The most surprising thing about this LA Times story is not discovering that California kids have lousy teeth. It's that someone has measured this in the first place:
Louisiana kids have the worst teeth and Rhode Island kids have the best. Allegedly. But why? Is it fluoridation?
Doesn't seem like it. The fit is lousy and there's only a tiny effect anyway. My guess is there's a correlation with average income, but I'm too lazy to check it out right now. In any case, California would be an outlier there too.
They should take data on "Bad Teeth vs Sugar".
I believe that state Medicaid programs are not required to offer dental benefits but some do (including Massachusetts). Perhaps that explains part of it.
How about bad teeth vs. food access metrics?
The hypothesis being access to primarily more processed (higher in sugar) foods -> worse teeth. Or put another way - lack of access to a baseline level of quality in food leads to worse teeth.
Some waters are naturally fluorinated,
Of course today most kids will have their teeth "sealed" so have much better outcomes. than back in the day. That might not be as accessible to the poor or immigrant communities.
Yes, those NE towns have deep granite sources which are naturally fluoridated.
So you'd expect that places that have to employ fluoridation would have worse teeth to begin with. Most private well water isn't fluoridated.
This might be an indicator of what percentage of children go to the dentist at all.
I was wondering that, too.
OT: One of your interests -- crime rates in the US. (LA Times article)
Probably a combination-giving kids soda, poverty, education, Medicaid. In Maryland, Medicaid includes child dental after a child died from a tooth abscess that went to his brain.
How about looking at cost for going to the dentist? When there food insecurity, dental work is not high on the list.
I live in one of the good teeth states on the list. We're also known for having high rates of health insurance, and people think it is totally normal to drink tap water here.
Beyond things like access to the dentist, I wonder how different rates of tap water drinking are by state.
I was in Europe recently and overheard two Americans with Southern accents discussing whether or not they could drink the tap water in Norway. One insisted they could. The other responded, "well, if I die, it's on you." Clearly, there are Americans who don't trust water from municipal systems at all.
Between the rise of bottled water, water tap filters, refrigerator filters, it is not surprising that there is a low correlation between fluoridation rates and dental caries.
For water filters, the effect on fluoride depends on the type. Activated carbon filters are ineffective at removing fluoride, but reverse osmosis and distillation filters are far more efficient.