…clothes or food, much less toothpaste,” said Dr. Kavita Ghai, a Union City dentist and one of many medical professionals in the state clamoring to add fluoride to the water supply.
“Fluoridated water is needed here. . . . if we had fluoride in the water, it would save not only children, but adults and also senior citizens, a lot of problems.”
According to the American Dental Association, 62 percent of communities in the United States currently have access to water with added fluoride. Recent studies show that fluoride, when released through saliva after entering one’s system in the water, constantly coats teeth with the element, and can reduce cavities by up to 50 percent in infants and by up to 60 percent in adults.
In addition to pamphlets and publications, the ADA regularly runs public service announcements – in both English and Spanish – on television and radio stations to highlight the importance of oral hygiene and fluoride. Fluoridation, which is not legislated at the federal level, is handled in most states as a local issue.
In New Jersey, Salem and Gloucester counties currently have naturally fluoridated water, while Atlantic, Burlington, Cape May, Hunterdon, Mercer, Middlesex, Monmouth, Ocean, Somerset and Union counties have water with added fluoride.
But Hudson County, with a population of 608,975 residents, including Jersey City – the state’s second largest city, with 240,055 residents – does not have fluoridated water.
Spokesmen from the county’s three water providers say that although there may be some naturally occurring fluoride in the water supply, they cannot purposefully add the element without approval from each of the communities they serve.
Bayonne and Kearny are serviced by the North Jersey District Water Supply Commission in Wanaque, which receives its water from a reservoir in Wanaque, Passaic County.
Harrison and East Newark are served by the Passaic Valley Water Commission in Little Falls, which receives its water from a Wanaque reservoir as well as the Passaic River.
Most county municipalities are served by United Water New Jersey in Harrington Park, which uses reservoirs in Oradell, Woodcliff Lake and Lake Tappan in Bergen County, as well as Lake DeForest Reservoir in Rockland County, N.Y.
Jersey City and Hoboken maintain partnerships with United Water, which maintains their pipes and service. Both municipalities supply their own water from reservoirs in Boonton in Morris County and Split Rock, Pa.
“It’s not uncommon to receive the occasional phone call on fluoride,” said Kevin Doell, manager of media relations for United Water, which serves almost a million people. “If we were approached by politicians, or seriously approached by large groups, we would certainly consider, or reconsider, the decision on fluoridating water.”
Once the subject of heated public debates in the county, local politicians say the issue of adding fluoride to the water supply has died down, although after more ADA studies, it may now be worth revisiting.
“It’s just not a topic that has come up in the six years that I’ve been on the Health Committee,” said state Assemblywoman Joan Quigley, D-Jersey City. “When I first began paying attention to politics, it was the hottest issue . . . but is hasn’t come up. I think people just accept it at this point.”
Carol Ann Wilson, director of the county’s Department of Health and Human Services, said she too hasn’t heard the issue mentioned in political or academic circles in the last decade.
“A decision was made a number of years ago, and I haven’t heard it mentioned since,” she said. “But maybe it should be an issue that should really be revisited. Maybe it’s time to reconsider it, to see if it has efficacy.”
In December 1974, despite public outcry that fluoridated water could cause cancer, a weakening of the bone structure, birth defects or other ailments, Jersey City and Hoboken added the element to their water.
Four years later, in September 1978, it was removed following a referendum.
The total vote for the two municipalities was 13,345 in favor of fluoride and 14,727 against.
At the time, proponents, including many dentists and the American Dental Association, said fluoridation of public drinking water was urgently needed. They cited studies from the 1930s and 1940s that showed fluoride markedly reduced tooth decay.
Opponents, such as members of the New Jersey Citizens Opposed to Forced Fluoridation, labeled it a “dangerous drug” that was tantamount to poisoning and polluting water supplies. Fluoride, they said, could be obtained from a variety of sources, like toothpastes, tablets and liquid drops.
Today, more than 20 years later, families such as the Romanos are still relying on a number of prescription-based fluoride supplements, while a coalition of dentists and pediatricians throughout the state are desperately trying to raise awareness on the need for fluoridated water.
Local dentists say they prescribe topical fluoride supplements to nearly all their patients, but many – including those eligible for FamilyCare or Medicaid, which cover prescription drug costs – don’t purchase the products.
The first-ever surgeon general’s report on oral health in May identified a “silent epidemic” of dental and oral diseases that burden some population groups, and called for a national partnership to boost the nation’s oral health.
“Those who suffer the worst oral health include poor Americans, especially children and the elderly,” then-Surgeon General David Satcher said in the report.
He added that living in a community lacking a fluoridated water supply may also exacerbate oral health problems. According to the report, 44 million Americans lack medical insurance, and about 108 million lack dental insurance.
According to the U.S. Public Health Service, the optimum concentration for fluoride in water is 1 part per million, or 1 milligram per liter. That level can vary depending on the geographic area.
Marc Millstein, director of dental health for the New Jersey Dental Association, a constituent of the ADA, said the organization has been endorsing water fluoridation for “many, many years.”
“We’ve been trying to get people to support it, because it’s a win-win situation for everyone,” he said. “What the political people are looking for is groundswell. They need interest from a lot of people on a continual basis. That’s what will pique their interest.”
But citizens or members of local associations or organizations have simply not raised the issue of adding fluoride to the county’s water system in recent years, said U.S. Rep. Robert Menendez, D-Union City.
“It’s not something that has come up,” he said. “But to move to such a process you obviously need a critical mass of citizens who believe it is a good thing and think it should be done.”
Through an Internet Web site, some concerned parents in Hoboken are trying to rally support among fellow parents and neighbors to add fluoride to the city’s water supply. According to the ADA, 50 cents per person each year would cover the cost of fluoridation in an average community.
“I’m doing what I can to ensure that my children get the proper dosage of fluoride as advocated by our kids’ pediatrician and dentist,” said David Oberholtzer, who has two children, 1 and 3, and has done some research on the topic.
“Originally I was frustrated that we did not have fluoride in the water supply in New Jersey,” he said. “After my investigations, I am cynically entertained because of the legal and political machinations involved in trying to get fluoride in the water.”
Hoboken Mayor Anthony Russo said adding fluoride to the city’s water supply would likely raise monthly water costs, but he is open to citizens’ concerns and invites an “open dialogue” on the issue.
“I’m assuming the water company would probably not be able to bear the burden of the cost of adding fluoride,” he said. “If parents and citizens realize that fluoride might be an additional cost, we would be open to listening to what their constructive criticism is.”
Dr. Morton Berenbaum, a pediatric dentist in Bayonne, said he prescribes fluoride supplements for all his patients, but added, “even though we do that, it doesn’t mean every family will actually use it.”
He said even parents who buy the extra products may forget to give them to their children, or may not renew their prescriptions, not realizing the importance of fluoride.
“That’s why we need fluoride in the water. The point is fluoride works. It makes teeth stronger and reduces the chance of tooth decay,” he said.
“It’s absolutely necessary.”