What is it about fluoridated water that incites such intense reactions from relatively small opponent-groups (pro-Fl vs. anti-Fl)?
The 2019 manuscript by Green et al (attached) is still a top citation in JAMA – maternal fluoride intake may adversely affect offspring IQ,….that is concerning.
Schluter et al’s recent manuscript from New Zealand (attached) captured my reading-eye because the word “neoliberal” is in their excellent Discussion. The authors argue that community fluoridated water unequivocally improves oral health, yet is thwarted as an evidence-based public health measure by a relatively small minority. Why? How?
Worth mentioning – usage of the word liberal is quite different today compared to The Enlightenment (John Locke, Adam Smith, and others). “Liberal” in the 17th and 18th C meant mankind has basic natural rights of freedom and individual choice (Latin liber – free), an inherent dignity that should not be violated by Church, Monarchy, or State. Today, liberal has morphed to a more common-good conception, an expanded social contract role of government to monitor and regulate interactions among individual groups,……and conservative (in political terms at least) today more resembles classic liberalism of yore.
Schluter et al use the word neoliberal to point out the constant tension/irresolution of public health measures that appear to benefit the majority but can (should?) be legitimately opposed by an active minority. Where do we draw the line of demarcation? How do we negotiate complex and costly healthcare issues rationally and yet meet the growing demands of population health missives,……simplistically put – “Here’s $11,000 per patient per year,….spend it on healthcare however you communally decide, but you’re not getting more.”
Do we have a grander, more fundamental challenge in 2020 than implementing compassionate, reasoned, consensus-based population health strategies? Isaiah Berlin, the prescient philosopher of Ideas, astutely argued that history shows liberty and equality to be competing values,……a zero-sum game.
Joe Kaempf, MD
District VIII Member Extraordinaire
Portland, OR
Volume 3, Number 34
I find the Green article confusing at best. Your comment in the main body of your essay as to “concerning”, in my opinion is not justified, and just feeds into the “anti-Fl” agenda. The findings, though real and of statistical significance, in my opinion have little clinical relevance. Yes, I’d rather have 4 more IQ points than not. But the maternal levels and intake needed to generate the effect on offspring (male only ?) are not documented as obtainable, not the is effect of decreased intake when Fl supplemented water supply is present in the community. In my opinion, having my mouth full of crowns and implants, and with two children in their thirties that have had one cavity between them, the long term effects of poor oral care are pretty significant, much improved with a comprehensive PLAN for oral heath in our youngsters. At present, pediatric dentists have flouride treatments and we have flouride drops to give to toddlers, etc. So is this argument at this point even relevant?