If there is one piece of scientific literacy that I wish the entire world had, it was the concept that toxicity is a function of dose.
Yes, fluoride is toxic. The EPA limit for fluoride is 4ppm, and that is probably too high (something like 2ppm would work better). There are parts of the country where the natural incidence of fluoride in groundwater is in excess of 4ppm, and therefore defluoridation needs to be done.
Fluoridation of drinking water is done to a standard of 0.5-0.75 ppm (US Public Health Service specifically recommends 0.7). Most of the country lives in places where the natural ground water concentration of fluoride is below this level, and thus fluoridation is necessary to reach the recommended level.
the real debate is on whether the toxicity of fluoride outweighs the benefits of using it to prevent tooth decay.
we know that it can cause issues. there are also issues that have not been measured.
a lot of folks forget that unless the outcome of X is death or cancer etc ... it is often not studied. your quality of life can be greatly reduced by something but if it doesn't kill you then no one is looking at it.
I won't argue about that being the best solution, but as someone that did not start to take dental health seriously until their 30's I don't think I'm in any position criticize others for their failure to do so.
It is toxic, it's rat poisoning. Do the lower levels of tooth decay outweigh the risks? So far they have decided yes in many places but that is changing (like lead pipes)
Fluoride in drinking water is a kind of truly marginal level of harm that’s perfectly designed to trigger paranoid libertarians.
A tiny amount of fluoride is helpful for bones and especially teeth. Fluoridated toothpaste covers this need perfectly, but many people don’t use it. Fluoride in drinking water covers this need also but (arguably) brings along small risks of symptoms of slight excess fluoride consumption.
The amounts that are actually put in drinking water do not seem to have any significant negative effects, and it seems reasonably clear that the population positive effects dominate, but being non-consensually subjected to a marginal risk of negative effect in order to achieve a positive outcome for the population is exactly the kind of thing that reliably provokes this kind of reaction from the paranoid libertarian set.
You'll notice one key thing is missing: Side by side comparison with communities that don't have fluoride in their water. That could be other countries. Or better, rural US communities that for the most part use well water. Those controls exist.
Note: Better diet also has an impact on oral health, and diet over the last 75 years has also improved.
I'm not saying not including that comparison is wrong, but as "the science" goes, it does feel odd that something so obvious is not included.
Peer-reviewed research isn’t a great standard, imo, for many reasons. There are sources available, ultimately it seems to turn into an ideological battle. FAN [1] probably has the most links out to different sets of research. Really it comes down to making your own decision, which is why I don’t think it should be automatically added to the water supply. Fortunately there are options to remove it.
Depends on the topic. If you're trying to prove (or, more accurately, fail to falsify) a certain set of results or a discovery, open data plus reproducibility should be the gold standard.
If you're trying to make decisions about personal health, it pays to take a cautious approach (IMO) and let people decide for themselves. It is not inconceivable that commercial entities finance "peer-reviewed research" in order to support public health policies.
A small but important reframing: I agree that (open data) + (reproducibility) + (review) is a better bar than any one in isolation.
(This applies to empirical sciences only. In contrast, for a mathematical paper, rigorous reviews of the formal logic are the gold-standard.)
I choose the phrase 'review' intentionally; it doesn't need to follow one of the typical [1] 'peer review' processes from a journal. There are likely alternative methods that are (at least as) or (more) effective. Some fields have seen amazing contributions from 'lay people' all across the world.
> If you're trying to make decisions about personal health, it pays to take a cautious approach (IMO) and let people decide for themselves.
For a person equipped with the time, skill, rationality, and motivation, I agree. But it is an empirical question to assess how many people have these skills. I also want to push back against what might be an individualistic bias [2] in the statement above. Even if one is an individualist, it isn't optimally efficient nor practical for an individual to 'take on' all this responsibility. It is rational and efficient to place some degree of trust in others.
[1] These processes vary and should be treated with a fair bit of skepticism. I want to to dig in more; e.g. to what degree have these processes been designed to account for human realities so as to maximize quality?
[2]: See also https://so2020.isosonline.org/conference/the-individualist-b... "Individualism claims that social entities (e.g. groups, institutions) are essentially nothing but suitably arranged aggregates of individuals. This is usually tried to be demonstrated through developing accounts of reduction or supervenience. Holism, on the other hand, claims that social entities are sui generis as something over and above individuals."
Peer review means someone knowledgeable about the subject read the paper and didn't spot anything wrong. They almost never attempt to reproduce anything.
Do you have a peer reviewed source on that? Major usually implies 50%+ . Are you saying that 50%+ of the peer reviewed scientific papers out there bogus and fraudulent?
I don’t think 50% or greater is a good standard for defining what we would consider to be a major problem with scientific fraud. I’m sure you’re well aware that “major” can refer to relative impact depending on the context of the issue being discussed. In the case of scientific publishing, I would argue that even 5% fraud rate would be grounds for labeling this as a major problem.
That said, this issue has received a lot of attention in recent years. Some articles try to put a positive spin on it but the stark truth of where we are today is that there are no standards enforced requiring data publishing (“available on request” doesn’t cut it) and reproducibility. This, combined with the amount of money in this industry and the impact that it has on public policy is an acceptable situation.
(This one puts a positive spin on the editorial process but the fact remains that there is a massive flood of fraudulent papers being published. Going back to standards of open data plus verified reproducibility would go a long way to mitigate this problem.
Replicated research. Peer review is when journals ask other researchers to look at a paper and determine whether it's suitable to be published. Attempting to replicate the findings is typically not part of the peer review process, peer review is a sniff test.
It’s fine to disagree, but please add something to the discussion. Remember, HN guidelines say the conversation should get more substantive as it goes on, not less.
