A 2024 meta-analysis found that while water fluoridation was very effective pre-1975, the most recent evidence suggests a small improvement in reducing decay and missing/filled teeth. In fact, it seems that it helps approximately one-quarter of a tooth.
And if you’re thinking that it sounds like basically nothing,
You’re right.
The study I debunked did have some useful data (amazing, I know) – report a 5.29% reduction in cavity-related Medicaid claims in fluoridated counties – essentially, out of 1,000 kids, it’s about 3-4 fewer decay-related visits per year. There are some red flags though:
- This is based on billing data, not real-life data, so we don’t know if the % of kids actually had fewer cavities or just didn’t go to the dentist yet.
- Medicaid populations often have low dental access, meaning many cavities go untreated and unreported. If you haven’t been a part of the nightmare that is Medicaid + trying to find a dentist that takes it…Let’s say I hope you never have to.
I have said that fluoridated water was one of the greatest American public health initiatives. But the truth is, as medical science has been getting better at public health messaging relating to brushing teeth, flossing, mouth breathing, reducing sugar, using fluoridated toothpaste, and more areas that impact cavities, it appears that—in the data—central fluoridation is not as effective as it used to be.
There’s a lot of nuance to unpack here. We need to consider:
- How health insurance works (and doesn’t) in the US
- How inaccessible dental care is to most people
- The effects of mental health on dental outcomes
Based on our current water fluoridation levels, we are well within the safe limits that should not impact IQ according to most recent evidence. Read through this article to learn about all the research on fluoride and cognition, including the safe limits- especially if you are pregnant or breastfeeding.
At the end of the day, it’s honestly really complicated.
And, at the levels we currently consume, it’s likely not something that we need to worry about too much. However, it’s important to be mindful of the research and remember that it changes all the time. After all, both humanity and science is dynamic.
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