Community Water Fluoridation Opinion

Posted: February 16, 2012 in Front Page

By Jeff Phinney, Director, Olivehurst Public Utility District

As presented to the Board of Directors Feb 16th, 2012

When this issue first came to us I was skeptical of Mr. DeVorss and his concerns. The question that I want answered is if the benefits of fluoridated water outweigh the risks.  

I take seriously our responsibility provide clean and safe drinking water.

Our decision needs to be based on the latest information. Our first concern should be with the public’s safety. Even if fluoridated water benefits a portion of our community, we need to be sure it will not cause any harm now or in the future.

There have been warnings from government and private sources regarding the adverse effects from using fluoridated water to reconstitute baby formula.  Doing so could result in our community’s children exceeding the maximum recommended daily intake of fluoride. Exceeding these levels in a child less than a year old could result in a mild to moderate fluorosis. Some researchers believe that fluoride crosses the blood brain barrier and may have an adverse effect on infant brain development. Numerous studies in China indicate lower average IQ levels in communities exposed to fluoride. With many sources of fluoride available other than water, risk of more adverse effects could occur. As an OPUD customer, a parent and grandparent, I am very concerned that I was not informed of the baby formula warning. My three grandchildren are really important to me. Since OPUD began fluoridating the water supply, the two youngest have had formula reconstituted with fluoridated tap water in my home. Had I been aware of these warnings, we would have had the opportunity to choose how we fed our grandchildren.

If we decide to continue the program, then I believe that we have a moral and ethical, if not legal obligation to fully inform our customers of any significant information related to what they are drinking.  The flow of information needs to be ongoing and effective. Effective public outreach will in all likelihood result in increased costs of service delivery of fluoride.

Another health issue strongly attributed to fluoride touches my family through the adverse effects to some endocrine glands. The NRC report from 2006 reported that;

“The Agency for Toxic Substances and Disease Registry (ATSDR 2003) discussed four papers on thyroid effects and two papers on parathyroid effects and concluded that “there are some data to suggest that fluoride does adversely affect some endocrine glands.”

My family currently struggles with Hypothyroidism, Parathyroidism, Graves and Addisons Disease. I wonder what effects may occur my family and other people that suffer from this disorders.

 The NRC report concluded that;

The effects of fluoride on various aspects of endocrine function should be examined further, particularly with respect to a possible role in the development of several diseases or mental states in the United States. Major areas for investigation include the following:

  • thyroid disease (especially in light of decreasing iodine intake by the U.S. population);
  • nutritional (calcium-deficiency) rickets;
  • calcium metabolism (including measurements of both calcitonin and PTH);
  • pineal function (including, but not limited to, melatonin production); and
  • development of glucose intolerance and diabetes.

 

Yes, I want to know that it is safe; But, I also want to know if it is effective. Does fluoride work as advertised? One of the primary reasons given to support fluoridated water is the reduction of caries in populations on the lower socioeconomic scale without access to dental care.  I have read a few articles from reputable sources that sought to answer this question. The first article titled “Community Water Fluoridation and Caries Prevention: A Critical Review” published in 2007. The researchers reviewed articles from MEDLINE published between January 2001 and June 2006. The article concludes that;

“For the past 50 years, CWF has been considered the most cost-effective measure for the control of caries at the community level. However, it is now accepted that systemic fluoride plays a limited role in caries prevention. Several epidemiologic studies conducted in fluoridated and nonfluoridated communities clearly indicated that CWF may be unnecessary for caries prevention, particularly in the industrialized countries where the caries level has become low. Moreover, the evidence of an increased prevalence of fluorosis, particularly in fluoridated areas, needs to be considered. Nevertheless, water fluoridation may still be a relevant public health measure in populations where oral hygiene conditions are poor, lifestyle results in a high caries incidence, and access to a well-functioning oral health care system is limited. Instead, topical fluoride offers an optimal opportunity to prevent dental caries among people living in both industrialized and developing countries, and the use of fluoride-containing products, particularly the toothpaste, needs to be maintained and expanded”

As recently as last month, a new research article was posted on the PubMed.gov website titled; “Association of vascular fluoride uptake with vascular calcification and coronary artery disease” The study assessed fluorides effects to various major arteries, including coronary arteries. The scientists concluded that “An increased fluoride uptake in coronary arteries may be associated with an increased cardiovascular risk” As time goes by we will most likely see more studies along this line. This is just one more piece of information that places a cloud of doubt over the safety of fluoride consumption.

 In 2009 an article published in the Journal of Public Health Dentistry titled; “Considerations on Optimal Fluoride Intake Using Dental Fluorosis and Dental Caries Outcomes – A Longitudinal Study”, reported;

“Today, evidence suggests that, although there appears to be some benefits from systemic/ingested fluoride, the benefits of fluoride are mostly topical. Therefore, with widespread water fluoridation and countless fluoride-containing products available, quantifying the intakes of fluoride is much more complex than it was several decades ago.”

A few weeks ago, I visited our family dentist of 26 years for my cleaning. I asked him what he thought of a fluoridated water supply. He told me that he has observed an increase in fluorosis amongst his patients living in fluoridated areas. He also shared that the majority of tooth decay occurs within the pits and fissures where food particles are trapped and provides a breeding ground for decay causing bacteria. He said fluoride has little effect in preventing decay in these areas and the most effective means of reducing decay is by frequent brushing and the application of dental sealants and. I found this interesting. A few days later I received an email from Maureen Jones with a group opposed to fluoridation. She cited a few quotes under the heading of Pits and Fissures. Those quotes help to validate what my dentist had said to me.

“Fluoride primarily protects the smooth surfaces of teeth, and sealants protect the pits and fissures (grooves), mainly on the chewing surfaces of the back teeth.  Although pit and fissure tooth surfaces only comprise about 15% of all permanent tooth surfaces, they were the site of 83% of tooth decay in U.S. children in 1986-87.” Selected Findings and Recommendations from the 1993/94 California Oral Health Needs Assessment.

“Nearly 90 percent of cavities in school children occur in the surfaces of teeth with vulnerable pits and grooves, where fluoride is least effective.” Facts from National Institute of Dental Research. Marshall Independent Marshall, MN, 5/92.

“Because the surface-specific analysis was used, we learned that almost 90 percent of the remaining decay is found in the pits and fissures (chewing surfaces) of children’s teeth; those surfaces that are not as affected by the protective benefit of fluoride.” Letter, August 8, 2000, from CDC Director Jeffrey P. Koplan, M.D., M.P.H.

As we have been told, the CDC is the organization that ranks Fluoridated water in the top 10 health achievements

There are studies comparing fluoridated and non-fluoridated communities in industrialized countries. Those studies observed similar declines of tooth decay within their populations. Some studies also observed that some communities ending fluoridation programs continued to experience a decline in dental caries. The conclusion is that industrialized countries have better education, dental care and fluoride product availability that has a significant effect on caries rates.

The next debate is decidedly an American one. That is the concept of freedom of choice. Even though no legal decision invalidates the practice there are some ethical and legal concerns in this area. I also share those concerns in that I agree with what President Reagan once said; “Government’s first duty is to protect the people, not to run their lives.’

Based on my personal review, it is apparent to that fluoridated water is not as effective as first thought 60 years ago and that there are serious questions needing to be answered as to its safety and effectiveness. We have also seen over the last several years, many communities like Fairbanks Alaska that have systematically and carefully studied the issue, which led to an informed decision to stop adding fluoride to the water.  

Tonight, I am urging my colleagues to take support and take steps to wind down and terminate OPUD’s fluoride program. I am also going to urge Yuba county health and social services to initiate simple programs to identify and educate at risk people within the community.  I will also encourage local dental health professionals to become further involved with their community by working with the appropriate county departments and school districts to develop and initiate programs that will help to reduce tooth decay in at risk populations.

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