[efirman]

Thanks for sharing that article. In reading it I noticed a few things: 1) the primary author is a well published structural engineer. The article was billed as review of the medical literature, so this is an odd match in regards to expertise and content. Their first co-author does have MD, MPH credentials, but they were fairly green having published only one other article. The journal itself seems legit and has been around for 100+ years.

In looking at the content 1) The methodology was essentially one paragraph and in execution it appears they cherry picked the literature and did not clearly indicate concentration of fluoride as they discussed certain postulated effects. 2) Often they reached conclusions based on single studies that do not seem to reflect the current body of evidence. For example, the reference to a Utah study on bone fracture in the elderly population. Many other studies have found opposite results and have been published prior to the publication of this study. 3) Their graphs that show a lack of association of water and salt fluoridation are used as evidence to make the declaration that there is no effect without discussion of causation for that difference.

In essence, this piece seems like a regurgitation of soundbites from US advocates opposed to fluoridation.

Chile continues its fluoridation program (70% of its population) and milk fluoridation for rural areas https://www.borrowfoundation.org/chile. The question over how to address cavities rates at the population level in rural areas where water fluoridation is not practical is a good one. And in looking at the evidence on milk fluoridation programs as I considered this article, there is room for further consideration and study there. However; this particular study is not enough to base such a policy discussion/ decision. The US does not currently offer or consider milk fluoridation in rural areas.