How Have Tooth Decay Rates in Japan Fallen Without Water Fluoridation?
Propaganda about water fluoridation in Japan is being laundered across the social media accounts and websites of many anti-vaccine influencers.
It’s true, tooth decay rates in Japan have fallen over the years despite the fact that they don’t add fluoride to their tap water.
But it is quite easy to explain why…
How Have Tooth Decay Rates in Japan Fallen Without Water Fluoridation?
While it is true that they don’t add fluoride to their water in Japan, it is easy to see that tooth decay rates have fallen because of all the other interventions that they do.
For example, instead of adding fluoride to drinking water, in Japan, they:
have universal health coverage into the dental care system, with subsidies for younger children
have free, legally mandated dental checkups at 18-months and 3-years for all children
have school dental checkups for school aged children
deliver preventative fluoride to younger school age children at school, with school-based fluoride mouth-rinse programs
Things you don’t see in communities that are taking fluoride out of their drinking water…
Thanks for this. It will help me prepare for the conversation that I know will one day come to clinic.
The study says "In addition, topical fluoride applications in Japan are not systematically
incorporated into routine school dental check-up programs and are typically
provided on an individual basis during dental visits. Although detailed
national data on their population-level use are limited, the latest National
Survey of Dental Diseases (2024) reported that the experience rates of
topical fluoride application, fluoride mouth rinsing, and use of fluoride
toothpaste (but only ineffective 500ppm) were 58.0%, 28.8%, and 73.1%, respectively, among children
aged 10–14 years6. These findings suggest that fluoride exposure at the individual level is relatively common; however, their contribution to the long-term national decline in caries remains difficult to quantify and is unlikely to fully account for the observed population-level trends.
This unique combination positions Japan as a distinct natural social experiment"
Compare that to the US which is about 72% fluoridated, doesn't sell fluoridated toothpaste lower than 1,000 ppm because 500 ppm fluoride has never been proven effective and has a glut of fluoride dental products (in higher concentrations and various forms - both over the counter and prescribed) applied and prescribed by several health professionals, dental students and some parents and even legislators who mandate fluoridation 70% of US children and adolescents are fluoride overexposed, afflicted with dental fluorosis. Yet tooth decay is epidemic