Michelle Roberts wants her three young children to have fluoride, which she knows can help prevent cavities.
For the past 20 months, though, her drinking water has not been fluoridated, and she had no idea.
“I have a 2 1/2-year-old and she’s had no fluoride for most of her life,” said Roberts, who lives near Cunningham. “What upsets me more is the customers — we were given no notice that the fluoride had been removed.”
Roberts found out about this recently in conversation with a fellow mom who works at the Montgomery County Health Department.
Since February 2006, the East Montgomery Water Treatment Plant has not fluoridated the water that flows to thousands of homes in the East Montgomery and Cunningham Utility Districts.
Through the guidance of two local dentists, the Montgomery County Health Council recently began working on a campaign to get the word out to affected residents on the importance of fluoride, which can prevent tooth decay by strengthening teeth to block acid from penetrating the enamel.
Local dentists Dr. Jeannie Beauchamp and Dr. Leon Stanislav brought the topic to light after they discovered the residents were mostly unaware of the change.
East Montgomery Utility District General Manager Randy Wilkins said customers receive yearly reports identifying the water’s additives. The word “fluoride” does not appear.
Of the roughly 513 registered water districts in Tennessee, about 155 choose not to fluoridate.
“There’s nothing to show it improves the quality of water, and our business is all about quality of water,” Wilkins said.
The treatment plant pumps water to an estimated 25,480 people, of which 17,160 reside in Montgomery County.
Stanislav said the company should’ve clearly alerted customers to the lack of fluoride so they would have had the opportunity during the past year to receive supplemental fluoride treatments.
“To me that’s a little surreptitious,” he said. “Unfortunately it’s impacting the health of a lot of people.”
Why stop fluoridation?
The treatment plant’s Board of Commissioners sought customer feedback and studies regarding fluoridated water in January 2006 before it made a decision, according to a prepared statement last week from John M. Atkins, Cunningham Utility District general manager.
The plant had been fluoridating its water since 1960, and the process cost about $10,000 a year.
In a phone interview, Atkins described the cost of fluoride as “miniscule.”
“It wasn’t a cost-based decision,” he said. “It was fear of the unknown.”
According to the written statement, the board met later in January 2006 and decided to discontinue the fluoridation process for the following reasons:
• One customer asked when the plant would stop fluoridating its water after she saw a TV news report about a link between fluoride and cancer.
• After studying the history of public water fluoridation, the board determined the availability of fluoride was not as bountiful more than 40 years ago as it is today with its use in toothpaste and other commercially prepared foods and drinks.
• The possibility of over-fluoridation leading to dental fluorosis (teeth-staining) in infants and children.
• Fluoridation of public drinking water is not required by the Environmental Protection Agency or Tennessee’s Division of Water Supply.
Clarksville Gas and Water treats its water according to the American Water Works standards, which follows the recommendation of the American Dental Association to fluoridate water to build stronger teeth, said spokeswoman Rhonda Fulton.
Fulton said fluoride does not affect the taste of the water.
The only other water provider in Montgomery County is the Woodlawn Utility District, which buys its water already treated and fluoridated from Clarksville.
Fort Campbell’s water is also fluoridated.
Dr. Stanislav said fluoride can prevent tooth decay by strengthening teeth to block acid from penetrating the enamel.
He said it’s important for young children to obtain fluoride because it will become embedded in the entire tooth, strengthening it and making it more dense as the child continues to grow.
“When you don’t have it as a child, it’s really taking a step backward,” he said. “They’re going to lose those years of development.”
Stanislav said residents should not worry about fluorosis, which he described as a cosmetic issue rather than a health issue. Fluorosis is a staining of teeth when too much fluoride is consumed.
The EPA and Tennessee Department of Environmental Conservation allow treatment plants to fluoridate water with up to 4 parts per million.
Treatment plants in Tennessee typically fluoridate their systems with an average of 1 part per million, which Stanislav said would not be enough to create fluorosis.
Cases of fluorosis in Tennessee, he added, will likely occur after consuming too much fluoride from secondary sources, such as children accidentally ingesting toothpaste.
The average tube of toothpaste contains about 1,000 parts per million of sodium fluoride.
Signs of trouble
Dr. Robert Galbraith, who runs a family practice in Sango, treats many patients from the East Montgomery area.
He said he’s noticed an increase in tooth decay among East Montgomery children between ages 2 and 9 who had previously reported tooth decay and received professional dental care on a regular basis.
“A lot of that attributes to the lack of fluoride because there’s been no change in their dietary habits or parental habits,” he said, after breaking down all the possible factors.
He said the 8th District Dental Society plans to meet with the treatment plant’s board members to discuss fluoridating the water.
“It’s really a subject that’s frustrating me quite a bit,” Galbraith said. “It is something I would really like to see changed.”
Stanislav said he’s worried about those who don’t have the means to get professional dental care or buy supplemental doses of fluoride.
All residents, though, should have at least been properly notified so they can make their own decision, he said.
“If 25,000 people show up at my doorstep and say they don’t want fluoride, then hey, I’ll back off,” Stanislav said. “I just don’t think they’re aware of it, and I think that is inappropriate.”