A Dentist’s Perspective on Water Fluoridation

I am a pediatric dental specialist who respects fluoride’s historical role in advancing public oral health but who now questions the appropriateness of systemic fluoridation in contemporary clinical practice (“The Folly of Investigating Fluoride Toothpaste,” Letters, May 20). The public-health rationale for fluoridating municipal water was compelling in the mid-20th century, when alternative methods of delivery were limited. That’s no longer the case. Children now routinely receive fluoride through toothpastes and professionally administered topical treatments—interventions that are effective, safe and tailored to individuals without systemic exposure.

Systemic fluoride, however, enters the circulatory system and accumulates in osseous tissue. An expanding body of research has associated chronic ingestion with skeletal fluorosis, diminished bone resilience and elevated fracture risk. These findings are no longer theoretical abstractions: Geriatric and adolescent fracture rates are surging, and orthopedic practices in numerous regions have reported exponential growth, suggesting a possible link to cumulative fluoride burden.

Moreover, the practice of delivering a pharmacologically active agent via the public water supply—without regard to age, weight, medical history or informed consent—is incongruent with modern standards of ethical, patient-centered care. It is time to re-examine outdated public-health dogmas. Fluoride remains a valuable tool but one best employed through targeted, evidence-based delivery that maximizes benefit while minimizing systemic risk.

Original article online at: https://www.wsj.com/opinion/a-dentists-perspective-on-water-fluoridation-supply-health-children-822d8e54