In a small Western Maryland dental clinic, William Tompkins examines X-rays that reveal the ravages of decay in the smile of a 4-year-old girl.

Glowing clearly from the fuzzy image of her mouth is the metal of 12 fresh fillings.

“That’s half her teeth,” Tompkins says, shaking his head. “My friends in Washington tell me if they saw that many cavities in one mouth, they’d be on the phone to social services. But out here, it’s not all that unusual.”

In most places, tooth decay counts as a low-grade public health concern. But in Maryland’s mountainous western reaches, an unlikely political force has put the region’s dental woes at the top of the agenda.

A group known as the Fluoride Dream Team, made up of dozens of dentists, has financed campaigns and claimed seats on the Frostburg and Cumberland city councils. Most significantly, this spring the group persuaded officials of both cities to do for the first time what most municipalities have done routinely for decades: add a touch of fluoride to the water supply.

The prudence of water fluoridation, once hotly debated across the country, is widely accepted as a cheap and effective preventive of tooth decay. But in this rural stretch of Maryland, as in a dwindling number of towns nationally, doubts about the practice have sustained an epic political battle and continue to stir emotions.

“They push this stuff as good for your teeth,” said Bernard W. Miltenberger, a Frostburg florist and self-proclaimed “pure-water” activist. “But we see it differently. Our position is that [fluoride] is poison.”

For four decades, opponents of fluoridation have held a tight grip on the list of ingredients entering the water supply that serves Frostburg, Cumberland and scores of smaller towns on the fringes of the Appalachian Mountains.

In the 1970s, they waged their campaign in a self-published local newspaper. More recently, they have been active on the Internet, establishing Web sites, trading research and strategy, and raising money for their legal efforts.

Until recently, fluoride foes prevailed here, even as the mineral was being added with little objection to water almost everywhere else.

Ten years ago, a brief attempt to add fluoride to Cumberland’s water so unnerved city residents that they ousted an otherwise popular mayor. That sent a powerful message, and elected officials assiduously avoided the issue thereafter, declaring it “the third rail of Western Maryland politics.”

But last year, fed up with state reports that the region suffered from the worst rates of tooth decay in Maryland, dentists organized political slates in Cumberland and Frostburg and took an active role in government. Frostburg dentist Jeffery Rhodes, 39, one of the newly minted council members, said his election victory in June signaled the region’s changing sentiments.

“Efforts to strike fear in people have finally worn down,” Rhodes said. “Reason has prevailed.”

Last month, after hours of contentious hearings, the Frostburg water superintendent added fluoride to the water supply for the first time. And this month, Cumberland officials reiterated support for a similar plan, despite promises of a lawsuit and ballot initiative from protesters.

The anti-fluoride crowd, led by an 80-year-old land surveyor who keeps shoulder-high stacks of files on the topic in her rural mountain home, has promised it won’t back down.

“They’ve got people brainwashed,” said M. Virginia Rosenbaum, the longtime Pure Water Committee leader. “They’re going to ruin the water.”

The basis for that accusation is culled from piles of research papers, most pulled off the Internet, that travel a well-worn circuit among fluoride foes around the country.

Some say fluoride causes brain and kidney damage; others link it to cancer and Alzheimer’s disease.

Public health officials say most of the research is marked by the flawed logic that helped breed earlier campaigns against fluoride. They call it “junk science” and compare it to claims of the 1950s, when opponents branded fluoridation a communist plot, and of the 1980s, when they suggested a link between fluoride and AIDS.

“We have years of accumulated science showing the safety of this,” said William R. Maas, who served for four years as the nation’s chief dental officer under the U.S. surgeon general. “But you can put anything out on the Internet, dress it up as science on a nice-looking Web site, and disseminate it rapidly.”

Occasional research efforts, such as the work recently published by Dartmouth College political science professor Roger Masters, raise new questions about the possible risks of fluoride.

Masters’s work focuses on the switch in many locations from the use of sodium fluoride to sodium silicofluoride. He says government testing on sodium fluoride would not have revealed possible links between the newer compound and elevated blood levels of lead in children.

The harmful effects of this “could be staggering,” he said, and would make fluoridation a possible culprit for problems linked to elevated lead levels in blood.

Masters’sresearch has brought sharp dissent from some scientists. But Masters says public officials can be fallible, and someone ought to “at least study [the issue further], before running the risk of poisoning the citizens.”

For activists like those in Western Maryland, Masters’s research offers more than enough validation to keep them fighting. Their latest move, with the aid of a Cumberland lawyer, is to plan a federal lawsuit challenging the constitutionality of the city’s public health effort — calling it “mass medication.”

The group’s unwillingness to yield brings frowns to the faces of the area’s dentists.

Tompkins, the dentist whose LaVale clinic was visited by the 4-year-old with 12 cavities, said their efforts will only hurt children.

He notes a University of Maryland study in which researchers examined the mouths of 54 local children. They found 213 cavities.

Dentists “deal with the consequences of these pure water folks,” Tompkins said. “It should come as no surprise that we have the worst rates of tooth decay in the state.”

Frostburg Mayor John N. Bambacus said his concern reaches beyond public health. He worries that time and resources have been wasted on the fluoride debate, when they could have been directed at other serious problems facing the region.

Towns that once depended on mining, manufacturing and railroads have had little success attracting new, high-tech industry to the rolling green mountains, 180 miles from Washington. Evidence is plentiful — in the empty storefronts, declining population and school closings — that the region’s economy is in decay. But talk still centers on teeth.

“Sometimes when I think about that,” the mayor said, “it’s hard to believe we’re in the 21st century.”

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Washington Post

June 5, 2001

A Fluoride Debate

Letter to the Editor

A Fluoride Debate

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Matthew Mosk’s May 27 Metro article about fluoridation could have benefited from a wider awareness of fluoridation globally. He presents fluoridation as universal, but less than half the U.S. population drinks fluoridated water, and globally almost no water supplies are deliberately fluoridated except those in the United States.

In Europe, for example, less than 5 percent of water supplies are fluoridated, and in many countries it is banned. Such laws were enacted in Europe after studies done in the Netherlands and elsewhere showed water fluoridation to be ineffective and possibly dangerous.

In Japan it is legal to fluoridate water, but no municipality does so because the dentists oppose it and scientific studies on fluoridation done in Japan have had the same result as in Europe: that it is ineffective and possibly dangerous.

Before representing Appalachian fluoride opponents as ignorant kooks, I think we should look beyond our own borders and take an objective look at the global evidence, which suggests they may be right after all.

JOHN CHAMBERLAIN
Natick, Mass.

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Can The Post produce one study that would substantiate the notion that a mouthful of ruined, decayed teeth can result from living in an unfluoridated area?

In 1986 the National Institute for Dental Research (by no means an anti-fluoridation outlet) conducted the largest survey on dental health ever done in the United States. It found the average difference in tooth decay between fluoridated and unfluoridated areas was a meager 0.6 tooth surfaces, which is less than 1 percent of the 128 tooth surfaces in a child’s mouth.

The Post’s story said that the fluoridation controversy is “dwindling.” Hardly, as evident this year by the vast opposition in Oregon to a mandatory fluoridation bill that couldn’t get the votes to make it out of committee.

Part of what has fueled this growing controversy about fluoridation is a request made last summer by the scientists and professionals at EPA’s headquarters union for a “national moratorium” on fluoridation in light of its inefficacy and deleterious effects on health.

MICHAEL CONNETT
Canton, N.Y.