Say this for Illinois: We love our fluoride.

Back in the 1940s, three Chicago suburbs were among the guinea pigs in an experiment to uncover the benefits of fluoridated drinking water. The mineral occurred naturally in west suburban Aurora, so its water system became a baseline. Then Evanston added fluoride and Oak Park went without. Over 15 years, the prevalence of dental cavities in children dropped by as much as 70% in the communities with fluoride, and a public health juggernaut was born.

Starting in the 1960s, most Illinois water systems were required to add fluoride, or adjust the level if it was already present, resulting in much healthier teeth. To this day, fluoride is required throughout Illinois. Altogether, nearly three-fourths of the nation’s population gets it in their water.

Now this public health triumph is under new scrutiny, including from one of the highest-profile Cabinet nominees of the incoming Donald J. Trump administration.

Robert F. Kennedy Jr. is slated to head the Department of Health and Human Services, a powerful role that sets the nation’s health care policy. He has called fluoride “industrial waste” and advocated for removing it from drinking water. Trump also nominated Dr. Mehmet Oz to head the Centers for Medicare and Medicaid Services, another telegenic politico with a history of advancing fringe medical theories, then digging in when challenged with scientific consensus.

This page opposed one of Trump’s Cabinet picks, the now-withdrawn Matt Gaetz, but we also recognize that Trump, like other incoming presidents, deserves a measure of deference.

We don’t intend to join the liberal panic attack over the nominees, especially before the Senate has conducted confirmation hearings (which are necessary, and should not be bypassed via recess appointments, as some Trump acolytes have suggested).

We’re mindful that in modern times the country has survived bad actors in Cabinet posts like Robert McNamara at Defense, James Watt at Interior and John Mitchell at Justice. In contrast, Trump has nominated a highly qualified economic team, for instance, and anyone claiming his Cabinet picks are the worst ever should check out Ulysses S. Grant’s.

Still, RFK and Dr. Oz give us pause and make us wonder how the U.S. got to this point of potentially having its health policy dictated by people outside the scientific mainstream. For the answer, look no further than the nation’s awful experience with COVID-19.

Policy errors, overreaches and miscommunication during the pandemic badly hurt the credibility of government scientists, at least for a big slice of the population, which is now open to the dubious pronouncements of RFK and Dr. Oz — not to mention that perennial parade of hucksters pushing supplements, fad diets and God-knows-what-else on talk radio, podcasts and social media.

With 1.2 million COVID-19 deaths, the U.S. did much worse than other wealthy countries in combatting the pandemic, largely because mistakes at the top made Americans doubt authorities who they should have been able to trust.

Even after studies showed that COVID-19 was very rarely contracted from contaminated surfaces and that transmission was much more common indoors than outdoors, cities and states kept parks, playgrounds and beaches closed. After research showed that schools could be reopened safely with basic public health measures, Chicago and other jurisdictions kept teaching online only for months past the point of logic. The federal government pushed surgical masks, distancing and hand-washing at the expense of ventilation and air cleaning, leading to thousands of preventable deaths, especially among frontline workers. And lockdown rules were deeply unfair: In Illinois, you could carry on building a new condo but not visit your dying parent.

Meanwhile, Trump often dissembled to the public, calling the pandemic a “new hoax” as it began to unfold, providing false reassurances and denigrating science with potentially harmful suggestions like self-medicating with anti-malaria drugs.

His confused leadership delayed important federal action such as mass testing, contact tracing, expanded hospital capacity and production of personal protective equipment. By the time Trump got behind rapid vaccine development, a genuine public health triumph akin to fluoridated water, America had a terrible death rate, and its citizens were understandably confused about how to protect themselves and who to believe.

Now even vaccines, Trump’s big success during the pandemic, have come under fire from RFK and others, undermining another fundamental bedrock of public health worldwide.

As for fluoridating water, the Tribune’s Adriana Pérez recently provided an authoritative analysis of the debate afoot with RFK’s nomination. While it’s fair to question whether fluoridation is necessary given the ubiquity of fluoride toothpaste and mouthwash, there is little to suggest that it causes harm at the levels used today. Still, a federal judge in California recently ordered the Environmental Protection Agency to more strictly regulate fluoride based on theoretical risks to infant brain development.

Bear in mind, the judge did not determine that fluoridated water is unsafe. In the ruling’s aftermath, the American Dental Association and American Academy of Pediatrics reaffirmed their stance that it is safe and beneficial.

Brace yourself for more debates like this. Many other hard-fought medical advances might well come under scrutiny. That’s not inherently a bad thing, and the opinions of public health officials, mostly a left-leaning crew, should not be treated as gospel. But neither a famous name nor a former TV platform imbue medical expertise. Yet the American public has never been more vulnerable to splashy claims from the likes of RFK and Dr. Oz, now massively empowered.

What the new federal health officials actually will do, of course, remains to be seen. But it will be critical for Illinois and Chicago to maintain wise, nonpartisan public health leadership to help citizens evaluate whatever Washington pushes in the years ahead.

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