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PaperclipPerfector  1yr ago (text post)   34204 thread views

Culture War Roundup for the week of November 4, 2024

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So, what's the deal with Fluoride in the water anyway?

According to this tweet by Marc Andreesen, a U.S. government review has concluded that Fluoride in the drinking water lowers IQ's in kids. The literature reviewed suggests that high levels of exposure reduce IQ's by 2 to 5 points.

If so, this would absolutely dominate any conceivable benefit from putting the stuff in the drinking water.

And it also seems largely unnecessary given that fluoridated toothpastes and mouthwash exist. Drinking the stuff is an incredibly poor intervention compared to, you know, actually applying it directly to our teeth.

Assuming Anddreesen's tweet is true (which I assume by default given his status as a top venture fund leader), this is absolutely scandalous.

One of my neighbors asked me if I gave my child fluoride pills now that we live on well water. I stifled a gasp and asked her to describe what she was giving her kid. Apparently her dentists said kids without city water need fluoride and this kid takes fluoride pills--like swallows them. I asked the woman if she understood how they work and she admitted she didn't know. Rather than kill the party I said it was interesting and went straight home and re-researched the topic to make sure I actually understood what I thought I understood: fluoride is a topical treatment to help re-build tooth enamel.

Not only did I remember how the stuff works and learned a bit more, but I discovered that it's insanely difficult to get good information. It's almost all propaganda that says, "fluoride prevents cavities! Trust us!" Effectively, fluoride ionizes existing chemicals in the mouth to boost enamel creation, which is a natural process. There is literally no benefit to consuming fluoride and it's clearly a dangerous chemical to ingest in large quantities. (https://journals.lww.com/jpcd/fulltext/2020/10020/how_fluoride_protects_dental_enamel_from.3.aspx)

I also learned that the guidelines for public water fluoridation had recently been dropped from 1 mg/L to 0.7 mg/L (https://www.cdc.gov/fluoridation/about/community-water-fluoridation-recommendations.html) and that there is actually a problem called fluorosis that will ruin your teeth. And besides...who even drinks tap-water anymore (except us Motters) amiright? It's looking bad for water fluoridation!

The thing that blew me away was the oft repeated claim that fluoridation lowers cavities by 30%. The best I could find was that health experts in the 80's found the addition of some fluoride to the water resulted in fewer cavities across the population but I found no evidence where it discussed the actual effect per individual. It really seems like a case of bad numeracy to me, where no one bothers to ask, "30% of what? how?" and everyone just presumes they'll have 30% fewer cavities if they even think about it that hard.

I feel like the real problem here is a lack of scientific curiosity on the part of dentists who just swallow the fluoride story in large breathless gulps.

I feel like we're living in the dark ages of dentistry. There's apparently also no data to support flossing or dental x-rays.

I stopped flossing about a decade ago. Yep, still no cavities. I'm going to drop the x-rays too. Cavities seem to be mostly a function of what kind of bacteria lives in your mouth + sugar consumption. I have the good bacteria, lucky for me.

In terms of fluoride, I'm going to do some research on how people suppose that fluoride is actually supposed to prevent cavities. Is it via consuming it orally? Because, if so, it's strange that there are also a bunch of products that APPLY IT DIRECTLY TO THE TEETH. Like you, I feel like there's not a lot of good information. The comments in defense of fluoride here have definitely not reassured me.

Anecdotally, I have used a high fluoride toothpaste in the past and it reduced teeth sensitivity.

Why can't we just put it in mouthwash and toothpaste and let people make their own choices?

Edit: I spent some time talking with Claude AI about this issue and it was strangely non-cucked and helpful. Yes, it would seem that topical application of fluoride is likely to confer more benefits than drinking it, and without the potential downsides. This seems like a no-brainer. The one exception is that children may need some fluoride while teeth are forming. Nevertheless, they get it from food anyway. I might look into a way to test and filter fluoride levels.

Anecdotally, getting a water flosser device has greatly improved how my mouth and gums feel. I’ve never been a big flosser, have never had a cavity either. But that water pick thing is really nice.

The two questions I have are

  1. Did the study convincingly show a causal link?
  2. Is it a priori plausible that IQ is so sensitive to a naturally varying element which is sometimes found in much greater concentrations?

Is it a priori plausible that IQ is so sensitive to a naturally varying element which is sometimes found in much greater concentrations?

You mean like lead? Yea, I think that's plausible.

Is it normal to have dangerous levels of lead in natural water supplies?

Water is a universal solvent, it's normal to have all sorts of shit dissolved in it, depending what rocks are in the aquifer. Mine has so much iron you can pick up the used sand filter with a magnet.

Iirc it wasn't a big deal in the old days before effective pumps, because people mostly lived off surface water of various kinds (where it has little contact with the bedrock and the worst you can get is, uh, cholera). But even natural spring water can be full of sulphur, lead, copper, mercury, arsenic, radium, oil, methane, etc.

https://youtube.com/watch?v=CVGeQepBlqk I remember watching this news story out of abeline, Texas. A California judge used a fluoride study to sue the EPA to stop putting fluoride in the water. The city of a Elise used this as an excuse to remove fluoride from their water, while stressing that their fluoride situation was nothing like the one in the study, and their fluoride levels actually meet the guidelines.

Water fluoridation is one of those things that always astounds me and reminds me how completely different the past was, politically and in terms of social cohesion and trust in science, experts and all that. The idea that a few scientists could run a few relatively short-term experiments (just a few years) and see a relatively minor benefit (tooth cavities hardly seems like an existential crisis) and based on this get the government to introduce a chemical to the water supply nationwide without facing widespread riots or resistance is just insane to me. I'm not trying to claim that fluoride is harmful or anything like that, just that the public seems to have had such complete trust in politicians, scientists, public health officials, bureaucrats and the media to accept it is an amazing demonstration of how different things are. It is an oft raised lament that "we don't build anything anymore" or that we aren't capable of the large-scale works of the past and I think this is directly related to that. I think there needs to be a certain level of blind trust in authorities to enable that which is a bit of a two edged sword.

It is becoming very hard for me personally to reconcile my lament that "we don't build anything anymore" with my own anti-conformist and stubborn opposition to things like covid lockdowns and covid vaccination as I think they are in direct opposition to some extent. As I've gotten older I have come to believe that public consensus and trust in institutions is more important than the actual content of that consensus or the 'correctness' of those experts and institutions, but at the same time I remain skeptical and stubborn. Does anyone else relate to this conflicted feeling?

Nothing was more "move fast and break things" than entire neighborhoods of kids riding their bike behind "the fog truck" spraying DDT everywhere.

I've often thought, "If they just told us what the trade offs were and were honest about it, they'd get my vote," but I doubt that's a winning strategy.

Just walking around a seeing the number of old people who don't have any teeth makes me think cavaties are actually a massive problem, still, despite water fluoridation. I'm sure it would be much worse without it.

Old people lose their teeth due to periodontitis, not cavities, usually.

In the particular case of fluoridating water, the ruling elite had a good story. Scientists knew that naturally occurring levels of fluoride varied from place to place. Did it matter? They did the epidemiology thing and decided that less than one part per million made tooth decay noticeably worse. More than four parts per million caused dental fluorosis, but nothing else showed up strongly with natural levels of fluoridation. So topping up fluoride to bring low fluoride water up to one part per million seemed super safe; lots of people were already living with 1ppm. And had been for their entire lives. It was a rare case where we have data (albeit epidemiological) on all cause mortality, due to pre-existing "natural experiments".

... without facing widespread riots or resistance is just insane ...

Your confusion is the result of a garbled account of events. That is bad in itself, but I want to make the case that it is important to say that "topping up" and "adding" are different and that the claim that we "add" fluoride to the water supply is a lie.

First I will offer paradigms of "topping up" and "adding" and then make my case that things can go horribly wrong if we tolerate people confusing them.

Topping up Measure the level. If it comes in at 0.5 ppm, add enough to increase the level by 0.5 ppm. Measure again. If it is in the range 0.9 to 1.1 ppm declare victory. If outside that range, find out why, and adjust appropriately.

Adding Don't bother measuring, or if some-else has measured, just ignore it. Add enough to increase the level by 1 ppm. Continue to fail at measuring and be smug that the level is at least 1 ppm because our addition guarantees that out-come.

Now picture a town debating water fluoridation. Why? Well, Mr Bad Guy hopes to get kick backs from the contracts for fluoridation equipment and chemicals. He persuades his fellow citizens to top up fluoride levels at public expense. They vote for it. Mr Bad Guy sets it in motion. The measured natural level turns out to be 1.3 ppm. There is nothing to be done. No contracts, no kick backs. Mr Bad Guy looks around and notices that nobody is watching. He arranges contracts for equipment and chemicals to add enough fluoride to increase the levels by 1 ppm. He pockets his bribe money. Fluoride levels increase to 2.3 ppm. Mr Bad Guy feels safe. No-one will notice 2.3 ppm and if he falls under suspicion for corruption, he can always say that he misunderstood.

Later Dr Nerd measures the fluoride and checks the records of the old measurements. Dr Nerd is unhappy about the waste of public money, or about the dangers of fluoride, take your pick. He tries to "blow the whistle". But what language does he speak? If he uses the vernacular he complains that we are adding fluoride to the water supply and we shouldn't be doing that, we should instead be adding fluoride to the water supply [sic]. Nobody understands his point. So he switches to Nerd-speak and complains that we are adding fluoride to the water supply when we should be topping up; very different. Topping up is free! But the towns-folk don't speak Nerd-speak, so Dr Nerd still fails to make himself understood.

Talking about topping up fluoride levels using the word adding is bad. It covers up corruption and is why we cannot have nice things.

Is this an actual thing that happens with any regularity? And even if it is, I'm skeptical that trying to teach the public scientific jargon will fix it.

A much better solution for Dr. Nerd-boy here would be to use vernacular language like a normal person instead of like an idiot. "The town government is wasting money adding extra fluoride to the water supply, when our water already had enough fluoride in it naturally!" Boom, now everybody understands what he's talking about.

But the language of "adding" rather than "topping up" has erased the concept of already has enough fluoride in it naturally. The idea is missing from the discourse. Lots of ordinary people have naturally occurring fluoride in their drinking water and have no idea that it has always been like that. Dr Nerd's third attempt at making his point will make not make sense to those people and they will ignore him.

We can tell that the idea of already has enough fluoride in it naturally has been erased from the discourse, simply by listening out for the missing follow-up questions. When some-one is on the media, arguing against fluoridation on the grounds that the recommended level is a health hazard, the interviewer questions them. The obvious line of questioning is "What about places with naturally occurring fluoridation? Do you advocate removing it? How? Are the health problems actually showing up? There have been multiple life times for them to appear!" But the obvious questions don't occur to the interviewer. The concepts have somehow gotten erased :-(

Yes, it would be nice if reporters interviewing anti-flouride activists would ask about this. Genuine, hard-hitting reporting is a rare and valuable thing in all sorts of fields, alas.

I do continue to wonder, though, whether your scenario of a town official deliberately adding unnecessary extra fluoride in exchange for kickbacks from the fluoride company has ever actually happened anywhere, and if it did happen how the situation was handled once it became public knowledge.

the claim that we "add" fluoride to the water supply is a lie.

And this is an extraordinarily bad idea. Any time you take a statement which is clearly true in vernacular speech, and try to tell normies it's false because Science(tm) has assigned a different definition to one or more of the component words, you are lowering the general public's respect for science and scientists.

You are right to press me on whether my corruption scenario has ever actually happened. My gut feeling is no, never. But the past few years have wrecked my world view, and I fear that I am old and have been left behind while the world changes.

Back in March 2021 I had the Astra-Zenaca mRNA vaccine for COVID. How dangerous could it be? I knew that the messenger RNA would cause my cells to produce the protein that the snippet coded for. Scary! But I knew that that is what happens in a viral infection, and what happens when you take a "weakened" vaccine. Indeed Edward Jenner's original cowpox vaccination for smallpox is doing the same thing; spoiling the host for the smallpox virus by getting host cells to produce a shared protein and getting the host to produce anti-bodies to it. I was a science enthusiast and marveled at the invention of mRNA vaccines.

I saw public health as a nerdy area, and took it for granted that traditional standards of safety and efficacy would be upheld. I was disappointed. The https://meaningness.com/geeks-mops-sociopaths dynamic had played out while I wasn't paying attention. The blot clots and myocarditis problems would have lead to the swift withdrawal of the vaccines when I was young; but the world had moved on.

My current understanding of how the world works goes something like this:

It is year N and Mr Blackpill has noticed that the incentives tend towards corruption. He claims that year N is already corrupt. It isn't. Mr Blackpill is undaunted; he claims that dynamics created by the incentives are fast acting and predicts that year N+10 will be corrupt. Nope. Mr Blackpill has complete faith in his reasoning and in human avarice. Year N+20 will definitely see a corruption scandal. Mr Blackpill is wrong again.

Eventually year N+30 arrives and with it a big corruption scandal. Mr Blackpill was right in the end. Worse, it turns out that the corruption is entrenched and hard to root out. It has been going on for fifteen years. Mr Blackpill was right about N+20. There are a variety of forces that tend to hide scandals and when they break out into the mainstream it turns out those in the know had been complaining, correctly, for many years.

Returning to adding versus topping up. I see the language here as one of those forces that tend to hide scandals. Ecbatic not telic. I don't know whether we are in year N, year N+10, or year N+20. Mostly I don't know because I'm not in the business. But I cannot know by reading the newspapers. People complain about fluoride being added to the water supply and I'm left to guess that they mean topping up. If there was a scandal of the kind that I speculate about, adding, not topping up the news reports would say much the same and the I wouldn't be any the wiser. It would be the year N+20 situation, where there is corruption but still ten years to go before the facts break into mainstream news.

At the end of the day, my guess is that there just isn't enough money in water treatment to attract the avaracious, and the potential for corruption goes unrealized. But the clumsy language, that stands ready to hide it if it ever happens, still give me the ick.

the claim that we "add" fluoride to the water supply is a lie.

And this is an extraordinarily bad idea.

I'm aware that I completely lack the common touch, so it is best that I defer to your expertise here. I would be interested if you had any ideas on how to push back against the confusion of adding and topping up.

IMO the best thing to do to clear up fluoride confusion is to remind people that it is a naturally occurring mineral, and therefore many water sources naturally contain some, without any human intervention. I suspect most of the anti-flouride sentiment would go away if people understood that, and the language question of adding vs topping up wouldn't make much difference.

Does anyone else relate to this conflicted feeling?

Every damn day. I have an uncomfortable blend of paleoconservativism and libertarianism in my blood, and I've already resigned myself to the reality that I'll never be able to resolve the conflicts between the two. The best way I can cope with the conflict is to follow my gut moral intuition when I approach an issue where they conflict.

Yes. The decay in the trust of institutions in the western world is already a massive problem , that will only get worse. You are exactly on point in my opinion. Trust might matter more then absolute truth . I am certain that lack of trust precludes substance and correctness in the long term. Lack of trust in each other and by extension in the institutions that govern us , renders us ineffective at best.

Is the problem a lack of trust or a lack of trustworthiness? Are they more trustworthy than we think? Or is it good for us to believe they're more trustworthy than they are?

As I've gotten older I have come to believe that public consensus and trust in institutions is more important than the actual content of that consensus or the 'correctness' of those experts and institutions, but at the same time I remain skeptical and stubborn. Does anyone else relate to this conflicted feeling?

No. Reality matters. A consensus contrary to reality is a disaster in the making, and trust in untrustworthy institutions is foolish and counterproductive.

I have a big issue with your statement. It sounds correct but in my mind doesn't stand up to scrutiny. What is reality? Who decides that exactly? How can you decide whether an institution , whether that is the police or whoever , did their job correctly? Are you capable or even interested in judging each and every move they make ? And what do you do with that judgement? Do you just use your judgement ( whether right or wrong) to fuel hatred and distrust? Because you are probably not using it to make a a practical change. So what is it? What is the goal? The cornerstone of society is trust. Trust has to be blind up to a logical point.

I have a big issue with your statement. It sounds correct but in my mind doesn't stand up to scrutiny.

Yes, but I'm not concerned about whether it stands up to scrutiny in your mind; I am only concerned about whether it stands up to scrutiny in reality.

What is reality? Who decides that exactly?

Let us say the institutions claim there is definitely no train coming down a set of railroad tracks. Reality is what decides whether someone standing on the tracks when that train arrives gets crushed or not.

A month later but yeah. I am surprised you have 16 likes considering you basically say nothing of substance and don't reply to my point but I guess the reddit virus is strong here as well. The fact that you think reality is such a clear thing leads me to believe this isn't a fruitful discussion and I am wasting my time but in any case.

We are not talking about a train coming down the tracks are we now? We are talking about complex issues that are not as clear. Unless you are ready to consider a big chunk of world population that doesn't have the same opinion as straight up crazy then you must admit there is a big amount of complexity right there. Does that realization elude you or what?

You just got warned to stop doing this, and you immediately go dig up a month old post to revisit an argument?

You're clearly not new here and everything you post so far is a sneer. You can argue and disagree with people without slighting their intelligence or waving your IAmVerySmart flag. Stop doing this or you will be banned.

How was any of this a sneer? He literally says nothing of substance in response to my point , why is it an issue when i highlight it? I wasn't overtly offensive or anything like that. In fact I will argue that he began with the sneer remarks with this comment 'Yes, but I'm not concerned about whether it stands up to scrutiny in your mind; I am only concerned about whether it stands up to scrutiny in reality.' .Which was unnecessary and missing the point.

What is reality?

That which does not go away when you stop believing in it.

Who decides that exactly?

No one decides it. It happens regardless. If you do a bad job planting your crops, people starve. If you do a bad job enforcing the law, chaos and violence reigns. If you do a bad job protecting your borders, foreign armies victimize your populace.

How can you decide whether an institution , whether that is the police or whoever , did their job correctly?

For the police, you derive a general understanding of what their job is by examining the laws they're supposed to enforce, and their actual enforcement of those laws, measure it versus the costs of maintaining them and the general realities that add friction to the system.

Are you capable or even interested in judging each and every move they make ?

Random sampling and statistics help a great deal here.

Do you just use your judgement ( whether right or wrong) to fuel hatred and distrust? Because you are probably not using it to make a a practical change.

That is certainly a thing people can do. For example, the BLM movement spun out of a coordinated attempt by Blue Tribe to generate hatred and distrust by pushing misinformation about the actual performance of law enforcement, resulting in a very large and quite partisan disconnect between public perception of police misconduct and actual rates of misconduct. And the result is that tens of thousands of additional black Americans are now dead, and hundreds of thousands of additional Black Americans have been victimized by serious crimes. That was a practical change of the sort you are describing.

So what is it? What is the goal? The cornerstone of society is trust. Trust has to be blind up to a logical point.

Alternatively, one can do one's best to verify that trust, and to withdraw it when one perceives that it has been repeatedly violated. It is always possible that one has been deceived, though, so it's best to keep an open mind to new evidence when it arises.

Its worth keeping in mind the pitfalls of the media landscape. A fund manger posts screenshots of an AP article to 1.5M followers, with the incisive commentary "wait, what?!" What does the payoff matrix look like in this environment?

On one hand, information is spread widely and quickly. Great! On the other hand, I have an aunt who has long told me that Hitler put fluoride in the water to shrink the pineal glad of the populace, reducing their creativity and making them obey. She teaches anatomy and physiology at a community college, and loves listening to Coast To Coast on the AM radio. Crank it up fuckers!

But what does the article say? Well, the AP reported on this "long awaited study" two months ago. We didn't find this out this until quite recently. However, it seemingly only applies to 0.6% of US water systems, and then again only to children and pregnant women. For adults, more study is needed. The 300 page report was done by the National Toxicology Program, part of the Department of Health and Human Services. In 2015 Federal authorities revised their recommended level of fluoridation down from 1.2 mg/L to 0.07mg/L. This study pertains to levels of fluoridation of 1.5mg/L and above. How much above? I don't know, but the WHO currently thinks that 1.5mg/L is safe. The EPA actually mandates that water systems contain less than 4mg/L, the impetus in that case being fluorosis. This study extends research done in China in 2006 about cognitive effects of fluoride - naturally occurring and otherwise - and wait, what!? This is fucking booooooring. A bunch of nerds debating a the effects of less than one PPM of fluoride in a country that already recommends half the level studied? Fuck that. Give me Hitler. Give me chemtrails. Inject me with autism. Lets blast some Coast to Coast on the AM radio!

I think it's worth noting that levels of fluoride in the water much higher than the recommended dosage are unlikely to be caused by intentionally dosing the water, and more likely to be caused by naturally high occurrencee of fluoride in the source water supply. So, if this were a scandal, the scandal would primarily not be the dosing of low levels of fluoride for dental health, but the laxity of the water safety regulations.

I wouldn't think so, because in the absolute worst case it shows the feds' old 1.5 limit was dangerously close to or exceeding the harmful-effects level, and ideally it should have all been filtered if possible. Give people the optimal topical dose through toothpaste.

(One reason I'm skeptical of any harm at <=1.5 doses is that the initial introduction of fluoridation should have had a pretty big and rapid -IQ signal, but... Could it have been drowned out by the fynn effect, which was peaking around the same time?)

Color me also skeptical, because otherwise one might expect to see noticeable IQ differences between the towns that don't add fluoride (famously, Portland) and the rest of the country.

Now, I have heard people suggest that "there must be something [not] in the water in Portland", but that is never followed by "and it's making them smarter than the rest of us."

Also - how many people even drink tap water anymore? (I am one of them, but my country chlorinates, not fluorinates the water). Almost everywhere around me is either bottled or filtered trough some britta like crap.

We have RO systems attached to our taps in my home, so I don't need Brita or bottled.

I would say almost everyone. I almost exclusively drink tap water.

I do!

I drink mostly tap water.

Depends on where you live; varying with the source tap water can be awful or quite tasty. The tap water in Toronto is delicious, in my opinion.

Many do, one of the reasons being that a lot of bottled water is literally just tap water.

I'm not joking- there was a study in the US earlier this year that upwards of 60% of bottled water is sourced from municiple tap water.

We can make the argument that a filter 'changes' it, but a lot of tap water is itself going through filters installed in homes / point of exit.

I drink it all the time. Most people in the lower classes do.

I have a Pur pitcher, but bizarrely... I like the way the tap water tastes.

I'm pretty comfortable and drink liters of tap water daily. Always have. I always saw drinking bottled water at home as low class coded, like buying furniture on credit, or keeping a cc balance. Who pays that much for water? Tap water where I grew up and live has been pristine. Superfluous bottled water at events, or premium branded water is the real divide in America. I'd bet that anywhere in the developed world the the risk adjusted ROI for drinking bottled water is massively negative barring govt alerts (ie blue baby).

I was always taught that drinking bottled water is a stupid waste of money.

It's convenient when leaving the house on a day trip or whatever, and it sorta takes up space that would otherwise be occupied by soda or juice boxes. My family kept a case of it in the garage fridge for that exact purpose. And we had well water.

Forgive me, I didn’t mean to imply that drinking bottled water was stupid in literally all circumstances, only that it would be strange to but it when properly treated tap water is a viable alternative.

I would normally refill a flask or old bottle from the tap if I wanted portable water, but I drink bottled water in countries where the taps aren’t safe or if I’m suddenly thirsty when out and about.

Agreed. I can't believe this whole planet fell for the scam, to be honest. I guess double-walled steel water bottles were more expensive in the 90s or something but...

The literature reviewed suggests that high levels of exposure reduce IQ's by 2 to 5 points.

Huh, I was worried that they were making a mistake like recreational ketamine (3g/day) causes bladder problems, therefore we must be wary of psychiatric ketamine (280mg/month), but the effect showed up at 1.5 mg/l vs. the EPA's limit of 4 mg/l in drinking water. Canada's recommendation of 0.7 mg/l is still pretty close to the studied dose.

Per the article, as of 2015 the US has the same 0.7mg/l recommendation as the upper limit. 0.6% of water systems in the US are above the 1.5mg/L studied. The EPA limit was arrived at separately, the impetus being fluorosis.

Cremieux recently did some Deep dives on fluoride

The tl;dr seems to be: fluoride might have tiny negative effects on cognitive ability, but they are so small as to be negligible

https://x.com/cremieuxrecueil/status/1853263599680061564

https://x.com/cremieuxrecueil/status/1826498294790414731

https://x.com/cremieuxrecueil/status/1754703750868910380

Eight of nine high-quality studies examining other cognitive or neurodevelopmental outcomes reported associations with estimated fluoride exposure. Seventy-two studies assessed the association between fluoride exposure and IQ in children. Nineteen of those studies were considered to be high quality; of these, 18 reported an inverse association between estimated fluoride exposure and IQ in children. The 18 studies, which include 3 prospective cohort studies and 15 cross-sectional studies, were conducted in 5 different countries. Forty-six of the 53 low-quality studies in children also found evidence of an inverse association between estimated fluoride exposure and IQ in children.

 

Existing animal studies provide little insight into the question of whether fluoride exposure affects IQ. In addition, studies that evaluated fluoride exposure and mechanistic data in humans were too heterogenous and limited in number to make any determination on biological plausibility. The body of evidence from studies in adults is also limited and provides low confidence that fluoride exposure is associated with adverse effects on adult cognition. There is, however, a large body of evidence on associations between fluoride exposure and IQ in children. There is also some evidence that fluoride exposure is associated with other neurodevelopmental and cognitive effects in children; although, because of the heterogeneity of the outcomes, there is low confidence in the literature for these other effects. This review finds, with moderate confidence, that higher estimated fluoride exposures (e.g., as in approximations of exposure such as drinking water fluoride concentrations that exceed the World Health Organization Guidelines for Drinking-water Quality of 1.5 mg/L of fluoride) are consistently associated with lower IQ in children. More studies are needed to fully understand the potential for lower fluoride exposure to affect children’s IQ.

Thanks!

Nineteen of those studies were considered to be high quality; of these, 18 reported an inverse association between estimated fluoride exposure and IQ in children.

That... seems very bad indeed. How is this not more well known in the general public?

I have to admit I always thought the anti-fluoride people were like weird anti-science hippies.

I have to admit I always thought the anti-fluoride people were like weird anti-science hippies.

There are "The government uses fluoride for mind control" types that get the most attention in the movement.

Feels like a poison-the-well tactic, no pun intended.

I did a deep dive a few weeks ago and thought about making an effort post of “Everything you wanted to know about Flouride”

But alas, I didn’t. Instead I’ll just drop this low effort summary:

  1. Recent studies are compelling
  2. (High probability) Fluoride is incredibly important for dental (and general health). Don’t pivot to the opposite extreme.
  3. (Moderate probability) Fluoride is bad for early development. Even at relatively normal levels of exposure.

Reasonable (according to me) responses:

  1. Don’t panic about your current consumption. It’s probably fine.

  2. IF YOU ARE PREGNANT, current evidence suggests it would be VERY WORTHWHILE TO TRY TO ELIMINATE FLUORIDE from your diet. Buy an appropriate water filter/purifier (not all remove it). Maybe even consider removing it from your toothpaste. 2a. If you have small children consider limiting their exposure.

  3. The magnitude of the effect is insanely large if true. National healthcare systems should be urgently prioritizing studies on it. This should be the number one priority study. ( the most compelling reason is that this would be an easy intervention. It’s not like we would have to tear out our entire infrastructure like with lead pipes. It’s about as close to flipping a switch as any intervention could ever be)

Since your post didn’t mention it: even more concerning than the IQ drop is the effect on rates of severe emotional/mental illness. That LA (?) study had some insane rates (if true).

*posting from phone so probably lots of typos. Sorry.

Edited summary #3 to add "Even at relatively normal levels." The interesting question is not: "can extreme levels of fluoride cause issues?" The interesting question is "Are current levels extreme?"

Maybe even consider removing it from your toothpaste.

Let's do the math on this. Toothpaste is about 0.1% fluoride. Typically you'll put about 1g of toothpaste on your toothbrush, so that's 1 mg of fluoride. If you ingest 10%, that's 0.1 mg. Fluoridated water is typically around 1 mg/L, so by using fluoridated toothpaste twice a day, you're probably ingesting about 10% of what you would get from two liters of fluoridated tap water. Not insignificant, but probably not a major concern.

On the other hand, if it's available in the US, hydroxyapatite toothpaste is a perfectly acceptable substitute, if a bit more expensive.

Agreed. Thanks for the note.

My inclusion of that line was intended to be more of a rhetorical flair to highlight how fluoride consumption is probably only relevant for the pregnant (and small children). Upon rereading I don't think I was successful at conveying that. The risk of using fluoridated toothpaste is likely to be zero or close to it.

My personal read of the evidence is something like:

If you are an adult in a 1st world country, don't sweat fluoride. If you are pregnant or have small children, maybe try to limit exposure when it's convenient. Don't freak out if your child drinks tap water at a friends house.

hydroxyapatite toothpaste is a perfectly acceptable substitute

Is it comparably well-studied? Devil you know and all that

hydroxyapatite is literally produced by your body. It's in your teeth and saliva.

Well if there's any point in putting it in toothpaste, it must be to increase the concentration way above that which is naturally-occuring. So I repeat the question.

Its functions appear to be neutralizing acids produced by mouth bacteria, and remineralizing enamel. Adding more mostly seems to counteract the higher acid levels generated by the modern diet. Fluoride apparently increases the effectiveness of both these functions better than just throwing morehydroxyapatite at the problem.

I expect it'd actually be a good idea for mothers anyway, since pregnancy makes it easier to lose teeth, but I'm going off anecdotes for that one.

Hypothetically, lets say the optimal societal solution to fluoride is the government injects the water, but pregnant women and new borns drink bottled water. What is the chance that society actually converges on this solution given the past policy decisions. Even if there was no past commitment from the government to the fluoride policy i feel like this would go down like a ton of bricks. Making people pay extra when they are making babies is not a popular policy position. But given a bunch of bureaucrats have committed to the fluoride i can't see them admitting there might be flaws in their approach.

Thanks for this.

Since you seem to know things, what's the mechanism for fluoride's prevention of dental decay? Can using fluoride toothpaste or mouthwash give us the positive benefits without causing the negative ones?

I wouldn't say I know things, or at least not these ones ;). It's not my area of expertise nor am I particularly interested in the question of "How does fluoride work?" (That being said... I think the current consensus on mechanism (https://en.wikipedia.org/wiki/Water_fluoridation#Mechanism) is pretty well supported - even the (smart) anti-fluoride folks agree. My, barely informed, take on the evidence is that topical applications can have the benefits with harms.)

My curiosity relates to the following three questions:

  1. Does fluoride work? Is it worth exposing oneself to at all? Answer: Yes
  2. Is it dangerous* at commonly observed levels of exposure? Answer: We don't know yet.
  3. Is fluoride skepticism a rational belief? Is there good evidence to even bother worrying about the impact on development? Answer: Yes.

*Dangerous is shorthand for the belief that "Water flouridation has a significant negative impact on a significant number of people". Note: this does not mean net negative. Even IF the evidence emerges that it is "dangerous", there is a good chance the benefits could still outweigh the costs

Afraid I don't remember the specifics (last looked at the evidence years ago, in the spirit of "honest reassessment of all widely-mocked right wing conspiracy theories"), but iirc there were Sailer Confounders on the IQ loss, and I wasn't convinced.

But yeah, I think putting literally any medication in the water supply is foolish. We try not to do it with livestock these days because you have no idea what dosage is actually being given. The same people who don't brush their teeth are likely to drink nothing but cola rather than tap water. And if you up the concentration to dose those people, you will absolutely give Water-Chugging Georg skeletal fluorisis.

When I was little kids got bottles of fluoride tablets from the county health department, which seems like a better option.

But yeah, I think putting literally any medication in the water supply is foolish.

You have to count the hits and the misses. Lets just concede that fluoride in drinking water was or is now a mistake. There is still chlorine/chloramine. Also gov't mandates and/or influence in the food supply: iodine, vit D, niacin, folate, iron, thiamine, riboflavin etc.

Interestingly, the gov't got I think niacin temporarily wrong, assuming the cause of pellagra was a corn heavy diet, delaying the addition of niacin. Which is fine I guess as extreme caution with the food supply is probably a good idea.

That sounds more dangerous to me, but it really depends on the amount in the bottles. AFAIK, the only known death from fluoride poisoning was a 3-year-old chugging a bottle of fluoride solution, but it was a bigger one at a dentist's office.

The main thing is that swallowing fluoride is fairly useless, and where the risks are. You want it to stay in your mouth.

Yeah in retrospect it actually doesn't seem great vs "literally just brush your teeth", but at least it was better for getting a measured dose.

What's a "sailer confounder"?

(and @jeroboam) I was using it in the general sense of "uncorrected for demographics because everyone knows you're only supposed to use proxies". It's not specifically blacks because the studies come from all over the world. Rural/urban demographics in every country are a unique complicated mess to untangle and don't respond well to a simple "correcting for income." The kitchen-sink "self-sufficiency index" in that one paper is a good example.

The exciting parts of these studies were the natural experiments with existing ppm differences with (ideally) no correlation to demographics. Unless Sweden banished all retards to the Speckle-Tooth Mountains sometime in the 1700s.

Presumably he is referring to Steve Sailer, who has written about the accuracy of stereotypes and is known for his Sailer's Law of Mass Shootings, and Sailer's Law of Female Journalists.

The implication, presumably, is that there are somehow more black people in the fluoridated group, and, furthermore that this is not being measured since the researchers falsely believe that all races have the same IQ. I don't know what the evidence for this claim would be though.

Surely the researchers would correct for income which would probably be good enough for fixing these problems.

I seem to be getting into a bit of a rut with my comments here (I guess I'm frustrated when people display certainty in something that I think is unfounded), but why would a venture fund leader have some premium access to the capital T truth that others do not?

Does your assessment of his accuracy change if, for example, you knew that he had spent 1 minute looking into the issue versus an hour?

Nothing about his tweet implies he looked into this issue in any depth. Maybe there ARE significant benefits that would outweigh the supposed drop in IQ. Maybe other studies found no such IQ drop at all. I have no idea whether this is true, but it seems like an error to dismiss all such claims as completely improbable right off the bat.

I'm not saying it's certainly wrong or a lie or whatever, but taking action based off this tweet seems rather premature

Edit: the report says that fluoride at DOUBLE the recommended limit had this effect. Is it really a scandal that a chemical provided above the recommendations set by health agencies would cause health problems?

Yeah, I believe him more than I do a random kook. He's proven to be intelligent and has a reputation to protect.

Obviously, this doesn't mean that he has access to special sources of truth, or that the government report he linked to is correct. But it does mean that the substance of the tweet is true namely 1) That there actually is a government report and 2) That is shows fluoride leading to a decline in IQs.

the report says that fluoride at DOUBLE the recommended limit had this effect. Is it really a scandal that a chemical provided above the recommendations set by health agencies would cause health problems?

Yes, this is a huge scandal. 1.5ppm, while more than twice the recommended level, is only 40% of the EPA limit.

0.7 = CDC recommendation for dental health

1.5 = Causes lower IQ's

4.0 = EPA limit

So a level of 1.5 is still well below the EPA limit. This could be a crisis on the level of lead paint and leaded gasoline. Imagine if we were putting lead in the water to prevent cavities, and then just assuming that the amount delivered to the consumer was the perfect amount to prevent cavities without causing negative effects. That's seemingly what we are doing here with fluoride.

Doesn't the actual article imply that this could only possibly effect 0.6% of water systems in the US? And even then only to children and pregnant women. And even then the cause is not government addition of fluoride, but rather government failure to remove fluoride below the separately arrived at EPA number?

If 1.5 ppm causes 2-5 points of IQ loss, how much does 0.7 ppm cause?

On the other hand, the benefits of fluoridation appear to be a (poorly studied) 30% reduction in cavities. That seems... minor. Especially given that fluoridated toothpaste exists which would appear to confer all the benefits with none of the downsides.

If 1.5ppm causes 2-5 points of IQ loss, how much does 1000ppm in toothpaste cause?

You're claiming this is a huge scandal on the level of leaded gasoline. Given what the report found, that seems hysterical.

2-5 IQ points are very important. Getting fluoride via toothpaste is superior solution.

He's proven to be intelligent and has a reputation to protect.

Being wrong about this would have zero impact on his reputation. Haters would put another hop in their gish gallop against him. Fanboys would ignore it or find some plausible deniability ("all he did was post a screenshot of a news article!").

Did Andreessen lose credibility when, despite having published "It's Time to Build", he hypocritically implored the city council not to build more housing? No. It is, as they say, already priced in.

So a level of 1.5 is still well below the EPA limit. This could be a crisis on the level of lead paint and leaded gasoline.

Only 0.6% of the population is on a water system with 1.5ppm or more of fluoride. Lead paint this is not.

Imagine if we were putting lead in the water to prevent cavities, and then just assuming that the amount delivered to the consumer was the perfect amount to prevent cavities without causing negative effects.

And water systems with such high levels of fluoride have it not due to fluoridation but due to groundwater with high concentrations of fluoride.

Did Andreessen lose credibility when, despite having published "It's Time to Build", he hypocritically implored the city council not to build more housing? No. It is, as they say, already priced in.

He seems to have lost credibility with you.

Not really. I still think that "It's Time to Build" was largely correct, and I've generally enjoyed listening to his appearances on CWT. If by "lost credibility" you mean I don't take his word about fluoridation, well, he never had it to begin with - that's not what he's for.

If 1.5ppm reduces IQ's by 2-5 points, what is the reduction in IQ's from the recommended level of 0.7? Keep in mind that the recommended level was 1.2 until recently.

Sure the 18 "high quality" studies might be wrong. I don't have a lot of faith in this area of science. But certainly the burden of proof needs to fall on those who would seek to add a chemical to the drinking water.

In any case, it's one thing to have a normalcy bias. I get it, normalcy bias usually points to correct outcomes. But to arrive at correct outcomes we also have to consider things outside the norm. Markets of ideas can't work if everyone just buys an index fund. Aren't you at all curious about this?

If 1.5ppm reduces IQ's by 2-5 points, what is the reduction in IQ's from the recommended level of 0.7? Keep in mind that the recommended level was 1.2 until recently.

The number is between zero and 2-5, assuming no hormesis. Based on Cremieux's arguments here, I lean towards closer to zero.

Markets of ideas can't work if everyone just buys an index fund. Aren't you at all curious about this?

Far be it from me to compel people to buy index funds. Let a thousand flowers bloom. For my part, I'm not convinced that there is a there there at all, and I don't see anyone making any argument that would suggest that the scale of the problem is anywhere near spewing lead from every tailpipe.

There also has to be someone buying puts for the market to function, after all.

It pretty might be that the discovered threshold is depedant on statistical power, maybe there's drop at 0.7 too, just we don't have enough power to detect it

Fair enough, my interest has been peaked after more skimming so I'm going to try to look more into the issue. I admit I am less skeptical now than when I saw your post. There are some governmental reports from my country on the topic as well that I'm going to look through and compare

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