It's good that you explicitly recognize the social & economic injustices in access to dental care and the consequences thereof. But aside from a few sweeping generalizations about how fluoridation alone is not always enough and something ought to be done about those injustices, the takeaway is to fluoridate everyone's water, rather than actually work to address those social and economic injustices. Injustices which apply to far more than just dental care, touching every aspect of contemporary life in the USA.

No, fluoridation is much more "cost-effective," and that after all is what really matters in our society. It would not be nearly so "cost-effective" to address social and economic injustices in dental care (among many relevant domains).

Also rather disingenuous is describing the mass adoption of fluoridation of public water supplies without public consent as "...had access to fluoridated drinking water." As though "access" had been a problem, and everyone was clamoring for it, and now that problem was solved. Which was not at all the case. It's a bit like saying "...had access to PCBs" or "...had access to BPAs."

Also inadequate is mention of USA food culture and the significant impacts that diets of highly processed, non-nutritious, and generally unhealthy food have on dental health, both directly and indirectly. It would probably not be "cost-effective" to do anything about that either. Meanwhile those people dying from dental abscesses in the 17th century mostly had a poor diet for different reasons - and, no manufactured antibiotics.

I don't give much credibility to a claim here of "unbiased science." It reads more like a PR piece for the fluoridation industry, triggered by recent political shifts that threaten that industry's story to date.

Addressing socioeconomic injustice in dental care and elsewhere requires thoroughly systemic perspectives, analyses, and interventions.