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National Fluoride Ban Could Lead to Millions of Rotten Teeth, Billions in Costs
A new study published in JAMA Health Forum paints a grim picture of oral health in the U.S. should fluoride be removed from public water systems. Researchers predict a potential surge of 25.4 million additional cavities in children within five years of a nationwide ban, escalating to a staggering 53.8 million within a decade. This translates to roughly one decayed tooth for every three children in the short term, more than doubling the current rate of childhood cavities.
The analysis, conducted by Dr. Lisa Simon of Mass General Brigham and colleagues, utilized data from the National Health and Nutrition Examination Survey, a comprehensive CDC-led study.
Researchers modeled two scenarios: optimal fluoride levels in all public water systems, and a complete national ban. The financial implications are equally alarming, with projected costs reaching $9.8 billion over five years and $19.4 billion over ten years just to fill the anticipated cavities.
These figures don’t account for additional procedures like anesthesia, long-term restorative care, or lost wages for parents attending to children’s dental emergencies.
The study comes at a critical juncture as fluoride faces increasing scrutiny, fueled in part by recent policy changes at the Department of Health and Human Services. Two states, Utah and Florida, have already banned fluoride in public water, and others may follow suit.
Dr. Tom Reid, president of the Wisconsin Dental Association, underscored the study’s significance, stating that it provides further evidence of the long-established benefits of community water fluoridation in preventing cavities.
Beyond the immediate pain and expense of fillings, severe tooth decay can lead to cracked teeth, chewing difficulties, gum disease, and infection. The study highlights the disproportionate impact such a ban would have on low-income families and children reliant on Medicaid, who often face barriers to accessing dental care.
The historical precedent of Calgary, Canada, offers a cautionary tale. The city removed fluoride from its water supply in 2011, only to witness a sharp increase in childhood cavities and ultimately reinstate fluoridation a decade later.
While opponents of fluoridation cite concerns about tooth discoloration (fluorosis) and potential cognitive effects, the study downplays these risks. Researchers found that a ban would result in only a minor reduction in fluorosis cases, a primarily cosmetic issue.
Furthermore, they did not include potential cognitive impacts in their model, citing a lack of definitive evidence linking current fluoride levels to negative neurobehavioral outcomes in the U.S. The study emphasizes that while removing fluoride may offer a slight reduction in mostly cosmetic dental issues, the potential for widespread tooth decay and its associated health and economic consequences are far more significant.