Sunday, May 12, 2013

Why I am mad about the fluoride debate and how Portland could resolve this issue

The City of Portland is voting on if fluoride should be added to the public water supply in an effort to improve the dental health of the city.  This has caused a heated debate about the merits of adding fluoride that not only questions the effectiveness of fluoride but also the safety.  Unfortunately, like many policy debates today, this has quickly devolved into a very unproductive debate with some of the anti-fluoride side claiming that public officials have been paid off to add a poison to the water supply and with some on the pro-side calling the opponents conspiracy theory nutjobs.

From what I have read, I am of the opinion that fluoride is safe and probably effective.  What makes me mad at both sides though is that they are convinced that they are right to a degree that does not allow open dialog on the issue.  I am willing to concede that it is possible that fluoride will not be an effective strategy in decreasing cavities.  In addition, given that there are a couple of studies that question the safety of fluoride in the water supply, I am willing to concede that we should research this more.  This does not mean we should not add fluoride to the public water supply in Portland.  The research overwhelmingly points towards fluoride as being both safe and effective.  The few research papers that point toward it being harmful tend to be of poor quality or have been difficult to replicate.

What this means is that we should stop yelling at each other and come together to solve this question.  We are lucky in that this debate is an empirical question of the effectiveness and safety of fluoride.  Both the pro and anti side should sit down with researchers from OHSU and develop a research agenda that would solve this issue.  I think we should start adding fluoride to the water and then use the research agenda that all sides creased to see what the effects.  We have a unique opportunity to be the city that solves this problem for the world.  Instead of fighting about this issue, we should come together as a community and resolve it.