Fluoride Action Network

Berlin. Commentary: Water fluoridation a one-sided debate

Source: The Berlin Citizen | January 20th, 2015 | By Charles Kreutzkamp

The Berlin Water Control Commission was given an award recently by the Connecticut Department of Public Health and the Centers for Disease Control and Prevention – the Water Fluoridation Award of Recognition.

“This award recognizes public water systems that adjust the fluoride concentration in drinking water and achieve a monthly optimum fluoride level for 12 consecutive months. The Berlin Water Control Commission operates the Elton Road Well which is both chlorinated and fluoridated. Water is also purchased from the New Britain Water Department whose water is also fluoridated,” Commissioner Dr. Jewel Mullen said in a statement.

Mullen said “this award represents a high level of operator care.”

The Berlin Water Control Commission praised its field staff in a press release: Wayne Bugay, Charlie Satkowski and Michael Perzanowski “whose diligence and professional work has earned them this recognition.”

Fluoride is a mineral that is naturally found in water sources people were drinking for all of human history. Although health experts hail fluoridation as one of the greatest public health policy successes, organizations such as the Fluoride Action Network have seen success in anti-fluoride advocacy.

The Fluoride Action Network argues that fluoride may have the “potential to reduce human intelligence.” But experts disagree. In fact, FAN admits that Dr. Myron Allukian “stated that the Harvard team found only ‘a half point difference in IQ’ between the children from high-fluoride and low-fluoride areas. According to Allukian, ‘a half point difference in IQ is meaningless. That’s like saying, we measured all the people in New York and Chicago and in New York they were a half millimeter taller.’” FAN goes on to argue that this half of one percent difference is significant in the face of Allukian’s assertion that a 0.5 percent difference is nothing more than statistical noise. Scientific American points out the study has been thoroughly refuted.

At the same time, FAN is hardly impotent. Only last year, it reveled in victory when Portland, Oregon voters rejected fluoridation for the fourth time.

While FAN argues fluoridation is harmful, the World Health Organization is hoping to see the practice catch on in more countries, especially poorer countries where dental care is less available. The CDC, meanwhile, has hailed fluoridation as one of the 10 greatest public health achievements of the 20th century, along with recognizing the harms of tobacco.

I spoke with pediatric dentist and Middlefield resident Daniel Shoemaker to make sense of this. Shoemaker agreed that fluoridation is a great health achievement. “Tooth decay has become epidemic among our youngest children,” Shoemaker said, “Early Childhood Caries (cavities) are on the rise.”

With studies showing “fluoridated communities can show up to a 60 percent decrease in caries,” Shoemaker thinks fluoridation is “amazing.” Though caries aren’t life-threatening, they are a leading cause of absence from school and work and are expensive to fix. As a result, fluoridation is a practice that may have the greatest benefit for the poorest citizens – something Scientific American and Gawker eagerly pointed out following Portland’s anti-fluoridation decision. The CDC estimates that every dollar spent on fluoridation saves $38 in dental bills — an impressive ratio.

Water fluoridation has been practiced since the 40s, following studies on communities with naturally high fluoride in their water supply. After being instituted, water fluoridation encountered opposition, with some detractors opposing government making health decisions for citizens. In the 50s and 60s some claimed water fluoridation was a Communist plot to reduce the intelligence of the citizenry and make it easier to control – a claim that seems suspiciously echoed by FAN’s concerns.

WHO and the CDC agree that fluoridation’s benefits outweigh its risks.

It is true that fluoride can cause health problems in large doses, which is why public water supplies seek to control fluoride levels. Some private wells have fluoride at higher than recommended levels due to fluoride’s natural presence in the water. At recommended levels, the CDC says that the primary risk of fluoridated water is dental fluorosis.

“I do have parents rightfully concerned about fluorosis and the effect of too much fluoride,” Shoemaker said. He explained that being exposed to too much fluoride in childhood can cause the condition. When excessive amounts of fluoride are ingested during the time when teeth are developing underneath gums, the excessive amount of fluoride can cause white streaks to appear on teeth. “These changes are barely noticeable and difficult to see except by a dental health care professional,” the CDC says. FAN, however, argues that fluorosis can cause “significant embarrassment and anxiety over the appearance” of teeth.

The condition “can only occur in young children,” Shoemaker explained, as it exclusively affects teeth developing underneath gums. “My advice to avoid fluorosis would be to not use fluoridated water to mix with (infant) formula,” Shoemaker said. The CDC agrees, adding that children should be breastfed.

Shoemaker said that parents concerned about fluorosis should be much more concerned about their young children swallowing toothpaste than fluoride in drinking water at recommended levels. “Fluoridation has been studied over and over and it has been repeatedly shown that using the right amount correctly is effective in reducing or stopping dental decay,” Shoemaker said.

“Most toothpastes have fluoride in them and it is meant to be spit out and not swallowed,” Shoemaker said.

“For children aged 2 to 6 years, apply no more than a pea-sized amount of fluoride toothpaste to the brush and supervise their toothbrushing, encouraging the child to spit out the toothpaste rather than swallow it,” the CDC recommends. Once teeth have developed the risk of fluorosis has passed.

I asked Shoemaker how the average person can evaluate health claims, when both sides can claim experts, studies, and statistics. “For the average person it can be very difficult to tell the difference between a true scientific study and someone’s personal opinions,” Shoemaker said. “Especially with the accessibility of the Internet, anyone can publish anything that they want. I personally look for peer-reviewed studies printed in known scientific journals.”

For the ordinary person, the CDC and WHO are good sources for information, Shoemaker said, as are the websites of the American Medical Association and the American Academy of Pediatric Dentistry.

“Sometimes, the best information is going to come from your own trusted medical or dental provider who has already sifted through the studies and can present the facts,” Shoemaker said.