HUMBOLDT – Whenever it comes up, the issue of community water fluoridation is marked by startling claims, strident rhetoric and strong emotions. But on the day before Manila’s vote on advisory Measure B, a fluoride defender denounced a statement made by the substance’s opponents with language unusually harsh for a public official. In capital letters, no less.

In a Feb. 4 e-mail message to Manilans titled “Fluoridation is socially just,” Humboldt County Health Official Dr. Ann Lindsay offered counter-arguments to points made by Humboldt Free, the Manila anti-fluoridation group.

Concluding the letter, Lindsay wrote:

“Now, let’s talk about an intentionally incorrect statement made against fluoridation. Anti-fluoridationists put door hangers out in Manila claiming the American Academy of Pediatrics said children under three should only drink a cup of fluoridated water a day. THAT IS AN OUTRIGHT LIE. The American Academy of Pediatrics said no such thing. The organization supports community water fluoridation.”

The “lie” comment begged for a response and, asked about it at last Thursday’s press conference, Humboldt Free co-organizer Liz Finger referred inquiries to former Environmetal Protection Agency scientist Mike Rademaker, who assisted the group during the Measure B campaign.

But Rademaker declined on-the-record comment, and appears to have disassociated himself from Humboldt Free.

Lacking an explanation from Rademaker, Finger offered the following:

“It is always difficult to communicate the nuances of technical information in terse campaign statements, and Humboldt FREE / No On Measure B (HF-NMB) has been asked to clarify a statement that referenced recommendations from the American Academy of Pediatrics regarding fluoride consumption. Although we now recognize that statement could have been worded more clearly, there was absolutely no intention to mislead anyone, and we welcome this opportunity to clarify the record.

“Campaign statements were based upon a policy document approved by the American Academy of Pediatrics (AAP) titled “Fluoride Supplementation for Children: Interim Policy Recommendations,” which was published in 1995 in the journal Pediatrics, (Vol. 95, No. 5, May 1995) which is the official journal of the American Academy of Pediatrics. The interim policy recommendations remain in effect today.

“In the text of the 1995 policy recommendation, the AAP recognized that many children were receiving “excessive” doses of fluoride due to the combined ingestion from food, toothpaste, pill supplements, and fluoridated water. They recognized that excessive fluoride consumption had resulted in an increased incidence of dental fluorosis (rates of dental fluorosis have increased even further since 1995). The AAP recognized that the only source of fluoride ingestion physicians could directly control was fluoride prescription supplements, which is why their recommendation was directed towards that particular source. However, they directed physicians to take into account the fluoridation level of a community.

“For instance, you will notice that the table in the article indicates that in situations where children are drinking water without significant quantities of fluoride (defined as less than 0.3 ppm in the table, i.e. non-fluoridated communities), fluoride supplements are NOT recommended for infants (0-6 months), and for infants and children (6 months – 3 years), no more than 0.25 mg a day is recommended. In communities with more than 0.3 ppm of fluoride, which would include fluoridated communities, they recommended that fluoride supplementation NOT be given at all to children under three years of age.

“So how did the HF-NMB campaign get to “THE EQUIVALENT OF ONE CUP OF FLUORIDATED WATER A DAY”? Fluoridated water (with a concentration of 1 ppm fluoride) contains 1 mg of fluoride per liter of water, and since one 8 oz glass of water (1 cup) is equal to approximately 237 ml, one cup of fluoridated water contains approximately 0.24 mg of fluoride. So the logic goes like this: if the AAP thinks that children under 3, who live in unfluoridated communties, should be limited to a 0.25 mg supplement of fluoride daily, then it would be logically consistent that children in fluoridated communities should only get a 0.25 mg “supplement” of fluoride from their fluoridated water, i.e. one glass of fluoridated water a day. Nonetheless, the AAP didn’t explicitly state this, therefore HF-NMB used the words “EQUIVALENT to one cup of fluoridated water” when referencing AAP recommendations. Again, the “equivalent of one cup” dosage comes from the fact that one cup of fluoridated water contains the same amount of fluoride as a 0.25 mg fluoride prescription supplement.”

Well, that clears that up. Or does it?

Dr. Steven Schonfeld, a local periodontist and also a former research scientist, who supports fluoridation, responded to Finger’s explanation:

“The statement that the American Academy of Pediatrics (AAP) recommends limiting toddlers to only a cup of fluoridated water is simply not true. The Academy has made no such recommendation – please check their website (aap.org) yourself.

“Like so many anti-fluoride claims, this one is based on a half-truth. The AAP does recommend limiting prescribed fluoride supplements to the amount of fluoride that would be ingested with one cup of fluoridated water. But confusing that statement with a limit on the amount of fluoridated water a child can drink ignores the difference between taking a concentrated fluoride supplement and drinking water with one part of fluoride per million parts of water. The more water you drink, the more water you eliminate and the more fluoride you eliminate as well. That’s why drinking fluoridated water is less likely to produce fluorosis than taking supplements or using fluoridated toothpaste (in fact, most fluorosis can be traced to these products and not to optimally fluoridated water) and is why you need a prescription for fluoride supplements but not to drink fluoridated water.”

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