mg/L is the ceiling for water fluoridation advised by the EPA ] for analyses of fluoride measured both in water and in urine."
There's a trade off. Fluoridation provides a likely benefit to dental health at the expense of a likely decrease in IQ scores in children. Therefore, whether to fluoridate is a value judgement, based on all sorts of philosophical priors about freedom of choice and willingness to tolerate doing harms, as well as practical things, like the modern availability of toothpaste. As I say, if the fluoride crop-duster flew over our houses every day spraying a brown dust, I bet our positions would not be so fixed.
Anyway, this is a very long winded Saturday morning way to say that it's *always* worth treating your opponent with respect and trying to understand where they're coming from.
P.S. I don't think it's likely that the scientists at the National Toxicology Program are right-wing MAGA fanatics producing massively biased work. But I admit that I don't have the chops or the time to critically appraise their work. For what it's worth there's a remarkable consonance between the studies they included in their systematic review.
Edited for grammar. I swear I can only proofread properly after I've posted :)
Even the recent MAHA Report recognizes that the IQ studies were done with higher than recommended levels of fluoride supplementation in community water.
"This [NTP] Monograph and Addendum do not address whether the sole exposure to fluoride added to drinking water in some countries (i.e., fluoridation, at 0.7 mg/L in the United States and Canada) is associated with a measurable effect on IQ."
The ideal level of fluoride ions for maximum benefit to teeth and bones is 1.0 to 1.2 ppm – yet still far below the maximum allowable level of 4.0 ppm. I think it was a mistake to make the recommended level 0.7 ppm. It was done for the same stupid reason as needlessly removing thimerosal from vaccines, resulting in LESS public trust and more.
Above 4.0 ppm, the EPA recommends the excess fluoride be removed, which is an expensive process. Some private water wells in the Southwest US have over 4.0 ppm.
As a 65 year old OBGYN I share Dr. Kaplan's outrage. Growing up with flouridated water on military bases and having regular free , government paid dental care as a child and young adult has deprived me of the the opportunity to lose teeth and have them replaced with shiny new implants. I received the new measles vaccine as a 3 year old and lost the opportunity to recover from measles . I did get to have chicken pox and scarlet fever and mumps though, so there is that. And, my father managed to catch the mumps from me and I got to be an only child , which is why I probably got into medical school since there were no siblings to compete for family resources. As one of the first volunteers for the new Hepatitis B vaccine as an intern I lost my ability to have my career cut short by a needle stick in the OR and therefore retire on long term disability. So I do see the advantage of the new governmental initiatives to MAHA. I am waiting to see my first cases of congenital Rubella in newborns and measles in pregnant women , since even at my age I never got to see any of this. I did get to see pregnant women die from COVID in the ICU while we were cutting their dying fetuses out of them , one never stops learning in medicine. You can hate on this all you want, and I invite you to stand in my shoes . Sarcasm font off.
I am an OBGYN just a couple years older than you. Grew up in East Tennessee, so no fluoride and no regular dental care and I have all the flashy (non cosmetic) dental interventions. I did not deliver a baby with congenital rubella syndrome but cared for a few young women with those devastating defects. Doubt anyone will recognize them now but I’ll never forget.
Good article. BTW VP and Marty are a breath of fresh air in the FDA. Unfortuantely they work under RFK Jr. He may have a few good points but overall what you see is what you get: A low character hack/nut who continues to believe the MMR vaccine(s) cause autism and the government is using our commericial airlines to poison /mind control us (chemtrails). RFK Jr is not looking for unbiased evidence. He is looking for any piece of information that can remotely confirm what he already believes. I appreciate Adam and SM supporting robust debate. I am a layman and benefit from their approach to conservative medicine. JFK Jr needs to be challenged when necessary. If he isn't I will have to exit Sensible Medicine....
The benefits of fluoride in water sounds astronomical, I wonder why other countries don't do it. Imagine how much it would save public healthcare annually!
Unless the cavity statistics comparing the US and their numbers are largely the same, perhaps because over the last 50 years the practice of removing food bits from the mouth with stiff hairs on a stick became routine. Fringe scientists might even claim that digesting fluoride has little dental benefit compared to topical applications of fluoride paste, and the improved dental hygiene of the world is unrelated to fluoridated water. Those poor unenlightened countries just continue to fall for junk science.
Some countries have areas where the water already has an ideal level of fluoride, or too much, as in parts of India and China. Some European countries sell milk or salt supplemented with fluoride. And in some countries, the anti-fluoridationist hold sway.
A community needs a population over 1500 to make fluoridation affordable.
If fluoride levels were the cause of cavity rate reduction in the US, why have all western countries cavity rates dropped substantially and to eqally low levels since 1970? But ignoring that entirely, by what mechanism does passing fluoride through the digestive tract improve dental health? Should proper advice be to swallow toothpaste for maximum effectiveness, or can brushing be replaced entirely by a split second water rinse?
If that seems silly, perhaps advocates for fluoridating who recognize any benefit is via contact-bonding with teeth should promote fluoridization for solid foods which maximize the interaction between teeth and fluoride with a process known as chewing, or recommend holding water in the mouth for 60 seconds between drinks and discouraging use of straws which bypass contact entirely.
The parallels between "add fluoride to water to make people's teeth healthy" and "remove foreskin so men can keep their genitals clean and healthy" are greater than optimal.
Ingested fluoride is absorbed from the gut and is attracted to bones and tooth enamel (via saliva). Acid in the mouth continually erodes tooth enamel, so when you have fluoride in saliva, it is continually rebuilt.
Swallowing toothpaste would help teeth and bones, except that the soap elements in toothpaste would cause belly ache. Fluoridated water and the foods made from it still keep a better, more consistent level of fluoride ions in saliva.
All forms of dental hygiene contribute to healthy teeth. Fluoridation is just getting the ideal amount of a mineral that naturally occurs in ground water – it is a mineral nutrient, like calcium and iron, that humans evolved to need for strong bones and teeth.
Citing an official HHS document for fluoride's benefits doesn't provide actual evidence of fluorides benefits. And I wonder if you will agree with all the official HHS documents that will come out in the next few years and just follow them blindly in your practice or just the ones that come out while your ideological party endorses them? Perhaps instead of honing in on sarcasm, you could hone in on the critical review of the literature. This substack literally teaches you how to do it! Without VP to provide an evidence based perspective, I worry this substack is not going to make it ...
I think certain topics in healthcare deserve the serious and honest approach necessary. In a time when health literacy is low due to widespread misinformation a satirical piece like this may create more resentment and confusion. Though I know the intent is good. I read the piece hoping for a scientific discussion but find that as many other health topics online it's clouded by political statements. Which is a shame given what we all went through not too long ago.
I really don't believe there is a push from dentists to remove fluoride based on loss of income. There is a shortage of dentists in the US. They are not in need of more patients.
There was an interesting piece from TTE regarding the evidence on the case for fluoride in drinking water:
https://open.substack.com/pub/trusttheevidence/p/flouride-in-the-water?r=owd62&utm_medium=ios
e.g. in Germany, no fluoride is added
Why are there less cavities in Western countries? It’s a complex picture. Dental care with fluoride products helps; foods made with fluoridated water can be consumed in unfluoridated areas. And as I said, some countries ingest fluoridated salt or milk.
You seem to be assuming that ingested fluoride is not absorbed in the gut. It is. That’s how it gets in saliva and to bones.
Studies found that fluoridated water, has the effect, on average, of preventing one cavity every 3 years. That is an effect in addition to using fluoride toothpaste, etc.
Let's set your red herrings aside (cholera, typhoid, lead, etc.) and get down to the crux of your argument, which is your defense of fluoride in public water systems. Perusing publications that support your point of view (there are many), it's impossible not to notice that they almost always begin and end their argument with words like "consensus" and "safe and effective." Where else have we been bludgeoned over the head with these words recently? And in the spirit of junk science, they also never address the competing hypotheses relative to both dental disease and fluoride administered systemically.
There seems to be no question that fluoride is a neurotoxin, only debate about what levels are safe. Nearly all research on this topic begins and ends with words like "limited data," effects unknown." and "more research needed." The consensus belief seems to be that certain levels - i.e., those added to public water supplies - are safe. Yet "more research is needed." It is known that fluoride from water ingested by a pregnant woman is found throughout every part of her reproductive system, including the fetus, amniotic fluid, placenta and umbilical cord. Through the mother, the fetus is ingesting and excreting fluoride. The impact on its development is unknown. Are you comfortable with that?
Fluoride is also added to a whole array of commonly used products such as toothpaste, mouthwash, dental flosses, products applied by dentists, not to mention all the food products made with fluoridated water. Is the cumulative amount safe? "More research is needed."
You can save your sarcasm. These are legitimate questions. Fluoride added to the water system does nothing to address the root causes of dental disease, namely diet. Rather, it lulls the public into believing they can continue to eat the cavity causing garbage that they do. See the reference below to Weston Price's research. Below is some data that counters your argument.
Tooth Decay Rates in Fluoridated vs. Non-Fluoridated Communities: https://fluoridealert.org/studies/caries02/
WHO Data on Tooth Decay Trends in Fluoridated vs. Unfluoridated Countries: http://www.cleanwatersonomamarin.org/static-content/Countries_States_Communities/WHO_Tooth-Decay-Data_01_Fluoridated-vs-Unfluoridated-Countries.pdf
Slaying sacred cows: Is it time to pull the plug on water fluoridation?: https://www.researchgate.net/publication/230607918_Slaying_sacred_cows_Is_it_time_to_pull_the_plug_on_water_fluoridation
Lastly, anyone really interested in this subject will want to read Weston Price's compelling study Nutrition and Physical Degeneration. It gets to the heart of the matter of the dietary roots of dental disease. That's the place to start.
I suspect that most people don't know the full history of the fluoridation movement. An observational study comparing the water supply in two towns in upstate New York showed that the residents of one that had naturally fluoridated water had fewer dental cavities than the one that did not have it. This difference wasn't extremely large and only occurred in children aged 5-9. Children older than 12 actually had more cavities in the town with the naturally fluoridated water. A followup study was initiated in Michigan comparing fluoridated and non-fluoridated water. The plan was to compare the dental statistics over a 15 year period but was terminated after a short time due to an increased demand for the fluoridation that was being heavily pushed by public health authorities. Fluorides are toxic byproducts of a number of industrial processes and disposing of these waste products was a difficult and expensive matter. Aluminum production generates a lot of sodium fluoride as a waste product and this is what was first used in fluoridation of water supplies. The big push for fluoridation began at the end of World War II when President Truman appointed Oscar R. Ewing to head up the Federal Security Agency which contained the Public Health Service as one of its divisions. Ewing then contracted with Edward Bernays to promote the idea of fluoridation to the general public. Bernays was known as the "father of public relations" and wrote textbooks on the methods of propaganda. Bernays was also the nephew of Sigmund Freud. Once the concept of fluoridation was sold to the public, Oscar Ewing retired from "public service" and resumed his lucrative legal practice which included his being Chief Counsel for the Alcoa aluminum company which now had a market for the sodium fluoride that had previously been a troublesome waste product generated by the production of aluminum. Some wondered why calcium fluoride was not used to fluoridate water since that was the fluoride that was found in naturally fluoridated water that started the whole business. But, of course, calcium fluoride is not a byproduct of aluminum production.
Wow this article was hilarious.
But you really should have started with “/S” first.
Or maybe put Dr. Cifu’s statement in all caps with 64 font size.
Here's where I'm at. Anytime the gov't has XYZ BILLION in something, it's never about XYZ. It's about some politician, some NGO getting a cut. So I'm at the slash/cut/burn EVERYTHING mentality. Also, a good litmus test is, what are other European countries doing? Do they have fluoride in their water?
Interesting comment section. Guess if everyone takes their ball and goes home we won’t have hardly ANY fun.
Hard to continue to support this platform with dumb articles like this. Why not have a nuanced approach to the topic if you want to encourage critical appraisal of important issues. I can watch The View if I’m interested in the mood for gratuitous ramblings.
People's cognitive biases around fluoridation are interesting. I bet if it was added to the air, instead of the water, by crop dusters flying over people's houses, or if it turned the water grey when it was added, we would have very different reactions towards it.
Anyway, after my road to Damascus moment with the media in 2020, I try and show much more goodwill to people whenever they are being shouted down with "studies have shown" or "scientists agree" totalizing messages from the news media. I've usually found that they're not wild fantasists, but have reasoned arguments, even if I ultimately disagree with them.
In the spirit of this I looked into JFK's position on fluoridation and discovered that there's a body of literature, by reasonable people, showing an association between fluoridation and IQ drops in children.
Indeed the government's own National Toxicology Program of HHS did a thorough review of the evidence and found "the results from 18 of the 19 high-quality (low risk-of-bias) studies (3 prospective cohort studies from 2 different study populations and 15 cross-sectional studies from 13 different study populations) that evaluated IQ in children provide consistent evidence of an inverse association between estimated fluoride exposure and IQ scores"
[ https://ntp.niehs.nih.gov/sites/default/files/2024-08/fluoride_final_508.pdf ]
The same group's findings were extended in a JAMA Pediatrics article in January of 2025 where they found a clear does/response relationship. "Among the subset of low risk-of-bias studies, there were inverse associations when exposed groups were restricted to less than 4 mg/L, less than 2 mg/L, and less than 1.5 mg/L [ crucially 1.5 mg/L is the ceiling for water fluoridation advised by the EPA ] for analyses of fluoride measured both in water and in urine."
[ https://jamanetwork.com/journals/jamapediatrics/fullarticle/2828425 ]
There's a trade off. Fluoridation provides a likely benefit to dental health at the expense of a likely decrease in IQ scores in children. Therefore, whether to fluoridate is a value judgement, based on all sorts of philosophical priors about freedom of choice and willingness to tolerate doing harms, as well as practical things, like the modern availability of toothpaste. As I say, if the fluoride crop-duster flew over our houses every day spraying a brown dust, I bet our positions would not be so fixed.
Anyway, this is a very long winded Saturday morning way to say that it's *always* worth treating your opponent with respect and trying to understand where they're coming from.
P.S. I don't think it's likely that the scientists at the National Toxicology Program are right-wing MAGA fanatics producing massively biased work. But I admit that I don't have the chops or the time to critically appraise their work. For what it's worth there's a remarkable consonance between the studies they included in their systematic review.
Edited for grammar. I swear I can only proofread properly after I've posted :)
Even the recent MAHA Report recognizes that the IQ studies were done with higher than recommended levels of fluoride supplementation in community water.
"This [NTP] Monograph and Addendum do not address whether the sole exposure to fluoride added to drinking water in some countries (i.e., fluoridation, at 0.7 mg/L in the United States and Canada) is associated with a measurable effect on IQ."
The ideal level of fluoride ions for maximum benefit to teeth and bones is 1.0 to 1.2 ppm – yet still far below the maximum allowable level of 4.0 ppm. I think it was a mistake to make the recommended level 0.7 ppm. It was done for the same stupid reason as needlessly removing thimerosal from vaccines, resulting in LESS public trust and more.
Above 4.0 ppm, the EPA recommends the excess fluoride be removed, which is an expensive process. Some private water wells in the Southwest US have over 4.0 ppm.
As a 65 year old OBGYN I share Dr. Kaplan's outrage. Growing up with flouridated water on military bases and having regular free , government paid dental care as a child and young adult has deprived me of the the opportunity to lose teeth and have them replaced with shiny new implants. I received the new measles vaccine as a 3 year old and lost the opportunity to recover from measles . I did get to have chicken pox and scarlet fever and mumps though, so there is that. And, my father managed to catch the mumps from me and I got to be an only child , which is why I probably got into medical school since there were no siblings to compete for family resources. As one of the first volunteers for the new Hepatitis B vaccine as an intern I lost my ability to have my career cut short by a needle stick in the OR and therefore retire on long term disability. So I do see the advantage of the new governmental initiatives to MAHA. I am waiting to see my first cases of congenital Rubella in newborns and measles in pregnant women , since even at my age I never got to see any of this. I did get to see pregnant women die from COVID in the ICU while we were cutting their dying fetuses out of them , one never stops learning in medicine. You can hate on this all you want, and I invite you to stand in my shoes . Sarcasm font off.
I am an OBGYN just a couple years older than you. Grew up in East Tennessee, so no fluoride and no regular dental care and I have all the flashy (non cosmetic) dental interventions. I did not deliver a baby with congenital rubella syndrome but cared for a few young women with those devastating defects. Doubt anyone will recognize them now but I’ll never forget.
Good article. BTW VP and Marty are a breath of fresh air in the FDA. Unfortuantely they work under RFK Jr. He may have a few good points but overall what you see is what you get: A low character hack/nut who continues to believe the MMR vaccine(s) cause autism and the government is using our commericial airlines to poison /mind control us (chemtrails). RFK Jr is not looking for unbiased evidence. He is looking for any piece of information that can remotely confirm what he already believes. I appreciate Adam and SM supporting robust debate. I am a layman and benefit from their approach to conservative medicine. JFK Jr needs to be challenged when necessary. If he isn't I will have to exit Sensible Medicine....
Thank you Larry.
The benefits of fluoride in water sounds astronomical, I wonder why other countries don't do it. Imagine how much it would save public healthcare annually!
Unless the cavity statistics comparing the US and their numbers are largely the same, perhaps because over the last 50 years the practice of removing food bits from the mouth with stiff hairs on a stick became routine. Fringe scientists might even claim that digesting fluoride has little dental benefit compared to topical applications of fluoride paste, and the improved dental hygiene of the world is unrelated to fluoridated water. Those poor unenlightened countries just continue to fall for junk science.
Some countries have areas where the water already has an ideal level of fluoride, or too much, as in parts of India and China. Some European countries sell milk or salt supplemented with fluoride. And in some countries, the anti-fluoridationist hold sway.
A community needs a population over 1500 to make fluoridation affordable.
If fluoride levels were the cause of cavity rate reduction in the US, why have all western countries cavity rates dropped substantially and to eqally low levels since 1970? But ignoring that entirely, by what mechanism does passing fluoride through the digestive tract improve dental health? Should proper advice be to swallow toothpaste for maximum effectiveness, or can brushing be replaced entirely by a split second water rinse?
If that seems silly, perhaps advocates for fluoridating who recognize any benefit is via contact-bonding with teeth should promote fluoridization for solid foods which maximize the interaction between teeth and fluoride with a process known as chewing, or recommend holding water in the mouth for 60 seconds between drinks and discouraging use of straws which bypass contact entirely.
The parallels between "add fluoride to water to make people's teeth healthy" and "remove foreskin so men can keep their genitals clean and healthy" are greater than optimal.
Ingested fluoride is absorbed from the gut and is attracted to bones and tooth enamel (via saliva). Acid in the mouth continually erodes tooth enamel, so when you have fluoride in saliva, it is continually rebuilt.
Swallowing toothpaste would help teeth and bones, except that the soap elements in toothpaste would cause belly ache. Fluoridated water and the foods made from it still keep a better, more consistent level of fluoride ions in saliva.
All forms of dental hygiene contribute to healthy teeth. Fluoridation is just getting the ideal amount of a mineral that naturally occurs in ground water – it is a mineral nutrient, like calcium and iron, that humans evolved to need for strong bones and teeth.
Shakespeare said “brevity is the soul of wit”
I think “satire is a soul of wit “
Bravo!
Ben Hourani MD MBA
Citing an official HHS document for fluoride's benefits doesn't provide actual evidence of fluorides benefits. And I wonder if you will agree with all the official HHS documents that will come out in the next few years and just follow them blindly in your practice or just the ones that come out while your ideological party endorses them? Perhaps instead of honing in on sarcasm, you could hone in on the critical review of the literature. This substack literally teaches you how to do it! Without VP to provide an evidence based perspective, I worry this substack is not going to make it ...