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irrelevantastic t1_ivavs0x wrote

I can see this is going to be very controversial, however, it is the elusive obvious. Fluoride isn't necessary if you avoid foods that promote bacterial adherence and the resultant damage to the enamel. This is something I have observed also in dogs and cats fed kibble vs those fed a BARF diet. However, if you eat a high-carb diet especially flour products etc that promote the development of bacterial biofilm, fluoride toothpaste at least is absolutely necessary to prevent caries.

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Meatrition OP t1_ivb1iof wrote

Abstract
Fluoride has no tangible health benefits other than preventing dental caries and there is a small difference between its minimum effective dose and its minimum toxic dose. Leading global organizations currently recommend fluoride supplementation because they recommend high-carbohydrate diets which can cause dental caries. Low-carbohydrate diets prevent dental caries making such fluoride recommendations largely unnecessary. A dental organization was among the first to initiate the public health recommendations which started fluoride-supplemented high-carbohydrate nutritional guidelines. This start required expert panels at this dental organization to reverse on three key scientific points between 1942 and 1949: (1) that topical fluoride had potential harms, (2) that dental caries was a marker for micronutrient deficiencies, and (3) that low-carbohydrate diets are to be recommended for dental caries prevention. Internal documents show that private interests motivated the events which led these expert panels to engage in pivotal scientific reversals. These private interests biased scientific processes and these reversals occurred largely in an absence of supporting evidence. It is concluded that private interests played a significant role in the start of public health endorsements of fluoride-supplemented high-carbohydrate nutritional guidelines.

​

  1. Introduction
    Dental caries is the quintessential disease of civilization, a disease which became prevalent with the start of cereal agriculture and rampant with the start of industrial sugar production [1]. A body of evidence supports the hypothesis that a diet leading to dental caries also leads to chronic non-communicable diseases [2].
    Most authoritative organizations aimed to protect public health ignore this evidence and take the view that dental caries is the only adverse side-effect of their high-carbohydrate nutritional guidelines, a side-effect which can be addressed with universal fluoride recommendations. The intrinsic starches-and--sugar diet which can cause dental caries is described as healthy by the United States Department of Agriculture (USDA) [3]. The carnivorous diet which prevents and stops dental caries is described as a probable carcinogen by the World Health Organization (WHO) [4]. This latter point is raised not to suggest that the carnivorous diet is the only solution for dental caries [5], but as an example to indicate that leading organizations dismiss diets which prevent dental caries and instead rely on fluoride and food fortification to, respectively, address the dental harms and micronutrient deficiencies induced by high-carbohydrate diets.
    The USDA and the WHO not only ignore the evidence that high-carbohydrate diets may lead to diseases other than dental caries, but also fail to prioritize high-quality evidence over low-quality evidence when writing their nutritional guidelines [6,7,8]. The latter observation was made by an expert who coined the term evidence-based medicine and who was a key developer of one of the most widely used evidence-based grading systems [6,7]. The USDA furthermore decided to largely ignore the 2017 recommendations of the National Academies for greater scientific rigor and thus failed to increase the trustworthiness of their scientific processes [9]. Unsurprisingly, editorials in The BMJ have described nutritional guidelines as bold policies based on fragile science [10,11].
    The economic theory of public choice may explain why expert panels with a commitment to public health ignore the principles of evidence-based medicine; organizations may have biased scientific processes within their organization because of the influence of private interests, not necessarily public ones. The aim of this report is to explore the private interests which were present when a dental organization took the first significant steps towards endorsing the current fluoride-supplemented high-carbohydrate nutritional guidelines.
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B0risTheManskinner t1_ivb4oen wrote

So what should I do for my teeth? Low carb and fluoride free toothpaste?

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Meatrition OP t1_ivb581y wrote

Replying to B0risTheManskinner (#457,716)

>Dental caries is the quintessential disease of civilization, a disease which became prevalent with the start of cereal agriculture and rampant with the start of industrial sugar production [1]. A body of evidence supports the hypothesis that a diet leading to dental caries also leads to chronic non-communicable diseases [2].
>
>Most authoritative organizations aimed to protect public health ignore this evidence and take the view that dental caries is the only adverse side-effect of their high-carbohydrate nutritional guidelines, a side-effect which can be addressed with universal fluoride recommendations

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irrelevantastic t1_ivbb1vc wrote

Replying to B0risTheManskinner (#457,716)

Flour products and sticky carb-rich foods that stick to the teeth result in increased biofilm production, and the resultant shift in pH from bacterial acids causing degradation of the enamel. Fluoride works bc it is incorporated into the enamel, replacing hydroxyl groups in hydroxyapatite to form fluorapatite which is more resistant to bacterial acids.

edit: among sticky foods, this also includes nuts/seeds (and nut butters by extension, incl. legumes such as peanut), as evidenced by archeological evidence suggesting that hunter-gatherers that relied upon such foods had a high risk of caries development. In contrast, hunter-gatherer peoples that ate primarily animal produce had a low rate of caries development until the introduction of refined carbs.

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DecentChanceOfLousy t1_ivbc3az wrote

The "private interests" mentioned in the abstract are... dental associations.

>A dental organization was among the first to initiate the public health recommendations which started fluoride-supplemented high-carbohydrate nutritional guidelines.

Note the verbal trickery there: before that, people just had high-carbohydrate nutritional guidelines. It was only after dentists recommended fluoride that it became a fluoride-supplemented high-carbohydrate guidelines. Before that their teeth just rotted.

While it's not really disputed that the sugar lobby is both well recognized and responsible for a lot of terrible public health recommendations, this isn't the issue here. This paper seems like it was written just for the headline.

"Fluoride isn't helpful if you eat a low carbohydrate diet" is true. But that doesn't change the fact that most people eat a high carbohydrate diet, so topical fluoride is helpful for them. "Don't eat sugary foods, drink soda, or other such nonsense" is already standard advice when you go to the dentist. People just don't follow it.

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irrelevantastic t1_ivbcvxl wrote

Replying to JohnFByers (#457,451)

starches in kibble enhance oral biofilm production and increases caries risk - i know this as a long time dog owner that switched 20 yrs ago to a BARF diet; it seems obvious, but this is just anecdotal

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Flaky_Bed3707 t1_ivbqsnp wrote

Imagine that, money and power effecting science study outcomes. Sounds familiar.

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Divallo t1_ivbsnui wrote

Replying to [deleted] (#458,611)

That's one of the most nuanced rational takes on fluoride I've ever seen.

What do you think about recovery for those already exposed to varying degrees? How much merit is there to reducing intake as an adult and what kind of timeline would someone be looking at to cycle some of it out of their body?

I've started purifying the fluoride out of my drinking water but still brushing my teeth with fluoride paste and spitting thoroughly.

This reminds me of when they told me amalgam fillings weren't toxic only to admit they totally leak mercury years later. Anyone who questioned it was antagonized.

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blueskies1800 t1_ivbtgsz wrote

I have always felt that the sugar industry has done a lot of damage to the USA. They fled from Cuba and bought the Everglades for pennies on the dollar and diverted water thus polluting Lake O. They also spent a lot of money on bribes to Republicans to get the government and the army corp of Engineers to assist getting their business going. They paid a lot of bribes to get so called professionals to declare fat as the enemy rather than sugar. Sugar is more highly addictive than cocaine and is a big factor in America's addiction to sweets.

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EscapeVelocity83 t1_ivcgi7h wrote

Better to call them profit interests or dominance interests

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grumble11 t1_ivd10xh wrote

This paper is basically deliberately misleading and frankly does the opposite of what scientific research is supposed to do - work to slowly improve humanity’s understanding of the world. Characterizing dental associations popularizing fluoride to prevent cavities (which it does) as some kind of ‘private lobby’ and associating them with the groups pumping carbs is a disservice.

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thehairyfoot_17 t1_ivdrbg8 wrote

Replying to irrelevantastic (#457,360)

This is not contraversial. In fact the "ecological plaque hypothesis" which is very well established in mainstream ondontology covers this.

The problem isn't that caries can largely be avoided in the vast majority of the population by diet and lifestyle choices. The problem is it is not avoided despite the knowledge.

Cheap and readily available high GI carb rich foods are the staple of modern civilisation. They are also likely a large cause of a lot of inflammatory and metabolic diseases such as diabetes which are increasing in prevalence.

So yes, academically fluoride should not be necessary as the cause and prevention of dental caries has been pretty firmly established for decades now. The problem is the practical application of this knowledge.

Anecdotally I would say the modern diet has largely degraded over the last decades despite this knowledge and sky-rocketing metabolic diseases. Despite public campaigns and education drives the understanding of what is actually a "carbohydrate" and what sugar is is abysmally low.

For now fluoridated water and toothpaste seems to be a necessary evil, unless we want to add crippling dental disease to the list of problems with the modern diet. (ironically you also find that people with less teeth or dentures tend to eat a poorer diet ie carb rich soft diet because it is not comfortable to chew whole foods...)

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DecentChanceOfLousy t1_ive4gz3 wrote

Replying to L7Death (#462,032)

The entire second section is about sugar/grain lobby shenanigans that took place decades after public officials started recommending fluoride (1961 and 1979/1986/1994 for American Heart Association and American Diabetes Association recommendations vs. 1940s for fluoridation recommendations). The diet recommendation reversals came more than a decade after fluoridation became public policy in the US, but they're presented first as an attempt to confuse the order of events for the reader.

I read the article. It's... not good. It relies on semantic trickery and intentional obfuscation to make its points. The parts that aren't nonsense ("sugar is terrible for your teeth/heart/diabetes", "fluoride would be less necessary if it weren't for excess sugar in popular foods", the actual record of events, etc.) are neither novel nor disputed.

Regardless, this belongs on /r/history, rather than /r/science. It's literally just a historical study citing snippets from other books and paper about events 50 years in the past, with 0 original research.

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