SALEM — During the 1950s, as cities across the nation considered whether to add fluoride to their water supplies to prevent tooth decay, communist machinations abounded as people questioned whether under the guise of offering stronger teeth was in actuality a government plot to control them with chemicals.
That was some three generations ago, yet today, the debate over fluoridating municipal water supplies rages on. The passion driving both sides of the contentious issues is as fervent as it was 50 years ago, as evidenced by Ashland’s ban on putting fluoride, or any other substance that would act as medication or a health supplement, in the city’s water supply.
However, that city ordinance, enacted in November 2006, would be short-lived if House Bill 3099 is approved. Now before the Oregon House of Representatives, the bill would require cities of more than 10,000 to fluoridate their water supply.
While House Speaker Jeff Merkley of Portland is opposed to state mandated fluoridation, a spokesman for Gov. Ted Kulongoski, a fellow Democrat, says the governor will sign the bill if lawmakers send it to him, characteristic of the division that exists among Democrats. Republicans are divided on the issue.
Supported by the American Dental Association, House Bill 3099 is the most recent proposal in the perennial debate over state mandated fluoridation. Similar proposals during the last three legislative sessions have stalled.
When the proposal is voted on by the full House on Thursday, there will be no mention of communist plots or conspiracy theories, but some legislators are apt to argue that mandatory fluoridation is an affront to personal liberty and a city’s right to choose for itself.
Only a quarter of Oregonians drink fluoridated water, compared with two-thirds of people nationwide, making Oregon among the three states with the lowest percentage of residents who have fluoridated water available to them.
The good news for opponents of the bill is that there is no money in the bill to fund the mandate, so cities would not be required to begin fluoridation until funding is available — whether from the state or other sources, including charitable foundations and non-profit organizations.
Democratic State Sen. Alan Bates of Ashland is among the harshest critics of fluoridation in the state Legislature. As a physician, he said he was taught, “First, do no harm.”
Unlike brushing with toothpaste containing fluoride, drinking fluoridated water has not been proven to be of any benefit, Bates said.
“There are a lot of contradictory studies out there on water fluoridation; some studies say it’s beneficial, some says it’s not,” Bates said. “But thinking that fluoride is beneficial is not enough to make people drink it.”
He added, “I am willing to change my mind as long as somebody can prove to me it works and it’s safe.”
Ashland City Councilor Cate Hartzell, an ardent opponent of fluoridation, said in an interview Monday night that the city’s water supply should “not be a means to medicate people” without their consent.
Rejecting the prevailing view that fluoride is essential for healthy teeth, Hartzell said that she did not give her four children fluoride-containing products — not even toothpaste that contained the chemical.
“There is this long-standing myth out there that fluoride is a good thing, but science shows that it isn’t,” Hartzell said. “Fluoride has been shown in several studies — from Harvard on down — to have deleterious health effects.”
Among them, she said, teeth discoloration, bone deterioration, cancer and brain cancer.
Hartzell said her position is bolstered by a 2006 study by the National Research Council and the subsequent warning by the American Dental Association against using fluoridated water to mix infant formula, as formula made with fluoridated water contains up to 250 times more fluoride than mother’s milk.
“What are poor families to do,” she said. “I work at the Food Stamp office; people can barely afford food let alone bottled water.”
Dr. Marion McDonagh was the lead scientist of a landmark University of York study in 2000 that reviewed 214 published studies on the benefits and risks of fluoridation. The study, she said, concluded that fluoridation reduces tooth decay.
“There is a benefit; it’s probably smaller than originally thought,” McDonagh said speaking from her office at Oregon Health and Science University in Portland. “There is at least some harm, too,” namely fluorosis, which causes unsightly white blotches on the teeth from exposure to too much fluoride.
McDonagh, an assistant professor of medical informatics and clinical epidemiology, conducts evidence reviews in OHSU’s Evidence-based Practice Center. She said her analysis for the British government, before arriving at OHSU, showed that aside from cosmetic tooth damage, there is no evidence of harm from fluoridation.
“When we looked at all the other harms — cancer and bone fracture — there was no association found,” she said.
Michael Framson is the southern Oregon liaison for Oregon Citizens for Safe Drinking Water. He disagrees, saying that fluoridation “has been a failure across America,” noting that the rates for cavities are “no better, no worse” in cities that fluoridate than in those that do not.
“Fluoride is sold on endorsements, not on good quality science,” Framson said in a telephone interview from his Medford home.
Evidence supporting the benefits of fluoride are “weak,” he said, while indications that the chemical may be harmful are “accumulating.”
On its Web site, the American Dental Association says for five decades it has “continuously endorsed the fluoridation of community water supplies and the use of fluoride-containing products as safe and effective measures for preventing tooth decay.”
Still, Ashland City Councilor Alice Hardesty said that local communities should decide what passes their lips not the state Legislature.
“This is just the wrong way to legislate,” Hardesty said. “Cities should be able to control their own destinies on matters like this.”
Fluoride, a byproduct of phosphate fertilizer manufacturing, may turn out to be the inexpensive and harmless way to help prevent cavities that proponents say it is, but that is yet to be determined, Hardesty said, adding that until there is “more conclusive” evidence she will remain cautious.
“I am concerned with fluoride’s safety,” she said, “especially if mainstream research organizations like the National Research Council advise us to be cautious.”
Willie Tiffany, a senior staff associate with the League of Oregon Cities, said putting the merits of pharmaceutical fluoride aside, his organization is opposed to the bill because the decision whether or not to provide fluoridated drinking water is one best made locally.
“There is nothing more fundamental than local governments do than provide their citizens drinking water,” he said.
Chris Rizo covers the state Legislature for The Daily Tidings. Reach him at firstname.lastname@example.org.