By Vesta Copestakes

Sonoma County’s debate on putting fluoride in our water system is heating up. It will cost more than $10 million to establish and more to maintain. Some people think it’s an effective way to help children grow up with healthy teeth – others consider it a poison in our water system. As the discussion continues, we have opportunities to learn the pros and cons of this concept.

The ReThink Your Drink Campaign is a perfect example of why this isn’t a simple solution. People don’t drink tap water. They drink bottled water, soda, coffee, fruit juice and more. Putting a glass under the faucet  isn’t the most common way to ingest liquid.

This campaign is especially targeting Latino communities where people have grown up with a distrust of tap water. This same community is the target for fluoride because children coming to emergency rooms with severe dental decay are primarily Latino children.

ReThink Your Drink tells us that people are choosing sugared drinks that are cheaper than bottled water. These sugared drinks are rotting our children’s teeth. Can we convince people to drink fluoridated tap water to save their teeth?

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Life is Better with Teeth

By Lynn Silver Chalfin, MD, MPH, Sonoma County Health Officer

It’s time for County residents to hear the other side of the fluoridation controversy. It’s about teeth.

Tooth decay is one of our most common health problems. Kids miss school and get lower grades. One third of poor elderly have no teeth left.  Daily nearly a dozen local kids are treated for serious tooth decay using general anesthesia. Over 1,500 County residents land in the ER annually for dental emergencies, at huge cost to their families. Residents get thousands of fillings, extractions, abscesses, and other painful and expensive – but preventable – dental work.

How can we change this? The answer is multi-pronged:  1: Better access to dental care for everyone. The Sonoma County Health Department is working with community partners to increase access to dental services. 2: Education: A new educational campaign – Healthy Teeth for a Healthy Life was just launched to increase awareness of dental disease – how to prevent it and to get care. But care is expensive and comes late. Prevention is better. 3: Improving diet is key – we work to increase access to affordable healthy food and decrease soda and junk.  4: Everyone needs preventive services and we work with partners to offer them to children and pregnant moms and are starting school-based services. 4: Water fluoridation is a highly effective preventive measure. It reaches every tooth, every day. Three quarters of Americans and most Californians receive safe, fluoridated water. Fluoridation safely reduces tooth decay in both children – by ¼ to ½ and adults by over ¼.  It is synergistic with other prevention.

Virtually every major health organization supports it, associations of your family docs, your dentists, nurses, the Institute of Medicine, the CDC, the American Cancer Society (over 100). Sonoma County Medical Association and Redwood Empire Dental Society support it. These people are not in the pay of the chemical industry. They are reading the studies.

What is this stuff? It is present throughout nature. Ocean water has twice as much fluoride as water fluoridation. The Russian River has natural fluoride. Water fluoridation simply takes fluoride from ground up rocks and standardizes concentrations at a very low level that protects teeth without causing harm. Fluoride is like salt or Vitamin A – your body needs a little bit but way too much is not good. The Institute of Medicine recommends an Adequate Daily Intakes to protect tooth health. A man drinking 8 cups of fluoridated water would get only about 1/3 of his adequate intake.

Mythbusting:

People go on an internet sites, with endless examples of scientific “evidence”, mainly about the “way too much” doses, taken out of context. This generates groundless fear. What did the people who actually wrote some of these papers have to say?

A prior Gazette author said:  “To start fluoridation … before the EPA has determined a new safe drinking water standard and goal, as recommended by the National Research Council in 2006, would be reckless and irresponsible.”  But John Doull, MD, PhD, Chair of that 2006 report says: “I do not believe there is any valid scientific reason for fearing adverse health conditions from the consumption of water fluoridated at the optimal level.”

Some opponents cite an Iowa study led by a national expert on dental fluorosis as a reason not to fluoridate.   Sonoma County Public Health reached out to fluorosis expert Dr. Warren in Iowa to ask what he thought about fluoridation. His answer:  “I am totally supportive of water fluoridation… the benefits of fluoridation far outweigh the risk of dental fluorosis (the only known risk associated with optimally fluoridated water)..Dental caries, which water fluoridation clearly helps to prevent, can be devastating – this disease can cause pain, infection, impair function and cause much greater esthetic concerns than fluorosis.  The trade-off between caries prevention and fluorosis prevention is a “no-brainer” – any rational person would chose to risk mild fluorosis for caries prevention. Iowa Fluoride Study

We all care about fish. Sonoma County Public Health reached out to NOAA/US Fisheries to find out what they know about our endangered species. Their Northwest Science and Research Center Director answered “ I’m not aware of effects on salmon in rivers receiving fluoridated water effluent”. We continue to study environmental issues with fisheries and other experts.

Whether or not county drinking water will be fluoridated will not be decided tomorrow. It is under public discussion. An advisory committee has been created, hearings held and opportunities for public input continue.  Please visit our website: www.sonoma-county.org/health/topics/dentalhealth.asp to learn more.

The issue will return to the Board of Supervisors in 2014. But rejecting a safe, practical and effective measure for a problem that causes widespread suffering comes at a steep price. Pain, lost school and work days and hundreds of thousands of families paying millions of dollars for dental work that can be prevented. Life is better with teeth.

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Fluoridation: Why NOT

By Thomas D. Bonfigli (Clean Water Sonoma Marin, a group which opposes water fluoridation)

Recently, the Press Democrat editorial department wrote an editorial criticizing our Grand Jury for not endorsing municipal water fluoridation.  While I, too, am disappointed that they took no stand, it is for the opposite reason, as I do not feel that fluoride, which is a by-product of the phosphate-fertilizer industry, belongs in our precious Sonoma County Water supply.  The dangerous side effects caused by fluoride are numerous, and include dental fluorosis, bone fractures and, as proven recently by a Harvard University study, diminution of I.Q.

However, the purpose of this article is not to dwell on the dangers but, rather, the inefficacy, ineffectiveness and expense of this old-school idea whose time has passed.

And to prove these points, we find ourselves reviewing the situation in Kentucky.

If municipal water fluoridation were the magic panacea and dental-health-care cure-all that some people in this county are claiming it is, then Kentucky, which is the most fluoridated state in the entire union, at 100%, and began the practice of municipal water fluoridation in 1951, should have the best dental health in the nation.  But the stubborn and irreducible fact is that they have among the worst dental health in the entire country.

In fact, recent statistics indicate that Kentucky has the second highest tooth loss in the entire country, at a staggering 38.1%, leads the nation in the number of dental cavities and has the highest number of toothless adults.  And in a 2001 study, half of Kentucky’s children had decay in their primary teeth.

Other cities and states, which boast of high rates of water fluoridation, West Virginia, Washington, D.C., Boston and Detroit, also suffer from high rates of cavities.

By contrast, Hawaii, which has just nine percent of its municipal water fluoridated, has the lowest rate of toothless adults in the nation at 10%.

Kentucky’s state governor, Steve Beshear, felt that the problem was so serious that he dedicated a large portion of his Governor’s Blog on 10-03-09 and 8-26-11 to address this serious health issue.

He said: “Kentucky has a problem with its national image.  Whether it’s 20/20 News show or a made-for-TV movie, too often, the face of our state is that of a person missing a mouthful of teeth” As a result, he has instituted a program called “Smiling Teeth,” which has three main components:

1.  Applying protective varnish to the teeth of children in 1st through 5th grade;

2.  Conducting outreach to increase public awareness of the importance of children’s dental health;

3.  Having local health-department nurses examine children for other dental problems and, if necessary, referring those who need additional treatment to dentists.

The governor also makes mention of increasing the number of mobile dental clinics in that state and purchasing additional dental equipment, as well as teaching dental education to the students.

You will note that nowhere in his program does he make reference to that state’s municipal water fluoridation program, which began in 1951.  That’s because to do so would be to admit that it has been a complete and utter failure, not to mention a colossal waste of taxpayer money.

I submit that what Governor Besher is proposing to do is the “new progressive.”

The question now is:  Are our county leaders going to follow Kentucky’s lead?  I will remind them that this is progressive Sonoma County.  We’ve supposed to be the leaders in this respect.

And, conversely, it cannot be denied that Kentucky has wasted a HUGE sum of money on fluoridation since it was first instituted in that state in 1951.  And what did they get in return for their unwise investment?  Some of the worst dental health in the nation.

Let’s learn from their mistake and not repeat their error here.  Let’s instead learn by their example and adopt some of the components of their program and make them available to those who need them most and toss the tired, old, anachronistic and scientifically discredited practice of municipal water fluoridation out the window where it belongs — once and for all.