Op-Ed: IQ is preferable to teeth in fluoride debate

Fluoride in public water supplies has just been one of those things that’s a fact of life. Aside from a few fringe conspiracy theorists floating the idea that it was actually a communist mind control plot, most Americans, including myself, just accepted the benefits of this nearly universal practice essentially as settled science.

Where I grew up and still live today, in rural northeast Louisiana, we drink water from a well, so questions surrounding fluoridation did not rise to the level of a second thought.

That all changed when a fascinating news article came across my feed one day, saying that it had been proven in court that fluoride above a certain level in water supplies lowered IQ. This came as somewhat of a shock.

After a little digging, I discovered that multiple studies have shown this effect. There have also been some studies showing that children of mothers who drink water with fluoride while pregnant have a slightly lower IQ.

In the year or so since that court case became news, there has been a lot more discussion surrounding fluoride, and I have done some reading on the subject, specifically in preparation for my role as surgeon general at the Louisiana Department of Health, where we regulate a multitude of water systems.

Interestingly, most of the fluoride that goes into water supplies is a chemical byproduct of fertilizer production. In Louisiana, we currently require that it be added to water systems serving over 5,000 people.

As is true in just about every scientific debate, there are studies saying that it does not reduce IQ, that it’s totally safe, and those studies may be correct. But one thing is clear: This is not settled science, and there are compelling arguments on both sides of the debate.

The American Dental Association claims this practice is necessary because it reduces tooth decay by 25%, which seems low if the potential tradeoff is IQ. Just one point of IQ reduction across a population could have profound negative effects on the future.

Another problem is that there is very poor control of the dosing. Some people may never drink anything but fluoridated city water, but others may drink bottled water or water from wells. In the practice of medicine, when you give someone a drug with a specific intended effect, dosing is always critical, and in the case of fluoride, it is all over the map.

Furthermore, the people have no choice in the matter. If you live in the city, you get it whether you want it or not, and if you live in the country, it may not be available at all.

This question closely parallels those surrounding synthetic dyes in food. We should be asking ourselves how we allowed this chemical to be forced upon us in the first place.

Those who want fluoride should be able to get it at the dentist’s office, and if evidence of clear benefit is compelling, insurance should probably be inclined to cover the cost. Certainly, that seems a better option than drinking something every day for your entire life.

As is the case for all medical decisions, we must weigh the risks against the benefits and make the best decision we can. From my perspective, the summary of fluoride as it stands today, with much uncertainty surrounding the practice, comes down to a simple question of what do we value more: IQ or teeth?

I would choose IQ and I hope the Legislature and the people of Louisiana choose the same.

Dr. Ralph L. Abraham M.D. is the Louisiana Surgeon General.