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Covering the science of water fluoridation Date: 07/03/13

Kyle Hill
Kyle Hill

By Mary Otto

Around the country fights over water fluoridation have made news in recent months.

Public health officials and dentists can show years worth of evidence that fluoride, when present at optimum levels in community water supplies, reduces tooth decay. But opponents protest that fluoride at any level is dangerous.

Late in May, Portland voters rejected a decision to fluoridate the city’s water.

Kyle Hill quickly weighed in on his Overthinking It blog for Scientific American in a piece titled "Why Portland is Wrong about Fluoride."

Hill, a freelance science writer who tackles a wide variety of topics, was good enough to share a few thoughts about his coverage.

Question: How did you decide to zero in on the Portland fluoride vote?

Hill: “Though I cover a lot of nerdy things, science is my passion, and nowhere does science come more into question than for controversial topics like fluoridation. The Portland story was a good opportunity to stand up for good science. Like other controversial topics such as vaccine safety and climate change, the data on the safety and efficacy of water fluoridation is in. There is no question that it is beneficial and safe (and saves us a great deal of money), so I think that scientists and science writers should stand up for science when it can actually make a difference in everyday life.”

Question: You summed up the decision of the Portland voters as a case of "chemophobia," saying:

"Fluoride—an aggressively electronegative atom with an extra electron—has been singled out for scrutiny with a smear campaign. The charge against this negatively charged particle uses propaganda laced with a high concentration of fear-inducing terms and mischaracterizations to rally a small but highly vocal base."

What do you think is at the heart of this fear of a chemical?  What inspires fluoride critics?

Hill: “Chemophobia isn't confined to fluoride, or really any specific aspect of the chemical itself. I find chemophobia to be a general dislike for anything chemical (though chemophobes forget that everything is a chemical). Though we regulate the levels and have proved it safe, I think simply adding anything to our water, especially fluoride scares people. You tell a person who may not know very much chemistry that the government is putting a chemical in your water, and it is aimed at your kids, and I understand the fear. But again, it's our job to stand up for good science. Chemicals can be amazingly good for us.

“Fluoride critics generally take two stances. They either dispute the science or argue for ‘freedom.’ The science isn't in question. There is one Harvard study showing decreased IQ in high-fluoride areas in China, but it's a review that actually has nothing to do with water fluoridation in the United States. Any other questioning of the science has to be cherry-picked or contorted exactly because the evidence for water fluoridation's benefits is so one-sided.

"‘Freedom’ is another issue. Opponents will argue that no other medicine is inserted into the water supply, and therefore it's their right to choose. But public water is a public resource. The government does have the authority to regulate public water (as long as everything is safe, of course). The U.S. also puts nutrients into bread and milk, but you don't see the same opposition there. If opponents want the freedom to put whatever they want in their water, they should get a private well (and a dental plan for their kids). Water fluoridation is so amazingly successful that it should be available to the public. It might even be immoral to refuse it to people, knowing how much good it does.”

Question: Have you written about other cases of "chemophobia?" If so, how do they fit in with the fluoride question?

Hill: “I haven't written much about other cases of chemophobia, but on the fluoride issue, I like to point out chlorine. It's another additive to public water, regulated to safe levels, that has enormous public benefit. Imagine a county or city refusing to have their water chlorinated.”

Question: Do you have a sense of what drives the continuing "smear campaign" against fluoride?

Hill: “The opponents of fluoride are a small group, but highly vocal. They have to be to overcome all the evidence against them. Because of the weight of evidence, they seem to constantly feel "suppressed" and "oppressed." When you feel like the underdog, or David fighting Goliath, I suppose you get a bit rowdy. I think the popularization of the smear campaign masks the fact that this is small group who doesn't really have an evidential leg to stand on.”

Question: You ended your piece with this point: "Until political questions are seriously informed by scientific answers, fear and freedom beats facts." Do you see a way for that to happen? If so, how?

Hill: “Issues like these aren't just objective, they affect people emotionally. From what we know psychologically, I doubt that straight-up facts will ever fully remedy an anti-science position. As science communicators, we have to stress accuracy instead of encourage defensive, emotional thinking. Of course, we could always use people on government science committees who actually believe in science, and more scientists and engineers in government positions. It's a long, hard fight, supporting good science. But we have to do it, if for nothing else than to save a few teeth.”