I'm no expert, but from what I can gather fluoridated water is at best a meh solution to the problem of dental health — low cost, low benefit, hassle to opt-out, and some lingering unknowns about negative health effects. We're drinking the medicine when only topical contact is needed.

Other alternatives have been shown to have far greater impact, with lower risk and often substantial side benefits:

- cutting sugar intake (huge benefits here, especially drinks)
- fluoridated toothpaste (higher dose, directly on the teeth, spit it out)
- daily brushing (a little goes a long way)
- hydroxyapatite toothpaste (repairs enamel and dentin with...wait for it...the stuff they're actually made of!)

Seems like we talk too much about fluoridation and not enough about much better solutions to the same problem.

FYI, I got a good rundown on a lot of this by asking Grok questions like these:

- How much does water fluoridation cost per person per year?
- What is the environmental impact of producing the fluoridation inputs?
- What is the environmental impact of fluoridated irrigation, runoff, and waste water?
- What are the negative health impacts of ingesting fluoridated water?
- How much does it cost people to remove it if they don't want it?
- How much is the marginal benefit of fluoridated water if other sources are also used (fluoridated toothpaste, mouthwash, etc.)?
- What would be the simplest way to get the same or similar benefits without water fluoridation for a single household?
- What interventions would move the needle far more dramatically than water fluoridation? Voluntary nutrition choices? Transparency/warnings on sugary foods?
- Compare benefits of hydroxyapatite vs fluoride toothpaste
- Compare tooth damage of sugary drinks vs. sticky foods (frosting, candy), sweetened foods (cookies, cereal, ketchup, crackers), and fruit