About 8,000 residents were impacted when Brevard County removed fluoride from the Mims water supply last month, and local experts say low-income families are among the most vulnerable.
But as the battle over water fluoridation in Mims comes to a head, not all Brevard dentists agree it’s the best thing for the community.
“Fluoride is a neurotoxin. There is no level that is safe,” said Dr. Chris Edwards, a dentist of over 40 years and founder of the Smile Design and Wellness Center in Viera.
Edwards is among a small minority of dental professionals who oppose the use of fluoride in drinking water as a way to combat tooth decay.
Many of his claims — especially the claim that any level of ingested fluoride can be toxic — are disputed by the American Dental Association, the U.S. Department of Health and Human Services, and U.S. Centers for Disease Control and Prevention, as well as many of his peers in Brevard.
But his position is representative of an increasingly influential movement in Brevard that seeks to halt fluoridation of city and county water supplies, arguing the mineral can have unintended harmful health effects.
The debate highlights the complexity of the issue — and the difficulties for Mims residents, who will soon decide whether to support resuming the addition of fluoride to their water — as supporters and critics of the practice both say the science is on their side.
Opponents of water fluoridation have long claimed associations between fluoride and negative health impacts. In support, they point to a body of research that purports to show links between high levels of ingested fluoride and certain harmful conditions.
Among the effects suggested in the scientific literature, Edwards said, were links to thyroid dysfunction and osteoporotic fractures, or brittle bones. Other studies suggest links between fluoride exposure and reduced IQ in children, he said.
“When it gets in the body … it takes over enzymes and hormones,” he said. “It’s harmful to the human body.”
The potential drawbacks meant the removal of fluoride from the water in Mims was a net benefit to the community, Edwards said — even if it does prevent tooth decay.
“What’s more important?” he said. “The health effects far outweigh any potential dental benefit.”
But many of Edwards’ peers in Brevard strongly dispute that notion.
The research linking fluoride to negative health effects is overblown and outweighed by a much larger body of evidence, according to Dr. Angela McNeight, president of the Brevard County Dental Society.
“Seventy-five years of scientific evidence support water fluoridation as the most effective, safe and cost-effective public health measure to prevent and repair tooth decay,” McNeight said.
Many of the studies cited by fluoridation opponents suffer from critical flaws that make their results unreliable, she said.
Moreover, water fluoridation is supported by nearly every major health industry group and government health agency, including the ADA; the CDC; the HHS; the American Medical Association; the American Academy of Pediatrics; and the World Health Organization, among others.
That’s no coincidence, McNeight said.
“They spend money, time, effort, employees … to sift through all the evidence and research, to make sure they’re giving the right stance for our country,” she said. “That’s why it’s important to trust these organizations, because it’s their job.”
Dr. Yoshita Patel, a pediatric dentist in Viera who occasionally performs free dental work for underserved communities, said the removal of fluoride from Mims water would likely hit children the hardest — especially those from low-income families.
“Mims in general has a very high-risk population, adults and children,” Patel said. “It’s a population that doesn’t necessarily have access to care.”
The census-designated community, north of Titusville in North Brevard, is far from the central part of the county where most local dentists practice, Patel said.
In her experience, many of the poorest families, who already go without the regular care afforded by dental insurance, lack basic transportation to even reach the dentist’s office, she said.
Those end up being some of the worst cases, as untreated tooth decay progresses into more serious conditions, like facial infections, that can result in hospitalization.
“My concern is the patients I’m not seeing,” she said. “The greatest tool we have for risk and (cavity) prevention is water fluoridation.”
While Patel acknowledged studies that showed the toxicity of extremely high levels of fluoride, she didn’t agree that was enough to classify it as a neurotoxin.
“When you label something toxic, you have to be careful. Water is toxic at 100 liters a day, but it’s good at 1 liter a day,” she said. “Obviously, fluoride is going to have problems at a high level, just like water.”
It was unusual for dentists like Edwards, who are trained in interpreting science, to take an anti-fluoride stance, Patel said, but not unheard of.
“Just as you have people that are against vaccination, you’re going to have that in dentistry as well,” she said. “They still deserve a voice, but I don’t believe it is an equivalent voice.”
The situation highlights the complexity of interpreting a body of evidence that is unwieldly, highly technical, often contradictory and full of potential pitfalls, Patel said.
Especially with hot button issues like fluoride, where the science is nuanced, people can be quick to jump on any research showing the possibility of harm, even when that research isn’t representative of the broader evidence.
“I get the fear,” she said. “In anything, you need a healthy dose of skepticism. … That’s why I think we should sit down and pick these things apart as a community.”
A public discussion on the fluoride issue is scheduled for 5 p.m. June 21 at the Cuyler Park Community Center, 2329 Harry T. Moore Ave. in Mims.
Eric Rogers is the politics and government reporter for FLORIDA TODAY. Please consider subscribing to support important local news on government, business, crime and other topics you care about.