102 l © 2025 American Dental Association
Section 4: Public Policy
In making decisions that affect the health of the community, it is important
to distinguish between someone’s personal opinion disguised as science and
information based on the best available scientific evidence.
In 1993, the US Supreme Court issued a landmark decision that can restrict the use of information
inferred as science in the federal courts and in those state courts that adopt this reasoning. The
court determined that while “general acceptance” is not needed for scientific evidence to be
admissible, federal trial judges have the task of ensuring that an expert’s testimony rests on a
reasonable foundation and is relevant to the issue in question.8 According to the Supreme Court,
many considerations will bear on whether the expert’s underlying reasoning or methodology is
scientifically valid and applicable in a given case. The Court set out four criteria that judges could
use when evaluating scientific testimony:
1. Whether the expert’s theory or technique can be (and has been) tested using the
scientific method.
2. Whether it has been subject to peer review and publication (although failing this criterion
alone is not necessarily grounds for disallowing the testimony).
3. Its known or potential error rate and the existence and maintenance of standards in
controlling its operation.
4. Whether it has attracted widespread acceptance within a relevant scientific community,
as a known technique that has been able to attract only minimal support may properly
be viewed with skepticism.8
The scientific validity and relevance of claims made by opponents of fluoridation might be best
viewed when measured against these criteria.8
Opposition Tactics
The techniques used by fluoridation opponents are well known and have been discussed at length in
a number of published articles that review their tactics, as discussed in this section.434,444,449,450,453-457
Targeting Politicians and Community Leaders: Opposition websites contain draft letters to be sent
to newspaper publishers, water departments, and public officials warning them of their “liability” should
they support or endorse water fluoridation. Leaders are urged to remain “neutral” and allow fluoridation
decisions to be put to a public vote, therefore relieving the leaders of any and all responsibility in the
matter. Fluoridation opponents use the time gained to conduct a public referendum to bombard the
public with misinformation designed to turn public opinion against fluoridation.
Unproven Claims: Fluoridation opponents have repeatedly claimed fluoridation causes a laundry list
of human illnesses, including AIDS, Alzheimer’s disease, cancer, Down syndrome, genetic damage, heart
disease, lower intelligence, kidney disease, osteoporosis, and hip fractures. None of these claims has
a basis in fact. These allegations are often repeated so frequently during campaigns that the public
assumes they must be true. Their appearance in print, even if only in letters to the editor of the local
newspaper, reinforces the allegation’s credibility. With just a small amount of doubt established, the
opposition slogan, “If in doubt, vote it out,” often rings true with voters.
Section 4: Public Policy
In making decisions that affect the health of the community, it is important
to distinguish between someone’s personal opinion disguised as science and
information based on the best available scientific evidence.
In 1993, the US Supreme Court issued a landmark decision that can restrict the use of information
inferred as science in the federal courts and in those state courts that adopt this reasoning. The
court determined that while “general acceptance” is not needed for scientific evidence to be
admissible, federal trial judges have the task of ensuring that an expert’s testimony rests on a
reasonable foundation and is relevant to the issue in question.8 According to the Supreme Court,
many considerations will bear on whether the expert’s underlying reasoning or methodology is
scientifically valid and applicable in a given case. The Court set out four criteria that judges could
use when evaluating scientific testimony:
1. Whether the expert’s theory or technique can be (and has been) tested using the
scientific method.
2. Whether it has been subject to peer review and publication (although failing this criterion
alone is not necessarily grounds for disallowing the testimony).
3. Its known or potential error rate and the existence and maintenance of standards in
controlling its operation.
4. Whether it has attracted widespread acceptance within a relevant scientific community,
as a known technique that has been able to attract only minimal support may properly
be viewed with skepticism.8
The scientific validity and relevance of claims made by opponents of fluoridation might be best
viewed when measured against these criteria.8
Opposition Tactics
The techniques used by fluoridation opponents are well known and have been discussed at length in
a number of published articles that review their tactics, as discussed in this section.434,444,449,450,453-457
Targeting Politicians and Community Leaders: Opposition websites contain draft letters to be sent
to newspaper publishers, water departments, and public officials warning them of their “liability” should
they support or endorse water fluoridation. Leaders are urged to remain “neutral” and allow fluoridation
decisions to be put to a public vote, therefore relieving the leaders of any and all responsibility in the
matter. Fluoridation opponents use the time gained to conduct a public referendum to bombard the
public with misinformation designed to turn public opinion against fluoridation.
Unproven Claims: Fluoridation opponents have repeatedly claimed fluoridation causes a laundry list
of human illnesses, including AIDS, Alzheimer’s disease, cancer, Down syndrome, genetic damage, heart
disease, lower intelligence, kidney disease, osteoporosis, and hip fractures. None of these claims has
a basis in fact. These allegations are often repeated so frequently during campaigns that the public
assumes they must be true. Their appearance in print, even if only in letters to the editor of the local
newspaper, reinforces the allegation’s credibility. With just a small amount of doubt established, the
opposition slogan, “If in doubt, vote it out,” often rings true with voters.
