Hydra Cap … not the best strategist, after all.

As Marvel’s big summer event, Secret Empire, winds down, the strangest thing to happen in the story might still be a throwaway line in the very first issue. We reached out to Dr. Grant Ritchey, dentist and skeptical activist, to try to figure it out.

In Secret Empire #1, Captain America has become an evil fascist bent on brutal control of the population, and he gets some odd, sinister advice from Dr. Faustus on how to further that goal.

Of course we all know this is from a comic book and it couldn’t really happen, right? Of course it couldn’t.

But it captures the imagination of its readers by playing to some longstanding fears about fluoride in general, and water fluoridation policies across the United States in particular.

Chemical Boogeyman

Fluoride comes in many forms, but it all works the same way. The crystalline molecule that makes up tooth enamel is called hydroxyapatite (HA), and it’s the toughest substance in the human body. Despite its strength, it’s susceptible to attack by acids, like the ones produced by bacteria in the presence of sugars. With fluoridation, the hydroxyl ion (-OH) in HA is replaced by a fluoride ion, which renders the crystal much more resistant to dissolution.

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It’s a simple and well-understood process, but fluoride opponents make many outrageous, unsupported claims which can frighten those who aren’t informed about the science. They say it can lead to a host of diseases; from multiple sclerosis to lowered IQ in children to Alzheimer’s Disease and everything in between; to stranger claims, like, “It calcifies your pineal gland, the seat of your Third Eye.”

Because there are fluoride-containing molecules in fertilizers and chemicals used in certain industries, anti-fluoridationists use emotionally-charged language such as, “The government is putting industrial waste in your water.” There’s also a meme passed around that claims Adolf Hitler used fluoride to pacify the Jews (and ostensibly where the idea for the Secret Empire line came from).

While clearly ludicrous, these claims are nonetheless frightening to many, and a lot of people prefer to take the “better safe than sorry” approach. Others accept the science and safety of water fluoridation, but oppose it on grounds that something is being added to the water supply involuntarily, and that this is an infringement on individual rights and liberties.

Can’t make this stuff up. Well, someone did.

Medical Marvel

The truth of the matter is that fluoride has been added to municipal water supplies for over 70 years, with tremendously positive results. The Centers for Disease Control have designated community water fluoridation as one of the top 10 public health achievements of the 20th century. Initially, fluoridation reduced dental caries (tooth decay) by as much as 60%, but now that dentists have many more preventive strategies at their disposal (e.g. dental sealants), and since fluoride is found in many sources other than municipal water supplies, that number has dropped.

That being said, community water fluoridation still confers an additional 25% caries reduction, even when taking into consideration other sources of fluoride. It’s estimated that every dollar spent on water fluoridation prevents $38.00 of dental treatment. That is a great return on taxpayer investment, and is even more significant when you realize that the people who benefit the most from fluoridation are the people who might not have access to dental care due to financial challenges or lack of dental insurance.

Despite the fear-mongering and popular misinformation, the science of fluoride risks and benefits is clear. It is a safe, effective, and inexpensive public health measure that has not only saved billions of dollars in health care costs over the decades, but also untold amounts of pain, suffering, and lost productivity. Until the government perfects the mass delivery of a tooth decay-preventing agent via chemtrails, water fluoridation is the best dental health bargain we have.

Wake up, sheeple!

Grant Ritchey contributes to the Science-Based Medicine blog and hosts the Prism Podcast, which explores the spectrum of science, medicine, and critical thinking. His areas of interest are in alternative medicine, pseudoscience of all stripes, cognitive biases/logical fallacies, and in employing effective communication skills to respectfully engage one another.