Pulaski, N.Y. — A decade ago, it was not uncommon for Harlow Dunton to look into the mouth of a 6-year-old and find a tooth so rotted and infected that he’d have to pull it.
That changed for the village of Pulaski dentist after 2005, when the village began adding fluoride to its water supply.
But now Dunton, who is retiring at the end of this year, expects dentists in the village to again find rotted and painfully infected baby teeth in the mouths of their young patients. That’s the because the village of 2,400 on the Salmon River stopped adding fluoride to its water Nov. 16.
In the past 12 years, 139 communities across the country have made that same decision even though fluoride has been named one of the top 10 public health advancements of the 20th century by the Centers for Disease Control and Prevention.
Communities began fluoridating their water in New York in 1945. About 73 percent of the population gets its water from a fluoridated source. Outside New York City, that percentage drops substantially: it’s about 42 percent, according to the state Department of Health.
More than 40 public water authorities in the five counties surrounding Syracuse do not add fluoride to their water, according to a database created by the Centers for Disease Control. Many other suppliers that provide water to mobile home parks in the region also do not fluoridate their water. Central New York communities without fluoridated water include the cities of Auburn, Cortland and Oneida, according to the CDC.
In Pulaski, public health officials with more than 50 years’ worth of research that shows both the effectiveness and safety of fluoride were not invited into the village water board’s debate before it voted to stop fluoridating.
The five-member water board approved Mayor Karl Hax’s request to turn the fluoride off the same night he asked. The mayor’s reason was a suspicion that the chemical was corroding Pulaski’s aging pipes.
Water board Chairman Mike Sacco said he wasn’t convinced that fluoride was corroding the pipes, but he didn’t think it should be in the water, anyway. He said it’s dangerous to people’s health and he’s not convinced of the dental benefits.
At the water board meeting that night, there was no talk of inviting experts before the board to answer questions about whether fluoride could be corroding the village’s pipes. The board did not decide to wait and invite an expert in to answer questions about the health risks of fluoride.
Bill Buckley, a dentist who had been on the board for 25 years, pleaded fluoride’s case the best he could. But he didn’t even know the matter was going to be on the agenda that night. The board voted 3-1 to stop fluoridating; one board member was absent. Buckley resigned after the meeting.
At the village board meeting the next month, 20 people showed up to speak. All but one of them wanted fluoride to stay in the water. They were doctors, dentists, nurses and dental hygienists. But the mayor and trustees let the water board’s vote stand.
The notion of shutting down the fluoride pump came up after the mayor stopped by a water leak that village workers were fixing a few months ago, said Gary Stevens, the village’s superintendent of public works. It was an average leak on Park Street: four guys, a backhoe, a dump truck. The broken copper pipes were replaced with plastic, Stevens said.
Hax said he asked the water board to turn off the fluoride because he thought it might be the cause of that leak and others.
Stevens said he has not seen an increase in leaks in the years since fluoride was added. But it seems the leaks had been different. The copper pipes are deteriorating from the inside, he said.
“Is it the fluoride?” Stevens said. “I don’t know.”
Stevens said he hadn’t been able to find any good advice on how fluoride affects the pipes.
Sacco, the water board chairman, said village water workers were told during one of their state-mandated training classes that fluoride damages the pipes.
Van Bartlett, the SUNY Morrisville instructor who taught them, said the course barely mentions the impact of fluoride on the pipes. This is all the text says on the topic: “Problems with fluoridation usually result from corrosion or encrustation from precipitates of calcium fluoride or silicic acid,” according to Bartlett.
“All that means is that there is the possibility that problems can occur from corrosion caused by fluoridation,” Bartlett said. He said he doesn’t discuss fluoridation’s impact on pipes beyond that sentence. The class does talk about handling the fluoride that’s added to the water supply, which, like chlorine, is dangerous before it’s diluted.
The CDC, state Department of Health and the New York Rural Water Association, which advises water systems including Pulaski, say fluoride does not cause corrosion.
Sacco said the pipes were not his true motivation for wanting to cut off the fluoride. He is worried the fluoride might be dangerous for the village residents.
“The fluoride is added as medicine,” Sacco said. “And it’s a nasty way to medicate people without their permission.”
Sacco, a retired utility line worker, was on the water board when it voted to add fluoride in 2005. He voted against it then, too. He’s unconvinced of the health benefits, he said. If people think it’s a good idea, they can decide to give fluoride supplements to their children, Sacco said.
Dentists in Pulaski had been prescribing fluoride supplements before the community began fluoridating.
Sacco also said he’s read that people have had medical problems from fluoride. He wasn’t sure what those problems were or where he’d read about them. But he said he was convinced that fluoride was poison.
Later, in an interview, Sacco said the village was violating the public’s right to informed consent. When asked about that, he said he was reading the passage from a book called “The Case Against Fluoride,” by Paul Connett, a St. Lawrence University professor of chemistry.
Connett’s book is often cited by the anti-fluoride movement. He often relies on studies of fluoride use in other countries, where concentrations are significantly higher. One of Connett’s main assertions, that fluoride is a dangerous, unregulated industrial waste byproduct, is disputed by public health professionals and was examined by PolitFact.com, which found the assertion false.
The only known health side effect of fluoride is something called fluorosis. If someone gets too much fluoride, the enamel on their teeth becomes stained and sometimes pitted.
Jayanth Kumar, a dentist and the director of the New York Bureau of Dental Health, was part of a National Academies panel that reviewed the potential dangers of ingesting too much fluoride. For the study, the panel looked at populations where the naturally occurring levels of fluoride in the water were four times the amount added to the water. The only negative effect found was fluorosis, Kumar said.
Kumar said fluoride is not considered medication because it’s something that naturally occurs in water and food, just not always in right amount to protect teeth.
Kumar recently studied New York state Medicaid payments for treating cavities in children. He compared the rate of those procedures in 2006 in communities with fluoride in their water to communities without. Kids in communities without fluoride in the water had 33 percent more dental procedures. Adding fluoride saved an average of $24 per child, according to the study.
A 2011 CDC study of children in Alaska found the same thing: a 32 percent higher rate of tooth decay among kids living in communities with nonfluoridated water.
Kumar said he’d like New York state to pass a law that mandates water system fluoridation. Twelve states already have such laws.
The backlash against fluoride is being fueled by the Web, where it doesn’t take a peer-reviewed scientific study to land at the top of a Google search. Often, anti-fluoride groups are paying to end up first in Web searches because they are selling books and other related products, said Shelly Gehshan, director of the nonprofit Children’s Dental Campaign at the Pew Center on the States.
“It’s all hogwash,” Gehshan said. “The more people o get information from the Internet that isn’t filtered, the harder it is to move forward.”
Her group, along with a coalition of others, started a website called Ilikemyteeth.org that lists the benefits of community water fluoridation and shows smiling kids with all of their teeth. The group is fighting fire with fire: It now also pays to land near the top of Web searches, too, she said.
Gehshan said, overall, fluoride is still winning. Over the same 12 years that Pulaski and 139 other communities decided to stop adding fluoride to their water, 297 others decided to start fluoridating. The most recent was Portland, where the water system serves 900,000 people. The issue was hotly debated there before a unanimous vote in September.
Pinellas County, in Florida, was one of the largest communities to stop fluoridating its water. It voted to turn off the fluoride pump in 2011. This year, lawmakers in that community of 700,000 voted to resume adding fluoride to the water.
Dunton, the Pulaski dentist, hopes that’s what happens in Pulaski, too. He said there’s been talk of a referendum to reverse the water board’s decision.
“We should be looking out for the kids that can’t stand up for their own rights,” Dunton said.