Just when Laura Gilmore had gotten used to having a new baby she found out there was another thing she had to worry about: fluoride.
“I always thought we had fluoride in the water,” said Gilmore, a resident of Treasure Island. “But when Evie (her first daughter) was born the pediatrician said since we live in this particular area we had to use fluoride drops.”
If we lived in a place where fluoride was added to the water supply countywide we wouldn’t have to think about it. The Centers for Disease Control and Prevention has said adding fluoride to drinking water to help prevent cavities is one of the 10 great public health accomplishments of the 20th century. The American Dental Association calls it “nature’s cavity fighter.”
But we live in Pinellas County, the largest county in Florida without fluoride in all the water supplies. Only 33 percent of the county’s drinking water has fluoride added. Unless you live in Dunedin, Belleair, the southern portion of Oldsmar, Gulfport or the city of St. Petersburg, your water doesn’t have it. And even some who have a St. Petersburg address get their water from Pinellas County, which doesn’t add fluoride.
The cost of adding fluoride, a naturally occurring mineral, to drinking water is less than a penny per thousand gallons of water. But the long debate over fluoride is not fueled by financial concerns. For all the dentists and doctors who praise fluoride, there are vocal critics who are concerned with government interference in drinking water.
“It’s been a continual fight in all my years in St. Petersburg. It’s so obvious that it has been of benefit and absolutely no harm,” said Betty Hughes, a St. Petersburg dentist for 29 years and past president of the West Coast Dental Association representing 1,700 dentists.
“When this comes up for debate every couple of years, the Pinellas County Dental Association is all there to support it. But unfortunately there are folks coming in from other states bringing what I call whackos out of the woodwork” to complain.
Since it’s not added in all the water, many schools offer students mouthwash with fluoride. And obviously brushing with a fluoride toothpaste helps prevent tooth decay, too. But those kinds of fluoride treatment only get to the teeth in the mouth. Fluoride in the water or in tablet and drop supplements is ingested into the body to help form teeth years before they ever break through the gums.
“Depending on where you live it’s too bad if you don’t have” fluoride in the water, said St. Petersburg pediatric dentist Miles Levitt. “A newborn baby, besides all the baby teeth growing in the mouth, has some of the permanent molars and tips of the front teeth already starting to grow.”
That’s why many pediatricians prescribe fluoride tablets or drops to babies who live in areas without fluoride in the water. Children usually take the supplement from about 6 months ofage to 12 or even 16 years. It sounds easy but there are still many questions and concerns.
Can too many fluoride tablets or drops cause white spots on the teeth? What if you live in anarea with fluoridated water but your children drink only bottled water? If your kids do get fluoridated water at home will they get too much fluoride if they get the mouthwash at school?
Gilmore was instructed to give the drops every day but heard from other parents that might cause white spots on children’s teeth. She also wonders if her children get the same protection as those with fluoride in the water.
“If you take too much fluoride you can get fluorosis of enamel, which is spotty looking enamel,” Levitt said. “But if you follow the guidelines, if you take the right amount every day, you will not get fluorosis and it’s not too much fluoride.”
Children who get a supplement at home in their water or take the tablets cannot be harmed by additional fluoride mouthwashes or toothpaste, he said. That’s because the fluoride in the water and tablets is ingested and the mouthwashes and toothpaste are only topical. But, he added, be sure your children aren’t swallowing the mouthwash or toothpaste.
Levitt also touted a new dental floss that has fluoride added to get between teeth. As for children who live in a house with fluoridated water but only drink bottled water, he doesn’t think they need supplements.
“They are still getting the fluoride,” he said. “When you make Jell-O or use it in Kool-Aid or when they are taking a bath or shower, or if they go to school and the water is fluoridated there, they are getting it.” So bottled spring waters that tout fluoride, such as the new Dannon Fluoride To Go aren’t necessary for either kids who have fluoridated drinking water or those who take fluoride tablet or drop supplements.
Hughes, however, disagrees.
“You might not do enough cooking. And a lot of foods do not use that much water,” she said. “Kids don’t have the opportunity to drink that much at school. Perhaps they might get one glass of water, but that’s not going to do it.”
One thing all the dentists agree on is that there would be a lot less confusion and many fewer cavities if fluoride were added to all of the county’s water. Even though supplements can make up for a lack of fluoride in the water, many children don’t know to take them and their teeth suffer greatly.
“We have rampant decay in some of the poorest areas,” said Haychell Saraydar, dental director for the Pinellas County Health Department. “For every $1 spent (to fluoridate all the water) each person would save $80 on dental treatments. We have tried for many years but the community has to request it.”
Residents might have their chance to voice their opinions in September when the County Commission meets with the county utilities department for a workshop on water quality.
“The new commission hasn’t been faced with the issue,” said Pick Talley, Pinellas County’s director of utilities. “Citizens could call and say they want the county to consider that.”
In 1997 the County Commission considered adding fluoride to county water but backed off when a few vocal critics came out against it.
“My review of it is the institutions with more credibility such as CDC, the National Science Foundation and water utility industry experts predominantly agree it is a significant benefit, particularly to the younger population,” Talley said. Even with an initial cost for equipment of about $100,000, he said the cost would be almost insignificant to water rates.
If you have an opinion on fluoridating all the water, call the Pinellas County Commission at 464-3377 or the county’s utility department at 464-3438.