When most of us think about oral health, we might not think far beyond brushing our teeth and our next trip to the dentist’s office. James Robbins ’16, however, knows that there’s much more to it than that. This summer as a Levitt Summer Research Fellow he is researching water fluoridation for improved public health. Working closely with Professor of Biology Herm Lehman, Robbins has been researching the public health debate about water fluoridation.
Robbins’ interest in the fluoride debate began locally. In his hometown of Bennington, Vt., the fluoridation of the public water supply has been a frequent subject of debate. Water fluoridation adds a very low concentration (approximately 0.7 mg per liter) of fluoride to the water supply. This helps to reduce tooth decay, prevent cavities, and strengthen teeth. Because of these benefits, the majority of the scientific and medical communities support water fluoridation.
However, many people adamantly oppose adding fluoride to the public water supply, arguing that fluoride may have toxic effects or may lower IQ. According to Robbins, however, these fears are based in bad science and are only supported by seriously flawed studies.
In Bennington, Robbins worked as a hospital nurse’s aide, and he witnessed the health concerns of community members first-hand. Robbins reports that Bennington’s economy has struggled in recent years, and healthcare is a primary local concern. He noted, “Any way that I could get involved in the healthcare process would be rewarding to me.”
He’s been able to fulfill that goal by studying the debate about water fluoridation. The Bennington Oral Health Coalition is looking to pass legislation on water fluoridation, which was denied this past March. Robbins has been working with the coalition on publicity to better understand the public perception of fluoride and to spread a positive image of its benefits.
Robbins set up booths at different local areas such as food pantries to speak with community residents and hand out free oral health supplies. By manning these booths, he communicated with many local people and gained a close understanding of their viewpoints. Many people in Bennington have not had consistent access to healthcare and are at high risk for poor oral health. However, many of them are against water fluoridation. Robbins explained, “They want to give their kids a better future; they want good health for their children…but they’re misinformed.”
As Robbins worked with the Oral Health Coalition, he gained an appreciation for the complexity of the fluoride debate. “There are very intelligent people on both sides of the issue,” he acknowledged. Most of all, however, Robbins saw just how important oral health can be. He explained “Not only is poor oral health detrimental to health and physiology as a whole, but it’s also about an aesthetic. If someone’s trying to get a job, the person with no teeth is likely at a disadvantage. It’s a vicious cycle. Oral health is hugely important in that way.” Improving oral health can also be beneficial to the community as a whole. Robbins reported that fluoridation can reduce dental medical costs by half in rural communities.
Even as he saw just how important the benefits of water fluoridation are, he learned how difficult it can be to educate the public. He realized that public health is not only about conveying information to the public, but about “social psychological manipulation.” Robbins saw first-hand that it’s much more difficult to convince someone of a plan’s benefits than of its dangers. As he commented, “fearmongering is always going to be easier than neutralizing fear.” The best approach, he learned, is to gradually normalize fluoride as a part of daily life so that people no longer fear it as an unknown.
The biggest challenge, from Robbins’ perspective, is the gap of knowledge between the scientific community and the general public. “To understand public health and the science behind it,” he explained, “requires an education. There’s a gap between what is known and what is heard, and that’s a dangerous gap that allows for manipulation.”
“I can’t promise I can solve that this summer,” he joked, but his research into public health may bring us one small step closer.