Late last year, the LA Times ran a fascinating series  on the rise in lethal yet legally prescribed prescription drugs. One pain specialist they interviewed had 16 patients die from drugs he had authorized – the highest total among doctors in four Southern California counties.
He said any patient death from an overdose was unacceptable, but added that he has treated thousands of patients successfully with the same drugs.
“Are we willing to trade that?” he asked. “Are we willing to withhold pain medications from everyone?”
Fluoride-defenders sometimes ask a similar question: Though too much fluoride can cause damage, are we willing to let kids – especially those in the poorest communities – lose their teeth to decay?
Of course, this presumes that fluoridation is, in fact, effective – a claim that has been widely questioned . As Pizzo and Pizzo sum it up in their 2007 paper in Clinical Oral Investigations, “It is now accepted that systemic fluoride plays a limited role in caries prevention.”
And still it gets touted as a silver bullet.
Yet consider a new study  in the International Journal of Paedeatric Dentistry. Its aim was simple enough: evaluate the oral health of preschoolers and identify risk factors for caries. The authors focused on Singapore, “a 100% urban community with majority of the population living in a homogeneous physical environment.” It’s also a fluoridated community.
Yet nearly half the children examined had active decay! (In the US, 42% of children aged 2 to 11 have had some decay, according to NIH figures.)
This is a highly effective intervention? So effective that it justifies dosing everyone at the same levels, regardless of individual risk?
The risk factors for severity of decay…include child’s age, breastfeeding duration, and parents’ ability to withhold cariogenic snacks from their child.
Were low-risk kids virtually caries-free, at least, thanks to all the fluoride they swallowed? Unfortunately, the abstract of this paywall-protected paper doesn’t say.
It does suggest fluoride isn’t enough.
The high caries rate suggests that current preventive methods to reduce caries in Singapore may have reached their maximum effectiveness….
Image modified from winnifredxoxo , via Flickr