In 1988, 100 people packed the auditorium at Morris Elementary School in Lenox, but the audience wasn’t there for a school play.
What was billed as a presentation about fluoridating the town’s tap water, according to Eagle archives, turned into a “face-off” over the pros and cons of tooth-hardening fluoride.
“Children and adolescents in Berkshire County have the highest tooth decay rates in the country,” said Dr. Louis Yarmosky in his argument for adding fluoride.
Jerome Connoy, a resident with a chemical engineering background and co-chair of the ad hoc Lenox Citizens Against Fluoridated Water, said it would add yet another source of fluoride to diets and risk overexposing children.
Lenox residents, for the second time, would vote against the measure.
Now decades later, this debate is back in the national news, forged into a political issue. Recent reports about the potential risks of fluoride for children’s brains has set off a fresh debate and a court ruling that forces the federal government to make rules to limit fluoride in water. All of this has come to a national tipping point as Robert F. Kennedy Jr., President Donald Trump’s nominee for secretary of Health and Human Services, calls for fluoride to be removed from water.
But at least 140 U.S. cities and towns had already beaten him to it. And in Berkshire County, fluoride has never been added to the water.
‘UNCONTROLLED DOSES’
Fluoride is a naturally occurring mineral found in soil, air and water that makes tooth enamel more resistant to acid produced by bacteria in the mouth. That bacteria feeds on sugar.
The fluoride sold to water utilities is mostly in the the form of fluorosilicic acid and is a derivative of phosphate fertilizer production. Most comes from factories in the U.S., according to the Environmental Protection Agency, and some compounds are imported from China.
The CDC says that, “The safety and benefits of fluoride are well documented and have been reviewed comprehensively by several scientific and public health organizations.”
But a number of studies by the government and other scientists over the years also has linked fluoride to health issues, including ADHD. Interpretation of the existing science on fluoride is complicated — so much so that The Journalist’s Resource at the Harvard’s Shorenstein Center on Media, Politics and Public Policy has issued a guide for those writing about it.
Roughly 58 percent of Massachusetts residents lived where drinking water is fluoridated as of 2022, according to the U.S. Centers for Disease Control and Prevention. Approximately 500,000 Massachusetts residents get their water from wells without the additive.
Back in 1988, Lenox residents questioned the broader health impact of fluoride additives that are sourced from the fertilizer industry, according to Eagle reports and letters to the editor at the time. People worried that they would be swapping one health problem for another. Some argued that putting it in the water removed the freedom to choose what is a medical intervention.
Others questioned whether adding it to water would have the intended benefits. A major concern was the abundance of other sources of the mineral that included prescription fluoride, toothpaste and mouthwash, and “swish-and-spit” initiatives in the county’s schools.
There was also fluoride in the packaged food and drink chain. The addition of locally treated water might cause overexposure, as Connoy told Lenox residents at the time. The “dosage” could not be controlled.
“You can’t control the amount of water people drink or cook with,” he said. But Yarmosky countered that children would have to drink “several bathtubs full of fluoridated water to be harmed by it.”
Connoy was “misrepresenting the facts,” Yarmosky said. The trouble the dentist added, is that “people believe Jane Fonda more than they do doctor’s about what’s good for you.”
Residents voted against being the first town in Berkshire County to add fluoride to their tap water. It was the second time they said no. And attempts to add fluoride to public drinking water in Pittsfield in the 1960s and then in North Adams in the 1970s also fell flat. Another attempt in Great Barrington, in the 1990s, also didn’t work.
Like most of the country, levels of natural fluoride in the Berkshires’ water are so low they tend to be undetectable. This is why there were efforts in some towns to supplement the water as a way to strengthen the enamel of young teeth and prevent cavities.
But fluoridation proponents like Yarmosky and the town’s Board of Health ran into resistance. Opposition to the measure stopped the adoption of what is considered by many dentists and government health authorities to be one of the great public health endeavors of all time.
Today, all these years later, Yarmosky says “misinformation” is what did it. Connoy could not be reached for comment. But he and other detractors at the time said their concerns had scientific and ethical merit. Adding the mineral to the water, opponents said, would risk unnecessary overexposure.
“We all want better dental care for our children,” Connoy said in 1988, ”but we don’t want it pumped into our drinking water in uncontrolled doses.”
At that meeting he also quoted scientific studies showing that the reduction in dental cavities was happening at “identical rates” whether towns fluoridated or not.
NEW RESEARCH
There are a few reasons why fluoride is back in the news, and all of these center around the potential risks of “uncontrolled doses.”
One is a report released in August by the National Toxicology Program indicating fluoride at elevated levels may be toxic to children’s brains.
And in September, a federal judge ruled that the Environmental Protection Agency has to develop fluoride rules, citing an “unreasonable risk” to the intellectual development of children. The EPA said on Jan. 17 that it would appeal this.
The American Dental Association points to flaws in that National Toxicology research that include studying fluoride levels that are twice the level recommended by the CDC, and that the study did not provide any “new or conclusive evidence” that should prevent water fluoridation. Another reason is that many of the studies were done in China.
But the report made for sticky politics: Biden administration health officials, it later turned out, had delayed releasing that report linking fluoride to brain harm, citing the credibility of the study.
The EPA, which may soon have to come up with rules for water to prevent overexposure, reported in 2010 that most of a person’s fluoride exposure comes from tap water containing fluoride and drinks made with fluoridated water.
And there are signs of overexposure, like a 2021 study that found that 70 percent of U.S. children and adolescents had dental fluorosis — the result of too much fluoride when teeth are growing. Visible symptoms are white or brown specks on the teeth, according to the CDC.
The CDC says that for children younger than age 8 who drink water that isn’t filtered, parents should check fluoride levels in the water. The recommended level is 0.7 milligrams per liter.
‘A NONPARTISAN ISSUE’
While there is research showing water fluoridation is beneficial in reducing a person’s amount of tooth decay, there is also research showing that it might not make much of a difference.
The Fluoride Action Network, an organization founded by scientists, doctors and dentists, continues to push for more research about the health effects of fluoride — not just the “efficacy” of fluoride’s tooth hardening effect, said FAN Executive Director Stuart Cooper.
FAN joined the lawsuit against the EPA to push for stronger regulations.
“This is a nonpartisan issue,” Cooper said, referring to Kennedy’s sudden involvement in the debate. Cooper said the evidence of fluoride’s neurotoxicity has been piling up for some time.
“Water fluoridation is just redundant and dangerously so, meaning that all it’s contributing to is overexposure at this point,” Cooper said.
Given the mounting evidence of potential problems, there’s going to be “a huge domino effect” of communities pulling fluoride from the water, Cooper said. But the United States, he noted, would be joining most of the world.
“You have to realize we’re joining 98 percent of Europe and 95 percent of the world, right?” Cooper said. “We’re the outlier.”
‘EVERYTHING IN MODERATION’
Ingesting just enough fluoride and applying it to the teeth can stave off decay and reduce the incidence of it in a child’s mouth by 26 percent to 44 percent, according to one Australian study.
Local dentists like Yarmosky say that protecting one’s teeth is critical to overall physical health and well-being.
Yarmosky, now retired, is still a believer in water fluoridation given his dental school experience in cities with both fluoridated and non-fluoridated water.
“It was night and day,” he said, referring to the teeth of residents in Baltimore, whose water was fluoridated at the time, and the teeth he saw in Boston, whose water was not.
But it is true, Yarmosky said, that it isn’t good to have too much beyond what is helpful, and this is true for many things, including “the sun.”
“It’s not the case,” he said, “that more is better.”
Yarmosky, who practiced in Pittsfield and Great Barrington, said that fluoridated water acts as a dental safety net in communities where poor hygiene and diet, or a lack of dental care are contributing to decay. He also points to a deeper contributor to cavities and other teeth problems: when people breathe through their mouths rather than their noses, the saliva can’t build up to shield teeth from the bacteria that causes decay.
Dr. Min Chao, who practices in Pittsfield, said that a lack of fluoride in the water is “just a recipe for cavities,” especially without good dental care. But sometimes fluoride can’t overcome all that.
“Honestly, if you don’t have a good diet and if your diet contains a lot of refined sugar, no amount of fluoride can help,” Chao said.
But Chao also says that among families who “oppose fluoride,” she sees “more smooth-surface cavities.” Those cavities are decay that forms on the smooth, flat surfaces on the sides of the teeth.
Chao is not unfamiliar with the research indicating that ingesting too much fluoride has risks.
“Yes, it is a neurotoxin, but everything in moderation,” she said.
Original article online at: https://www.berkshireeagle.com/news/local/fluoride-debate-health-risks-water-safety/article_7f7bb01c-d51c-11ef-809c-63757087a222.html