Fincher: Choosing a side on fluoride

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“Dan’s feet are sore; he’s yearnin’ for just one thing more than water … cool, clear water.” – from the song “Cool Water” by Bob Nolan

Going as far back as the previous century, one might compare the competency of the Birmingham Water Works to that of the Legion of Doom, the bumbling opposition to the cartoon Super Friends.

Whether that comparison is an insult to the Birmingham Water Works or to the Legion of Doom should tell you all you need to know.

But this is not a column on the longstanding problems of the Birmingham Water Works, now rebranded as Central Alabama Water. It is about a recent decision made by its management to stop adding fluoride to its water supply.

A Central Alabama Water spokesperson told WVTM-13 reporter Bryce Oselen that the decision was based solely on cost savings and safety concerns for employees who handle the fluoride additive.

This might be true, but the timing is interesting due to a growing political debate on the addition of fluoride to water pumped through public systems.

Last year Florida and Utah passed bans on public utilities adding fluoride to their water, and there are efforts to ban fluoride at various state and local governments throughout the country. There seem to be two main lines of reasoning behind this movement.

The first is that by adding fluoride to a public water supply, people are not given the opportunity to provide their consent to the fluoride addition – meaning, in theory, fluoride might be forced upon people who do not want it.

The second is people have become concerned fluoride might have some detrimental health effects.

The first reason seems a bit silly since no one is forcing you to drink tap water. NBC News correspondent Mirna Alsharif reported Florida Gov. Ron DeSantis tried to turn that question on its head to defend Florida’s fluoride ban saying, “There’s nothing preventing you in your house from adding fluoride to your water.”

This may be possible, but it is certainly not financially feasible or safe to attempt for most people, so that is a silly stance to take.

The reason involving possible negative health effects at least makes more sense. While low levels of fluoride prevent tooth decay, overexposure can harm teeth and weaken bone structure.

There have been numerous scientific studies on the negative health effects of fluoride, but these are usually from foreign countries where fluoride is more likely to occur naturally in groundwater at several times the recommended level here in the U.S.

Of greater concern is a Canadian study stating there could be a connection to expectant mothers’ absorption of fluoride and a small drop in IQ among the boys who were birthed by the mothers involved in the study.

The problem with that study is, so far, no one has been able to replicate it. Replication means if you follow the exact steps taken in the original research and get the same or very close to the same results, the original findings are much more likely to be legitimate.

That has not yet happened, and other experts have called some of the study’s research methods into question since it was published. Until it is replicated, the link between fluoride and IQ should be considered shaky at best.

The problem with removing fluoride is it takes away an easy victory for public health for no important or legitimate reason. Water fluoridation, where it is available, may be many people’s best bet against poor dental health, and it is cheap and easy to provide.

In 1999, the U.S. Centers for Disease Control and Prevention (CDC) listed water fluoridation as one of the 10 greatest achievements of public health in the 20^th century.

Tooth decay and adult tooth loss saw dramatic declines over those 100 years with safe water fluoridation believed to be a major factor in this success.

In 2024, the Retirement Systems of Alabama’s newsletter, The Advisor, published an article from Alabama Department of Public Health state dental director Tommy Johnson.

Johnson stated every $1 spent on water fluoridation saves $20 in dental visits. He also pointed out Alabama ranks 51^st in the country – with Washington, D.C., included – in dentist-to-population ratio, and seven of the state’s counties have only one or zero local dentist.

It is popular to doubt science right now. Nonetheless, if you are claiming fluoride supporters like the American Dental Association, the World Health Organization, the American Academy of Pediatrics, the CDC and others are all conspiring to worsen your well-being, then maybe you are just rotting your teeth to spite your face.

Brandon Fincher is an academic journal editor at Auburn University. He lives in Opelika with his wife, daughter and two Labrador retrievers. You can find his writing at brandonfincher.com.