An unexpected consequence of the election of Donald Trump as President of the United States is the return to public debate of an old American public health measure: water fluoridation. Robert F. Kennedy Jr, expected to become the future Secretary of Health, the equivalent of the Minister of Health in France, is not only a notorious anti-vaxxer, he is also a firm opponent of the addition of fluoride in the running water, claiming that this practice is associated with “arthritis, bone fractures, bone cancer, loss of intelligence quotient [QI]neurodevelopmental disorders and thyroid diseases ».
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If some of these claims are not scientifically supported, in particular the link between exposure to fluoride and the appearance of cancer, more and more scientific studies and official reports question the relevance of this practice which is still current in twenty-four countries around the world, including Australia, Canada and Malaysia, but almost non-existent in Europe.
Fight against cavities
In the United States, 62.8% of the population has access to tap water supplemented with fluoride. The decision is made at the local level, generally by the municipality, to add fluoride salts such as sodium fluoride, more easily soluble than calcium fluoride, naturally present in the environment, to the water, or to other compounds such as fluorosilicic acid or sodium fluorosilicate.
This practice has become popular across the Atlantic since the end of the Second World War in order to fight against dental caries. Because fluoride has the particularity of attaching to tooth enamel, reinforcing this natural mineral barrier against the bacteria responsible for cavities. Numerous studies have since shown its effectiveness in combating this extremely common infection. So much so that in 1999 the American government agency the Centers for Disease Control (CDC) listed water fluoridation among the ten major public health achievements of the 20th century.e century in the United States.
But it's all a question of dosage. Consumed in too high quantities, especially in childhood, fluoride can cause white or even brown spots on tooth enamel and make them brittle. This is fluorosis. At very high concentration levels, fluoride can also bind to bones and harden joints. This is why the World Health Organization (WHO) has set the threshold beyond which the concentration of fluoride – including natural fluoride – can be dangerous at 1.5 milligrams per liter (mg/l). In the United States, it was historically recommended to stay within a range of 0.7 to 1.2 mg/l, until the 2015 revision, setting the limit at 0.7 mg/l. « concentration optimal and fluorine » to combat the increase in fluorosis in the country.
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