The fluoridation of public water has been a contentious topic in Texarkana.
Attempts to add the chemical to the water system have twice been rejected by Texarkana, Ark., voters, and since the water utility is a shared operation of both the Texas and Arkansas sides of town, this has effectively quashed the efforts.
People pushing this agenda—primarily those championing the dental health benefits of fluoride—generally have looked at the opposition as if they were a bunch of kooks, or, even worse, ignorant, backwoods ingrates.
Those against fluoridation have said there are no dental health benefits from the ingestion of fluoride; but instead, because it is swallowed, it increases the risk of other health problems.
Fluoridation proponents are generally from the established medical and dental community, while opponents tend to get their voice from the academic and scientific community, although these lines are far from absolute.
Because of the way the argument has unfolded over the years, those favoring fluoridation tend to see themselves as beyond reproach, secure in the absolute backing of most major medical associations. Opponents, on the other hand, are often portrayed as radicals crying “wolf,” or yipping at the heels of establishment critics.
That may be changing by degrees.
For one thing, more and more communities are saying no to fluoridation. In the early years of this 60-year-old debate, there was little organized resistance and the odds strongly favored fluoride. Nowadays, votes on fluoridation are about as predictable as a coin flip. Some go one way; some go the other.
For another, there is new information that suggests the kooks weren’t without a cause.
Last month, the National Academy of Sciences released the results of its fluoride study—one of the most thorough in a long time. One telling recommendations of the study, which was paid for by the Environmental Protection Agency, is that there were enough health risks associated with fluoride that it recommended the current level of fluoride allowed in drinking water should be lowered.
The study also asked the EPA to do a risk assessment and determine a new maximum fluoride level. Currently the max is 4 milligrams per liter. Most water systems, including Texarkana’s is about 25 percent of that. Most areas that exceed that level, including some in Texas, do so because additional fluoride seeps into the water from other environment sources. But all of us are exposed to fluoride in multiple ways, not just the water system, and it is the total amount of fluoride that can increase the risk of harmful dental fluorosis.
But the report looks much deeper than the affect of fluoride on our teeth.
It found evidence that fluoride increases bone breaks, and, in the elderly, contributed to joint stiffness. The report showed a relationship between fluoride and Alzheimer’s disease, and questioned if it might marginally affect a child’s ability to learn (impair IQ).
The NAS report says that “fluoride appears to have the potential to initiate or promote cancers, particularly of the bone.”
It should be noted that there is a fairly wide difference between what the EPA considers the maximum level of fluoride in the water system (4 mg. per liter) and the best level for preventing cavities (about 1 mg. per liter).
Still, the report gives pause, not only because we all collect fluoride from a variety of sources, but because the potential side effects seem to infiltrate so many areas of our medical health.
When looking at the whole picture, opponents say simply that you can best protect your teeth by getting your fluoride from toothpaste and mouthwashes and you can best safeguard your bones by removing fluoride from your drinking water.
While dentists still largely believe the benefits outweigh the risks, fluoridation is no longer beyond dispute. At the very least, the report indicates a need for caution.
Virtues and vices sometimes come in the same package. What’s good for the teeth looks more and more like it’s bad for other body parts. That’s not a slam dunk, that’s a trade off.
If nothing else, as this debate goes forward, all of us who have an interest in this issue should to be more willing to question what we think we know about fluoride and its effect on all parts of the human body.
Does this mean that the pendulum has swung in the other direction?
It’s too early to tell. But it does seem as if the perceived gap between the two sides has closed, not only on the rhetorical front, but also on the substance of the argument.