The longstanding public health practice of adding fluoride to public drinking water systems in the United States is facing new challenges and bans in some places, and experts have warned that the change would come with significant costs – both to the health of children and the health care system. A new modeling study, published Friday in JAMA Health Forum, estimates that removing fluoride from public water in the US would lead to 25.4 million excess decayed teeth in children and adolescents within five years, along with $9.8 billion in health care costs. After 10 years, these impacts would more than double to nearly 54 million excess decayed teeth and $19.4 billion in costs. That translates to one additional decayed tooth for every three children in the US – but the costs wouldn’t be spread evenly, said Dr. Lisa Simon, an internal medicine physician with Brigham and Women’s Hospital and co-author of the new study. “We know that the people who have the most benefit from fluoride are people who otherwise struggle to access dental care,” says Simon, who has been researching dental policy for a decade. “When we think about those 25 million decayed teeth, they’re much more likely to appear in the mouths of children who are publicly insured by Medicaid or come from otherwise low-income families.” Fluoride is a mineral that can be found naturally in some foods and groundwater. It can help prevent tooth decay by strengthening the protective outer layer of enamel that can be worn away by acids formed by bacteria, plaque and sugars in the mouth. Adding fluoride to public water systems started in the US in 1945 and has been hailed by the US Centers for Disease Control and Prevention as one of the 10 greatest health interventions in America in the 20th century In 2022, close to two-thirds of the US population was served by community water systems that had fluoride added to them, according to CDC data. But US Department of Health and Human Services Secretary Robert F. Kennedy Jr. said in April that he would tell the CDC to stop recommending that fluoride be added to public drinking water, and lawmakers in two states – Utah and Florida – have banned the practice this year. To estimate the effects of removing fluoride from community water, Simon and co-author Dr. Sung Eun Choi from the Harvard School of Dental Medicine assessed clinical oral health data from the National Health and Nutrition Examination Survey to create a nationally representative sample of US children. At baseline, the data showed that about 1 in 5 children between the ages of 2 and 5 were estimated to have dental caries, a chronic infectious disease involving tooth decay and cavities, along with more than half of children ages 6 to 12 and more than 57% of teenagers. But removing fluoride would raise those prevalence rates by more than 7 percentage points, the researchers found. “This is a huge cost for our country and it’s all avoidable. There is no better replacement for the time-tested, doctor trusted use of fluoride in community water programs,” Dr. Brett Kessler, president of the American Dental Association, said in a statement. “No amount of political rhetoric or misinformation will change that good oral health depends on proper nutrition, oral hygiene and optimally fluoridated water, or fluoride supplements if community water programs lack fluoride.” On the campaign trail last fall, Kennedy called fluoride “industrial waste” and claimed that exposure has resulted in a wide variety of health problems, including cancer – claims that both the American Cancer Society and the CDC have disagreed with. And in April, HHS and the US Environmental Protection Agency announced that they would study the potential health risks of fluoride in drinking water – a review centered around a government study from last year concluding that higher levels of fluoride are linked to lowered IQ in children. In the new modeling study, researchers found that only about 1.5% of US children in 2016 had exposure to this excess level of fluoride – considered to be above 1.5 milligrams per liter – that posed risk for fluorosis, a condition that leaves streaks or spots on teeth, or other harms. Meanwhile, about 40% of US children had access to optimal fluoride levels that effectively prevent tooth decay – between 0.6 and 1.5 milligrams per liter – while about 46% had access to even lower levels. The authors of the new study did not assess the neurocognitive effects of fluoride because “current federal guidance does not find an association” at the levels used in public drinking water. They found that removing fluoride would only help prevent about 200,000 cases of fluorosis over five years. Tooth decay can mean a lot of things, Simon said, but their model was picking up cases that would likely need at least a filling along with severe cavities that could turn into a root canal or a tooth extraction – the costs of which would be borne by families, insurers and the government. “Talking about money, which is really important, is only one way to measure that cost,” Simon said. “It’s also a cost in terms of children being in pain, children not being able to eat, children missing school or not being able to pay attention in school because their teeth hurt, parents missing work, children losing teeth that are supposed to stay with them for their entire lives, and those children growing into older adults who are more likely to be missing teeth with all of the health consequences that entails.” Forecasts in the new modeling study mirror real-life impacts that were measured in other parts of the world after fluoride was removed from drinking water. Calgary, Alberta, stopped putting fluoride in its water in 2011, and a study found that children there had more cavities than those in cities that kept fluoride. Calgary will resume fluoridation this year. Simon worries the effects in the US might be even greater because of health inequities that are especially pronounced in the dental care system. “We’ve had fluoridated water for so long and it’s worked so well that we’ve stopped appreciating the amazing things it’s done,” she said. “When something has been a success story for 80 years … you don’t know which kid never got a cavity because they were exposed to fluoride, and we don’t know which older adults aren’t wearing dentures because of that.”
Removing fluoride from public drinking water may lead to millions more cavities in US children, study estimates
TruthLens AI Suggested Headline:
"Study Warns of Increased Cavities and Healthcare Costs from Removing Fluoride in US Water"
CNN
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TruthLens AI Summary
The addition of fluoride to public drinking water in the United States, a practice that has been in place since 1945, is facing significant opposition and potential bans in several states. A recent study published in JAMA Health Forum highlights the potential consequences of removing fluoride from community water systems, estimating that such a change could lead to 25.4 million additional decayed teeth among children and adolescents within five years, resulting in approximately $9.8 billion in increased healthcare costs. Over the span of a decade, these figures could escalate to nearly 54 million excess decayed teeth and $19.4 billion in healthcare expenses. Dr. Lisa Simon, co-author of the study, emphasizes that the greatest impact of fluoride removal would be felt by children from low-income families or those covered by Medicaid, who already face barriers to accessing dental care. The study's findings underscore the importance of fluoride in preventing tooth decay, particularly for vulnerable populations who benefit most from this public health intervention.
Fluoride has been recognized for its role in dental health, with the Centers for Disease Control and Prevention declaring its addition to water systems as one of the top health achievements of the 20th century. However, recent political rhetoric has sparked debates over its safety, with some officials suggesting the cessation of fluoride recommendations. The study, which utilized data from the National Health and Nutrition Examination Survey, found that the prevalence of dental caries among children could increase significantly if fluoride were removed from water supplies. Concerns regarding fluorosis, a condition resulting from excessive fluoride exposure, were also addressed, indicating that only a small percentage of children are affected by higher fluoride levels. Dr. Brett Kessler, president of the American Dental Association, remarked that the benefits of fluoridation are undeniable, and the potential consequences of its removal could lead to not just financial burdens but also a decline in children's overall health and quality of life. The study's predictions align with observations from other regions, such as Calgary, which experienced increased cavities after halting fluoride use, further emphasizing the critical role of fluoride in public health.
TruthLens AI Analysis
The article sheds light on the potential consequences of removing fluoride from public drinking water in the United States. It highlights a recent study published in JAMA Health Forum that estimates significant increases in dental issues among children if fluoride is banned. The analysis explores the underlying implications, societal perceptions, and possible motivations behind this news.
Public Health Concerns
The article emphasizes the public health ramifications of discontinuing fluoride use in drinking water. The research suggests catastrophic increases in dental decay among children, particularly affecting those from low-income families who already face barriers to accessing dental care. By quantifying the potential health costs, the article seeks to raise awareness about the importance of fluoride in preventative dental health.
Target Audience and Perception
This news likely aims to reach parents, public health officials, and policymakers to provoke concern and discussion around dental health and public health policy. The focus on vulnerable populations, such as children from low-income families, fosters a sense of urgency and social responsibility. It suggests that the decision to remove fluoride may disproportionately affect those who benefit the most from it, potentially mobilizing advocates for public health measures.
Possible Hidden Agendas
While the article presents data from a credible study, one might question if there is an agenda to sway public opinion against fluoride bans by exaggerating the negative outcomes. The emphasis on financial costs and health implications could be a tactic to reinforce the status quo, especially given fluoride's historical significance in American public health.
Manipulative Elements
The news piece employs a narrative that may invoke fear regarding children's health outcomes, which could be seen as manipulative. By stating that each child would have one additional decayed tooth, it personalizes the issue and may lead to emotional responses that push for continued fluoride use without addressing broader discussions about the safety of fluoride itself or the motivations for its removal.
Comparative Context
When compared to other health-related news, this article fits into a larger narrative concerning public health policies. It may be connected to ongoing debates about government regulations, healthcare access, and socio-economic disparities in health outcomes. This broader context suggests that discussions around fluoride could intersect with wider issues of health equity and access to care.
Economic Implications
The projected financial burden of increased dental care costs may resonate with policymakers concerned about healthcare spending. If fluoride is removed, there could be increased pressure on Medicaid and other public health systems, which might prompt discussions around funding and resource allocation.
Community Support Dynamics
The article seems to cater to communities concerned about children's health and public health advocacy groups. It may also attract support from dental associations and healthcare providers who recognize the value of fluoridation in preventing cavities.
Market Impact Considerations
While the article does not directly address financial markets, the implications for dental products and services could be significant. Companies that produce fluoride products or dental care services may see changes in demand based on public perception and policy decisions stemming from this issue.
Geopolitical Relevance
In a global context, the conversation about fluoride use can reflect larger discussions about health care policies and public health strategies. It may not have immediate geopolitical implications but aligns with ongoing debates about health interventions worldwide.
Artificial Intelligence Influence
There’s a possibility that AI tools were used in the analysis or presentation of the data. However, the language and framing seem more aligned with traditional journalistic practices, focusing on factual reporting rather than AI-driven narratives. If AI was involved, it might have contributed to the optimization of the article for readability and engagement.
In summary, the article presents a compelling argument for the continuation of fluoride in public drinking water, highlighting significant public health risks and economic implications. The concerns raised about children’s dental health are grounded in research but may also serve to rally support for maintaining established health practices. The reliability of the information presented appears strong, as it is based on a peer-reviewed study, although the framing may influence public perception.