thehairyfoot_17 t1_ivdrbg8 wrote

This is not contraversial. In fact the "ecological plaque hypothesis" which is very well established in mainstream ondontology covers this.

The problem isn't that caries can largely be avoided in the vast majority of the population by diet and lifestyle choices. The problem is it is not avoided despite the knowledge.

Cheap and readily available high GI carb rich foods are the staple of modern civilisation. They are also likely a large cause of a lot of inflammatory and metabolic diseases such as diabetes which are increasing in prevalence.

So yes, academically fluoride should not be necessary as the cause and prevention of dental caries has been pretty firmly established for decades now. The problem is the practical application of this knowledge.

Anecdotally I would say the modern diet has largely degraded over the last decades despite this knowledge and sky-rocketing metabolic diseases. Despite public campaigns and education drives the understanding of what is actually a "carbohydrate" and what sugar is is abysmally low.

For now fluoridated water and toothpaste seems to be a necessary evil, unless we want to add crippling dental disease to the list of problems with the modern diet. (ironically you also find that people with less teeth or dentures tend to eat a poorer diet ie carb rich soft diet because it is not comfortable to chew whole foods...)