A debate is looming in Burlington on whether to continue fluoridating the city’s water supply.

On the pro-fluoridation side are arrayed the weight of the state and federal governments, plus organizations such as the American Medical Association, the American Dental Association and the World Health Organization.

The Centers for Disease Control and Prevention, in a recent fact sheet, lent its august voice to the argument by endorsing water fluoridation without reservation. “A comprehensive review of the benefits and potential risks of fluoridation confirmed its safety and value,” the CDC fact sheet said.

The Fluoride Action Network, a Burlington group, argues that fluoridation has a demonstrated link to bone cancer in young boys. Michael Connett, the director of the 500-member international organization, says the risks of water fluoridation are real and amply documented.

He also describes the debate as a rights issue, and argues that individuals should make their own decision about fluoride exposure, rather than have the state impose a one-size-fits-all policy. “Allow those people who want to, to use it,” he said last week, “but don’t mandate it for everyone.”

Fluoridation will be debated tonight at City Hall before the Board of Health. After hearing from experts both for and against fluoridation, and after a forum for the public at another City Hall meeting June 23, the board will make its recommendation to the City Council, said board Chairman Ian Galbraith.

The council has authority over the city’s water supply, said Assistant City Attorney Nikki Fuller, but she said the city may need to seek permission from the state’s Agency of Natural Resources if the council decides to end Burlington’s 53-year practice of fluoridating tap water.

The Columbia Encyclopedia describes fluoride as a soluble compound of the element fluorine, found in the mineral fluorite or fluorspar. Fluorine compounds are widely used in industry, in insecticides and formerly as aerosol propellants.

Fluoridation debate Passions run high on both sides of the question. For the state’s Department of Health, which supports fluoridation, the question was settled long ago.

In a letter addressed last month to city residents, Dr. Paul Jarris, the department commissioner, said water fluoridation has been a “safe and effective dental public health measure” since 1952 in Vermont and “the single most important commitment that a community can make to the oral health of its residents.”

Jarris, writing in anticipation of the health board’s deliberations, was unequivocal in his conclusion.

“I urge the City of Burlington to continue water fluoridation as an essential foundation of dental care, improving the oral health of everyone over a lifetime,” he wrote.

“The best known advice to date is still that water fluoridation is safe and effective,” said Dr. Steve Arthur, head of the health department’s division of oral health. Arthur and Dr. Donald Swartz, head of the department’s health improvement division, will represent the state at tonight’s hearing.

Connett doesn’t discount the value of fluoride in preventing cavities, but argues the chemical should be applied by those who wish to do so through readily available toothpaste or mouthwashes rather than swallowed.

“When fluoridation began in Burlington in 1952,” he said, “it was believed fluoride needed to be ingested to be effective. Since then, dental researchers better understand that teeth can be helped most through direct contact. Ingesting it has little if any benefit to teeth.”

A question of safety The state Department of Health has prepared a thick binder containing hundreds of pages of reports and testimonials supporting water fluoridation. A 30-page “Question and Answer Guide” written for the department in April 2005 by Dr. Michael Easley, the national fluoridation director of Oral Health America, is included.

Easley writes that “the gold standard for dental disease prevention is community water fluoridation. Community water fluoridation,” he continues, “should be implemented whenever it is technically feasible.” Oral Health America is described on its Web site as “a fully independent nonprofit public benefit corporation.”

In his guide, Easley argues that “antifluoride activists” have tried to “induce panic in the public” by falsely linking water fluoridation with diseases such as cancer. “These claims,” he writes, citing studies published from 1954 to 1998, “have resulted in the conduction of a substantial amount of scientific research, all of which demonstrate that the antifluoridationists’ claims are without substance.”

Connett identifies Easley, the Health Department consultant, as “one of the most active fluoridation lobbyists in the United States” for the fluoridation industry.

A Department of Health fact sheet, “Frequently Asked Questions about Fluoride,” unreservedly endorses fluoride safety.

“Adding fluoride to drinking water at the optimal level is not harmful to your health,” the fact sheet says. “It does not cause cancer, heart disease, diabetes, high blood pressure, AIDS, liver and kidney ailments or allergic reactions.”

The Fluoride Action Network, however, points to conclusions reached by the Environmental Working Group, a nonprofit investigative organization founded in 1993 and based in Washington, D.C. The group previously has documented government subsidies to agribusiness, tracked shipments of nuclear waste across the country, and influenced legislation restricting pesticide use.

Last week, the Environmental Working Group, citing what it calls “compelling” research, urged the National Toxicology Program to list fluoride in drinking water as a carcinogen. The National Toxicology Program, a division of the Department of Health and Human Services, according to its Web site, “identifies and discusses agents, substances, mixtures, or exposure circumstances that may pose a hazard to human health by virtue of their carcinogenicity.”

The Environmental Working Group cited a number of studies and concluded fluoride in drinking water is linked with bone cancer in young boys. One of the studies mentioned was a 2001 Harvard School of Dental Medicine doctoral thesis by Elise Bassin. The Working Group got its information on the Bassin study from the Fluoride Action Network.

Richard Wiles, the Environmental Working Group’s senior vice president, wrote to the National Toxicology Program: “The safety of fluoride in America’s tap water is a pressing health concern.” He noted that “more than 170 million people live in cities and towns with fluoridated water.

“The weight of the evidence,” Wiles wrote, “strongly supports the conclusion that millions of boys in these communities are at significantly increased risk of developing bone cancer as a result.”

Arthur said he is aware of the Bassin study and the Environmental Working Group. The Bassin study, he said, has not yet been replicated by other researchers. Serious published studies, he said, are normally reviewed in due course by other researchers and their conclusions would be incorporated into the health department’s recommendations.

William Hirzy, a senior pollution and toxic risk-assessment chemist with the Environmental Protection Agency and a senior vice president of the EPA’s Headquarters’ Union for Scientists, will speak for the EPA’s union at tonight’s City Hall meeting. He said flatly that water fluoridation presents “an unreasonable risk” to the public.

The EPA union, he said, has opposed water fluoridation since the mid-1980s because the EPA, under political pressure, used “bad science” to determine acceptable fluoride levels in water. The union represents about 1,500 scientists and other professionals at EPA headquarters in Washington, D.C.

Over the years since water fluoridation became common in the United States, Hirzy said, exposure to fluoride has risen because of its presence in processed food, fruit, tea, soda and fluoride toothpastes and mouth rinses.

“It is now virtually impossible to avoid fluoride,” he said.