Health

Water fluoridation: a Comprehensive View of the Debate

Medicine / By

Introduction:

The debate over water fluoridation (adding extra fluoride to community water) started in the 1960s, about ten years after the National Fluoridation Program was launched. Now, about 2/3rds of communities in the United States have fluoridated water to help prevent cavities. This is often referred to as one of the best achievements in public health in the last century. However, the United States is one of the few countries that does this, and, with Health Secretary RFK Jr. planning to tell the CDC to stop recommending water fluoridation, debates over water fluoridation have intensified. With there being a lot of debates over the Health Secretary himself, this debate in America has become increasingly political with both sides of the debate ignoring facts and ethical concerns that do not align with their political beliefs. So, this will be a comprehensive analysis of information on both sides to allow you to better understand this issu

Concerns:

There are a lot of studies about the ethical problems with water fluoridation and the medical issues it could potentially cause. The most major concern that people have is with having too much fluoride. The Department of Health and Human Services suggests having .7 milligrams of fluoride in every liter of water you drink, while the World Health Organization says that 1.5 milligrams per liter is needed to risk negative health effects. After the fluoridation process though, there is no possible way to control how much fluoride each person intakes. This is because some people, such as athletes and diabetics, have to drink more water than other people do. How much water people drink also depends on where they live because people in warmer climates usually drink more water than people who live in cooler areas. 

Some people might say that fluoride is completely safe because it is in toothpaste. However, when the fluoride is in the water, you ingest it and then about 50% of that ingested fluoride accumulates in places such as your tissues and bones. Having too much of this fluoride can cause skeletal fluorosis, which is a bone disease that causes bone/joint pain because the bones can become hardened and then be less elastic. This makes fractures more likely and can cause less joint mobility. Among other things, too much fluoride can also hurt a person’s parathyroid gland, which can cause hyperparathyroidism. This causes there to be less calcium in your bones and more calcium in your blood.

There are also concerns about the effects excess fluoride can have on children. For young kids, it could cause mild dental fluorosis where there are noticeable, yet harmless, white specks or streaks in their teeth’s enamel. Ingesting extra fluoride also has no benefits and only risks for infants younger than one years old. 

Finally, there is the ethical concern about forcing people to take medicine. This concern is actually why most European countries do not fluoridate their own water. Every person legally has the right to choose if they take a medication or not, and a lot of people question if water fluoridation violates this right. All of these combines issues make people wonder if community-wide water fluoridation is actually a good solution.

Benefits:

No matter the concerns, water fluoridation has been going on for decades in America for a reason. First of all, fluoride promotes teeth’s remineralization, meaning that it makes people’s enamel stronger so their teeth are better at fighting bacteria off. This reduces how quickly your teeth decay by 20-40%. By providing this fluoride to communities automatically, it saves people money on the dentist. This helps vulnerable communities more than you might think. When water is fluoridated, it diminishes oral health disparities where the economically disadvantaged have less access to dental care than others. The true impact of this is that when analyzing economics, it was found that if a person has less cavities, they are more likely to earn higher wages as an adult. 

To find out if water fluoridation really does have meaningful effects or not, a 2018 study was done about the city of Juneau, Alaska. In 2007, Juneau had stopped the fluoridation of water in their community. The team that performed this study went through youth’s dental records between 2003 and 2012. They found that in 2003, before the decision to stop water fluoridation, there were only 853 teens and young kids who needed dental care. In 2015, that number rose to 1,052. The study’s authors also found that “The odds of a child or adolescent undergoing a dental caries procedure in 2003 was 25.2 [percent] less than that of a child or adolescent in [2012].” Overall, this study shows how much of a positive impact fluoridation has while also exposing the dangers of stopping this practice. 

Conclusion:

While water fluoridation remains a hotly contested topic, some of the impacts can not be ignored. One on hand, cavities dropped by 60% in kids after the practice started. On the other hand, it is widely considered medicating without permission and could have adverse effects on people if not done properly. Debates over ethics and medicine have persisted for centuries, and this one is no different. Health Secretary RFK Jr. can not stop water fluoridation though. He can only stop the CDC from recommending it, and, if that happens, the choice to fluoridate water or not will be left to individual communities. So, no matter the politics, the debates over water fluoridation will last long past his decision and it is likely that a lot of communities will continue with this practice. 

References:

Brazier, Y. (2018, February 21). Why do we have fluoride in our water? Medical News Today. Retrieved May 12, 2025, from https://www.medicalnewstoday.com/articles/fluoride-toothpaste#toothpaste-ingredients

Public Health on Call. (2024, November 26). Why Is Fluoride in Our Water? | Johns Hopkins | Bloomberg School of Public Health. Johns Hopkins Bloomberg School of Public Health. Retrieved May 12, 2025, from https://publichealth.jhu.edu/2024/why-is-fluoride-in-our-water

Unde, M. P., Patil, R. U., & Dastoor, P. P. (2018). The Untold Story of Fluoridation: Revisiting the Changing Perspectives. National Library of Medicine. Retrieved May 12, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC6309358/

Microplastics are everywhere — but are they dangerous?

Ecology, Immunology, Medicine, Science / By

Originally perceived as a marine issue, with oceanographers estimating a total of 15–51 trillion microplastic particles floating on surface waters worldwide, scientists have recently discovered that these tiny particles can contaminate rivers, soils and air. Furthermore, these minuscule particles have been found in a range of food, human stool, and even made their way into some of Earth’s most remote regions; including the poles, the equator, and even Mount Everest.

Plastics are a group of materials, either synthetic or naturally occurring; used in numerous applications in our daily life. They are the third most abundant material, after concrete and steel, and are used in countless sectors; ranging from medicine to transport.

Microplastics are microscopic fragments of plastic debris, that usually emerge from plastic litter due to sunlight exposure, which causes the material to degrade and weaken over time; they can also come from plastic items due to wear and tear. For instance, up to 1.5 million microfibres, a type of microplastic, can be released per kilogram of clothing during a wash. Remarkably, even opening a plastic bottle can create thousands of microplastics. One may ask, are humans ingesting these minute particles?

The short answer is: yes, with the discovery of microplastics found in stool verifying this question. As of today, microplastics have been found in foods and drinks, mainly bottled and tap water, salt, dust, and more. According to a study conducted in Queensland, researchers studied samples of rice from different countries around the world, detecting microplastics in every sample; whether the rice was grown in Thailand, India, Pakistan, or Australia, and packaged in plastic or paper. In an interview, Dr Jake O’Brien, a lead author for Environmental Health Sciences, states “Washing the rice reduced the amount of plastic likely to be ingested. But the study used special filtered water for rinsing, and most households only have access to tap water; which contains microplastics.”

There currently isn’t enough evidence to say that microplastics are harmful, as the topic is relatively new. A lack of information and research surrounding the phenomenon is scarce, as scientists aim to establish an evidence base. Prof Ian Musgrave, a toxicologist at the University of Adelaide, expresses “Knowing if microplastics are harmful to humans is hard to untangle when we are exposed to so many other substances. While we are consuming things that have tiny amounts of microplastics, we don’t absorb them. But because we can’t demonstrate damage, that’s not a reason to be casual.” Additionally, this explains why multiple studies on the ingestion of microplastics by marine animals, can’t completely isolate the impact microplastics have against all the other pollution and pressure they are exposed to in the environment, as it’s difficult to perform.

Likewise, there are emerging studies on the effects of ingesting high levels of microplastics in rats and mice, concluding that high levels of microplastic accumulation can affect reproduction. Nevertheless, it is more likely that the smaller the particles the greater the potential to cause harm, as smaller specks have an easier chance of entering cells or tissues; however, quantifying these issues and understanding where they come from is a challenge.

While the debate is still ongoing as to whether microplastic could cause harm, you may still wish to limit your exposure. To limit your exposure, you can drink filtered tap water, and choose natural-based products over plastic for yourself and your environment will help reduce microplastic exposure. Overall, minimising microplastic exposure globally requires a substantial effort to limit the release of plastics, and microplastics, to the environment. Reducing plastic waste, washing your clothes less often, and bringing your own bag whilst shopping; all can contribute to limiting plastic release and even production; thus decreasing microplastic exposure.

Whatever the solution, it’s important that it’s better for both the planet and people.