MONTPELIER, Vt. –A letter to the editor in a newspaper describing fluoride as a poison prompted two local dental hygienists to shoot back.
“Community water fluoridation is the number one way to prevent dental decay,” Terri Weinstein of Marshfield and Michele Feccia of Barre wrote. “Sixty years after the first community (Grand Rapids, MI) adjusted the fluoride content of its water, the Centers for Disease Control and Prevention ranks community water fluoridation as one of the top ten public health achievements of the 20th century.”
That in turn generated a second letter from Randolph Center sheep farmer Stewart Skrill.
“If fluoride is as harmless as you would have all believe, why have Denmark, Poland, Sweden, Russia and Italy prohibited fluoridation, by law?” he wrote.
“We must demand that our state and nation make it illegal to medicate us through our drinking water with fluoride or with any other controlled medical substance.”
It’s a debate cropping up in newspapers and town halls around Vermont as several communities take on the touchy topic of whether to add fluoride or remove it from their tap water.
The issue was stirred up on a national level this summer when Harvard University announced it was investigating whether a dentistry professor downplayed research showing an increased risk of bone cancer for boys who drink fluoridated tap water.
The Centers for Disease Control and Prevention responded on its Web site: “The CDC continues to strongly support community water fluoridation as a safe and effective public health measure to prevent and control tooth decay and to improve overall health.”
In Vermont, 45 communities are served by a fluoridated water system. The state estimates that roughly 245,000 of the state’s 600,000 residents receive fluoridated water.
Brattleboro and Bennington have decided not to add fluoride to their tap water. Bellows Falls is holding public hearings on the topic. And fluoride opponents have been pushing Burlington officials to either reduce or eliminate fluoride from the city’s water supply, which is the state’s largest and serves almost 50,000 people.
The debate has drawn both philosophical and scientific responses, with arguments over the success of fluoride in solving the public health problem of tooth decay to opposition as well from those who see as the government unfairly medicating their water.
“On a very basic level it’s a medical ethics issue,” said Michael Connett of Burlington, project director for the Fluoride Action Network, which is driving much of the debate in Burlington. “Fluoride is defined as a medicine. … But they’re crossing the line when they say, ‘I want you to have it, I want you to have it, I want every person in this community to have it,'” he said.
Supporters say adding fluoride, a naturally occurring element, to water delivers a tooth decay fighting agent to people who don’t have access to or who can’t afford dental care. The American Dental Association says it cuts down on tooth decay by 20 percent to 40 percent.
Advocates say fluoridating water is a community, rather than an individual, decision.
“We do this as a community,” said Dr. William Maas, director of the Division of Oral Health at the CDC.
Those who oppose fluoride don’t have to drink the water, he said.
“From a community standpoint it’s a good way for a community to work together on a pretty simple fix.”
“We want to spread fluoridation across Vermont wherever it’s appropriate to do that,” said Dr. Donald Swartz, director of Health Improvement at the Vermont Department of Health.
Research shows that fluoride is not detrimental unless it’s taken at inappropriate levels, Weinstein and Beccia said. That can cause fluorosis, a defect in the teeth enamel that occurs in some children.
But opponents say they cannot control how much they are ingesting in the water supply, and in soda and juices reconstituted with fluoridated water. And they say people have access to far more fluoride, including in toothpaste, than they did in the 1950s when places like Burlington started their water fluoridation program.
Harvard University said it is collaborating with the National Institute of Environmental Health Sciences to examine the research in question.
Chester Douglass’ study found that the odds of having osteosarcoma for those who drink fluoridated water were “not statistically different” from those who drank non-fluoridated water.
But Elise Bassin, a doctoral student supervised by Douglass, reported in her 2001 thesis that boys who drink fluoridated water appear to have an increased risk of developing the cancer.
The National Cancer Institute says studies of people living in communities with fluoridated water “did not find an association between fluoride and cancer risk.”
Meanwhile in Burlington, the Fluoride Action Network is pushing for a reduction in the amount of fluoride in the drinking water.
The city council said it’s waiting for a study on fluoride to be released in the spring by the National Research Council’s Committee on Toxicology.
“I think it’s a really hard decision,” said Joan Shannon, a member of the Burlington City Council. “And I do support putting it on the ballot, for voters to decide.
I think it’s kind of funny, it’s this weird version of socialized medicine. Fluoridated water is very good for a certain number of people,” she said. “But taking it out of the water supply we risk hurting a group of low-income folks.”