It’s in toothpaste, in dental washes for elementary school kids, in special drops and tablets. In minuscule amounts, it occurs naturally in food and even in nonfluoridated water.
This summer, after a 12-year respite, Palm Beach County commissioners will take up the decades-old debate again. Fluoride: magic bullet or poison.
“Fluoridating water is the most important thing we can do for public health,” said Bob Dumbaugh, dental director for the Palm Beach County Health Department. It prevents cavities and reduces health costs, he says.
Commissioner Jeff Koons is pushing to add it to the county-owned water system, which provides drinking water to nearly 400,000 residents, mostly in unincorporated areas and mostly south of Okeechobee Boulevard and west of Military Trail. A commission workshop has been set for Aug. 26.
Commissioners are likely to find organized opposition.
“It’s still an insidious method of trying to medicate people against their will with a toxic substance,” said Pat Moreell, a Boca Raton resident who has argued against it before numerous city councils.
Slightly more than 25 percent of county residents, some 296,670 people, get fluoridated tap water. The latest to add it — Boynton Beach and Wellington — approved it in 2000 after rancorous debate. Fluoride also is put in the water in West Palm Beach, Delray Beach, Belle Glade, Pahokee and South Bay.
Koons was on the West Palm Beach City Commission when fluoride was approved in 1991.
“I was shocked when I learned” that it wasn’t in the county system, he said. “It’s cut-and-dry. I just can’t let it go. Anything we can do for prevention we ought to do, especially with all the cutting back in federal and state money.”
Cost considered low
County officials estimate that the cost of buying equipment to fluoridate the water is relatively inexpensive, $500,000 to $600,000, with a $75,000 annual cost for maintenance and chemicals.
Commissioners approved fluoridation once before, in 1988, but they reversed themselves three years later, before the program began. Moreell and other opponents pointed to a 1990 federal study showing that four of 80 rats given 80 parts per million of fluoride in their water over a long period of time developed a rare bone cancer.
A person would have to drink 20,000 gallons per day to consume that much fluoride, the American Dental Association said. Palm Beach County would have 0.8 parts per million if approved.
Mary McCarty and Karen Marcus are the only current commissioners who were in office during the fluoride debate in 1991. Both voted against it.
“Twelve years is a long time. I’ll listen to what people have to say,” McCarty said. “I believe five of the other commissioners have made up their minds. I don’t think I’m the swing vote.”
Commissioner Addie Greene is already a firm supporter. “I always thought the water was fluoridated.” She and her eight siblings grew up in Alabama on fluoridated water and had few dental problems. “When I know something is right, I’m not going to let a small vocal group change my mind.”
Fluoridation has been hailed as one of the top ten public-health achievements of the 20th century by the federal Centers for Disease Control and Prevention. About 68 percent of the nation has fluoridated water, and the U.S. Public Health Service is aiming for 75 percent by 2010.
More than 70 percent of Floridians drink from public water supplies with fluoride added. All of Broward and Miami-Dade counties, with the exception of two small Miami-Dade communities, drink fluoridated water.
Stuart and Martin County will begin adding fluoride to the water in 2004. A St. Lucie County ordinance requires systems that produce more than 1 million gallons of water a day to add fluoride.
Dumbaugh, dental chief of the Palm Beach County Health Department, points to a 1982 study in which students from Pahokee, where the water wasn’t fluoridated, developed a 45 percent higher rate of tooth decay than students from Belle Glade, who drank fluoridated water.
Critics cite ‘relentless push’
Opponents argue that fluoride is a toxic byproduct of the manufacture of fertilizer and that it causes fluorosis, a symptom of which is speckled teeth, in youngsters. They say it is risky for the elderly because it may lead to a higher incidence of hip fractures.
“It’s a relentless push that originates with the U.S. Public Health Service despite all evidence of harmfulness,” said Palm Beach Gardens resident Naomi Flack, who said she helped organize the New York State Coalition Opposed to Fluoridation in the 1970s.
Dumbaugh says a shelf’s worth of peer-reviewed studies show fluoride is effective and safe. He said fluorosis is caused by swallowing too much fluoridated toothpaste or tablets, not by drinking fluoridated water.
He said no clear relationship has been shown between fluoride and bone fractures. He added that the production of fluoride is not toxic.
“As a public-health dentist, fluoridation is my No. 1 priority,” Dumbaugh said. “It’s cheap and it’s socially equitable. It doesn’t care if you’re rich or poor. It works.”