Chances are that even the Tooth Fairy who shows up annually at Riviera Elementary can’t tell the difference, but there’s a little less fluoride flowing in local water these days.

Several Brevard cities — including Palm Bay, Cocoa, Melbourne and Titusville — are among those whose water supplies now mirror recently released federal guidelines calling for lower fluoride levels.

Officials agree that because so many sources of it are available — in toothpaste, mouthwash and other products — there’s not as much need for municipal water to have higher levels of fluoride, popularized in the 1940s as a tooth-decay deterrent but capable of causing medical problems at elevated levels.

The new guideline, 0.7 milligrams of fluoride per liter, replaces the previous range of 0.7 to 1.2 milligrams.

Utilities director Jason Yarborough said Palm Bay, which began putting fluoride in water in 2002, “has a duty to the community to stay familiar with changes in policy and processes that affect the treatment of drinking water.”

The change wasn’t drastic in Palm Bay. In the years since the city began the fluoridation process at its water treatment plants, the city’s levels had hovered on the low end of the recommended range — about 0.8 milligrams per liter. In February, the average fluoride level was 0.76 milligrams for the 6 million gallons of water leaving Palm Bay’s water treatment plants daily, Yarborough said.

Dr. Kristin Mirda, a pediatric dentist in Melbourne, said the updated federal guidelines are much better than the previous 1.2 high end, which would be “pushing it,” she said.

She doesn’t see much enamel fluorosis — caused by too much fluoride during tooth development and marked by discoloration or brown marks on the teeth — in her young patients, but does see rampant tooth decay because of poor dental care.

“The 0.7 is definitely good. There are a lot of misconceptions about fluoride,” said Mirda, who did research on it during her residency. “At that level, it’s doing its job.”

Levels vary

Titusville, which supplies water and also purchases water from Cocoa, started fluoridation of water around 1983, said Maureen Phillips, water conservation and public outreach manager. The naturally occurring levels of fluoride in area water “is not that great,” so Titusville started adding it “to benefit our population,” she said.

The annual drinking water quality report for 2010, reflecting samples from 2009, showed Titusville’s level at about 0.9 milligrams per liter in February of that year, she said.

“As with anything, too much is bad and too little is bad,” Phillips said. “That’s why we’re constantly reviewing recommendations and what our requirements are for health and safety in our drinking water.”

Troy Howell, superintendent of Cocoa’s water plant, said the city has been fluoridating water for more than 20 years. The latest annual drinking water quality report showed a level of 0.6 milligrams per liter for a sample taken in May 2009.

And in Melbourne, the level is now consistently around 0.7 milligrams, said Ralph Reigelsperger, public works and utilities director. The 2010 annual water quality report, for January through December 2009, listed fluoride at 0.8 milligrams per liter for a May 2009 sampling.

Controversy

The use of fluoride remains controversial worldwide, with those opposing it citing potential medical risks from its use at high levels. Mirda said she has talked with parents who don’t want products containing it used in their children’s treatment.

In Melbourne, where fluoride has been used since the ’60s, “we get both sides of it, two extremes,” said Reigelsperger. “One side says it’s poison; the other says it’s important and reduces cavities.”

The current Palm Bay fluoridation process is a far cry from 2002, when a FLORIDA TODAY story reported that a pediatric dentist was leading the charge to get fluoride added to city water. Within four years, the city received the first of back-to-back awards from the Centers for Disease Control and Prevention for meeting monthly optimal ranges of fluoride concentration levels.

Complaints have been few, Yarborough said.

“In my six years with the city, I am only aware of three concerns about the use of fluoride in our water,” he said. “They were concerned about adding too much fluoride and I communicated that we use the lower end of the range.”

Kids learn early

At Riviera Elementary in Palm Bay, information about fluoride starts early. For the past three years, members of the Brevard County Dental Hygiene Association and the Tooth Fairy have met once a year with children in kindergarten through second grade.

“They offer a free fluoride rinse — with parents’ permission — and watch a video about brushing, flossing, eating proper foods and lowering sugar,” said Vice Principal Sally Ann Corbley.

“The children then get a fluoride rinse and the Tooth Fairy sings a song about health care. It’s been very successful and the parents are happy with it.”

By the numbers

0.1 to 0.2: Milligrams per liter of naturally occurring fluoride in Palm Bay water in 2002, before city started fluoridation. 0.7: Milligrams per liter of fluoride recommended in new federal guidelines. 77: Percentage of state population on community water systems with fluoridation. $15,000: Annual cost for fluoride in Palm Bay water. 195,545,109: People in the United States who had access to fluoridated water through public water systems in 2008. — Palm Bay, Florida Department of Health, Centers forDisease Control

How does fluoridation work?

In Palm Bay, after raw water is processed and treated to remove bacteria, viruses and other contaminants, a 23-percent-pure fluoride chemical (the other 77 percent is water and other inert ingredients) is injected into the treated water. The fluoride then travels throughout the water distribution system.