WORCESTER– Fluoridation opponents yesterday said the Central Massachusetts Oral Health Initiative has been “disseminating misleading and false information” in an attempt to persuade voters to approve fluoridation of the city’s water supply.
Fluoride proponents defended their positions and contend that the measure’s opponents are singling out individual studies instead of “the preponderance of scientific evidence.”
The issue of fluoridating the city’s water supply is on the Nov. 6 Worcester election ballot.
Fluoridation foe Linda Zambarano, a psychologist and mother of two teen-age children, pointed to assertions by advocates that putting fluoride in public drinking water would prevent anywhere from 40 percent to 60 percent of cavities. Ms. Zambarano is a member of Worcester Citizens for Total Health, which opposes fluoridation.
“They don’t cite studies that document this, and they can’t cite credible ones because they don’t exist,” she said.
Janice B. Yost, executive director of the Central Massachusetts Health Foundation, which has financed and organized the Oral Health Initiative’s fluoride campaign, said studies conducted decades ago, when water fluoridation was the only available source of fluoride, showed cavity prevention rates at high levels. More recent studies attribute lower prevention rates to water fluoridation.
She said her group relies on conclusions made by the American Dental Association and “garnered from numerous studies” that predict a 60 percent cavity prevention rate for children and 35 percent prevention rate for adults.
Ms. Zambarano cited a 1987 study by the U.S. National Institute of Dental Research, involving 39,207 children ages 5 to 7, that found “no statistically significant differences” in dental decay rates in children from communities with fluoridated water and those from areas without fluoridated public drinking water.
She said the most recent review of such studies shows “at most” a 15 percent prevention rate.
Ms. Zambarano also rejected statements, in a booklet distributed as an advertisement in the Telegram & Gazette, that said water fluoridation is practiced in 60 countries.
“This is a complete myth,” she said. “In fact, we know of only five countries that fluoridate extensively and only a few others that fluoridate a small percentage …”
Ms. Yost yesterday cited 12 countries in which, according to the pro-fluoride campaign, there is extensive fluoridation. Numerous other countries, she said, “must use it somewhere” because the American Dental Association reports that 60 countries practice fluoridation.
“We didn’t say 60 countries use it extensively,” she added. “I think we are stating the facts.”
Fluoride opponents contend it is inappropriate for the pro-fluoride campaigners to draw conclusions about the effectiveness of fluoridation by comparing dental problems in Worcester to those in neighboring Shrewsbury and Holden, where fluoride is added to public drinking water.
Ms. Zambarano said the higher rate of dental decay in Worcester is because of inadequate dental services for low-income residents.
“Worcester can be compared with cities such as Boston, Lowell, Taunton, and Southbridge … that have been fluoridated for 20 to 30 years and have worse oral health crises than Worcester,” Ms. Zambarano said.
Ms. Yost defended the comparisons, pointing out that they are not intended to compare communities of similar economic status.
“I don’t think the intention has been to say these communities are ‘even-steven.’ The point is to say our neighbors have used fluoridation and are seeing good oral health as the outcome,” she said.
Ms. Yost said she wasn’t familiar with studies comparing cavity rates in children from Worcester to those in Boston, Lowell and Southbridge. She said she has been told that cavity rates in those communities remain high because they have sizable numbers of immigrants, minorities and low-income residents.
Fluoride opponents also are critical of television and media advertising showing a child’s open mouth in which the teeth are almost completely black and rotted away.
“They show pictures of the mouths of young children with horrible decay, but never tell you this is caused by baby bottle syndrome, which is found in poorer communities and cannot be corrected with fluoridation,” Ms. Zambarano said.
Ms. Yost said she is not certain that baby bottle syndrome, caused by bottles being kept in infants’ mouths for long periods of time, is what caused the decay. She said it is not the pro-fluoridation campaign’s intention to imply that fluoridation would stop that condition.
“I don’t think anyone has said fluoridation is a cure for baby bottle syndrome, but fluoridation can help any dental situation. I don’t think anyone said it would prevent baby bottle syndrome,” Ms. Yost said.
Members of the anti-fluoride group also questioned an endorsement of the use of fluoride by Consumers Union, which produces Consumer Reports magazine.
In a letter last month to Worcester Citizens for Total Health, Consumers Union spokeswoman Jen Shecter said the organization compiled research in 1978 debunking some myths about fluoride. “Given the new research conducted by others … we cannot state that we continue to stand behind the determination of 22 years ago,” she wrote.
Ms. Yost said she was uncertain of the basis for using the specific endorsement and that a group working on the fluoride campaign had put the list together.
Ms. Yost noted that fluoride opponents frequently refer to fluoride as “toxic,” even though it will not cause acute toxicity when diluted in water at recommended concentrations. She said a committee of the Institute of Medicine reported in 1974 that chronic toxicity would not occur at recommended levels even after 10 or 15 years of use.
“We stand by the Centers of Disease Control, who issued a reaffirmation in August 2001 of the safety and efficacy of fluoridation, and we think if anyone has a question, they should call their doctor and their dentist,” she said.