Is adding fluoride to the water supply one of the all-time great public health initiatives?
Or is it a plot to weaken the population or perhaps dispose of industrial waste?
There’s a new push in Pennsylvania to require that fluoride be added to all public water systems, based on widespread agreement among scientists that it leads to healthier teeth.
The Pennsylvania Dental Association is leading the campaign, even though dentists in the trade group say healthier teeth will mean less business for them. They have a ground swell of support from a consortium of health-related organizations, including the Carlisle Area Health and Wellness Foundation.
“I think a lot of people just assume Pennsylvania’s water is fluoridated,” said Rob Pugliese, spokesman for the association.
Actually, about half of state residents get fluoridated water.
Legislation in the state House would require all water systems with 500 or more customers to add fluoride. The bill was approved 28-1 by the House Health and Human Services Committee. It’s in the Appropriations Committee now, and it’s unclear when the full House might vote.
The committee wants to discuss adjusting the timing so water systems can budget for the expense, rather than be hit in the middle of a fiscal year, said Barb Fellencer, communications director for the committee.
Supporters of fluoridated water cite the U.S. Centers for Disease Control and Prevention’s stance that it’s one of the great public health initiatives.
“The state supports fluoridation as a preventive measure. It has been proven and it’s supported by research from the CDC, the American Dental Association and other independent researchers,” said Dr. Howard Tolchinsky, the state’s public health dentist.
Tolchinsky said fluoride works through contact with the teeth, rather than by traveling through the body. So it benefits both children and adults with fully-formed teeth.
Pugliese said every dollar spent on fluoridated water saves $38 in dental care.
But some oppose the idea, arguing that fluoride has harmful health effects, and the push for fluoridated water might really be a way to dispose of industrial waste.
Dr. Steve Markus, a New Jersey dentist based just outside Pennsylvania, claims no evidence shows that people who live in communities with fluoridated water have healthier teeth than those who don’t. He also points out that the benefit of fluoride comes from direct contact with the teeth, so the majority of fluoride consumed in drinking water has no affect.
“If everybody wanted shinier floors, would you put floor wax in the water supply?” asked Markus, 57.
State Rep. Stephen Barrar, R-Chester, introduced the legislation. He worries that “junk science” will derail a bill he believes can greatly reduce what the state spends on dental care for poor children.
Supporters of fluoridated water contend many poor children don’t get fluoride if it’s not in their water. These children have poor dental health that affects their appearance and performance at school.
They also argue that many poor children don’t get routine dental care and say there’s a shortage of dentists who take patients covered by Medicaid, the government health plan for the poor.
Bets Clever, executive director of the Carlisle Area Health and Wellness Foundation, said 33 percent of children in the foundation’s service area don’t see a dentist regularly.
“The cost to repair those teeth is far greater than [fluoridated water]. I’m not a doctor or a scientist, but I wouldn’t promote it if it wasn’t considered a positive public health strategy,” she said.
State Sen. Pat Vance, R-Cumberland County, also is convinced that fluoridated water produces healthier teeth and can reduce some of the ills resulting from lack of dental care.
However, Vance, a former registered nurse and one of the Legislature’s top authorities on health care issues, has not favored a fluoridation mandate. She’s concerned about the expense for tiny water systems, such as those that serve mobile home parks, but said she might consider a bill that would exempt small systems.
Supporters say fluoridation costs between 50 cents and $3 a year per person, depending on the size of the water system.
United Water Pennsylvania supplies some Harrisburg-area communities that have fluoridated water and some that don’t. Spokesman Bob Manbeck said when a community wants fluoride, the first step is an engineering study that looks at the cost of needed equipment and alterations to the water system.