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Sixty seconds on . . . water fluoridation

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2359 (Published 24 September 2021) Cite this as: BMJ 2021;374:n2359

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Re: Sixty seconds on . . . water fluoridation

Dear Editor

I don't understand how fluoridation could be deemed a success when evidence out of the US shows it has failed to achieve its objective - to prevent tooth decay, save money, close the disparity gap, put dentists out of business and keep Americans out of the hospital for dental conditions with only 10% of children afflicted with the mildest, little noticed form of fluoride fluorosis. After 76 years of fluoridation reaching record numbers of Americans:

• 70% of US children and adolescents are afflicted with dental fluorosis (1) – much of it moderate/severe – requiring expensive cosmetic dentistry (2)
• Tooth decay is epidemic, according to the American Association of Pediatric Dentists (3)
• In 1950 there were 42 dental Schools. Now there are 68.(4)
• 16,555 were enrolled in dental school in 1969-70. Now 25,995 are enrolled, the most ever. (4)
• Dental spending reached a historic high of $136 billion, according to the American Dental Association (5)
• Dental hospital emergency room visits doubled from 1 million in 2000 to 2.2 million in 2012, costing 1.6 billion dollars annually. (6)
• Dental disparities persist (7)

Maybe, as in the US, UK children are “dentist-deficient” and need dental care; not fluoride?

References:
1) Ecotoxicology and Environmental Safety: "Associations of low level of fluoride exposure with dental fluorosis among U.S. children and adolescents, NHANES 2015–2016" https://www.sciencedirect.com/science/article/pii/S0147651321005510?via%...

2) Dentists advertisements to cover fluorosis
http://tinyurl.com/DentalFluorosisBeforeAfter

3) Contemporary Pediatrics https://www.contemporarypediatrics.com/view/tooth-decay-epidemic-among-t...

4) American Dental Association "Then and Now Dental Education in the US" https://pages.ada.org/ada-news/dental-education-then-now?utm_campaign=AD...

5) Dentistry Today: "Dental Spending Increases in 2018"
https://www.dentistrytoday.com/news/industrynews/item/5981-dental-spendi...

6) USA Today: "ER visits for dental problems rising" https://www.usatoday.com/story/news/local/2015/06/24/er-visits-dental-pr...

7) Int J Environ Res Public Health. 2019 "The Persistence of Oral Health Disparities for African American Children: A Scoping Review" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427601/

Competing interests: No competing interests

27 September 2021
Carol S Kopf
writer
Levittown, NY, USA