A Dentist's Perspective on Water Fluoridation

Wall Street Journal

4 days ago

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.