The Rutland City Board of Aldermen’s recent debate over fluoridation of city water borders on the Twilight Zone.
First, it’s as close as we’re likely to get to a settled argument in the convoluted world of public health policy:
• Fluoridation of municipal water supplies has a 60-plus year history, having begun in Michigan in 1945 and now having spread to cover about two-thirds of the population, including the vast majority of the 50 biggest cities in the country. If it had hidden dangers, they would have shown up by now.
• The Centers for Disease Control has called it “one of 10 great public health achievements of the 20th century.” It’s endorsed by the CDC, the U.S. Public Health Service, the American Dental Association and the last five surgeons general, among many others.
• City water treatment plant director Michael Garofano called fluoride “some corrosive stuff.”
The active element, fluorine, is a naturally occurring volatile gas, so is almost always found in combination with some other element, which makes it chemically stable.
Sodium fluoride is the salt most commonly used in treating drinking water; for reference, sodium chloride — with chlorine instead of fluorine — is table salt.
Both chlorine and fluorine are indeed harsh poisons in concentrated form; both are routinely applied to drinking water in minute amounts. The recommended level for fluorine in drinking water is around 1 part per million, for chlorine, it’s 2 to 3 parts per million. There are places around the country, mostly in the south and southwest, where fluorine in water naturally exceeds 4 parts per million, the maximum recommended safe level for consumption, and there’s a debate over whether that limit should be lowered.
• Beyond a concern that infants fed primarily or exclusively formula made with fluoridated water may get damaged tooth enamel if they get too much fluoride, there’s no credible debate that it is good for teeth.
According to the Public Health Service, “Extensive studies over the past 50 years have established that individuals whose drinking water is fluoridated show a reduction in dental caries (cavities).
Although the comparative degree of measurable benefit has been reduced recently as other fluoride sources have become available in nonfluoridated areas, the benefits of water fluoridation are still clearly evident. Fewer caries are associated with fewer abscesses and extractions of teeth and with improved health. The health and economic benefits of water fluoridation accrue to individuals of all ages and socioeconomic groups, especially to poor children.”
• As half the children in Rutland’s public schools qualify for free or reduced lunches, there are a lot of kids helped by this program. And the CDC notes that as more older citizens are keeping their teeth into later life, the benefits accrue to them, as well.
That brings us to the second point and the core of Mayor Christopher Louras’ argument, supported by three of the five aldermen on the Public Works Committee, that fluoride has gotten too expensive.
According to a recent University of Georgia study, fluoridated water results in average savings in dental bills, per person, of $19 per year. So at $14,000, Rutland’s treatment pays for itself in preventative dentistry after just 737 people. That’s a great bargain, and a conservative estimate. A CDC study says it’s closer to $38 per year saved at the dentist for every $1 spent on fluoride.
If the city board is really that concerned that the voters directly decide every $14,000 line item in a multimillion-dollar budget, they should let us vote on the entire thing, either line-by-line or in an up-and-down vote.
We could start with the overhead cost for the Public Works Committee.
For more information visit www.cdc.gov/fluoridation/.