In the battle against tooth decay, fluoride has been one of the government’s biggest swords for 60 years.

But the standard practice of adding the compound to public drinking water has come under more scrutiny of late. And several Gaston County municipalities are considering lowering the amount of fluoride they put in their water supplies, in response to a federal recommendation to do so this month.

“We are definitely going to look into it,” said Ed Cross, Gastonia’s division manager of water treatment.

Fluoride has been hailed as a godsend of dental care since the 1940s, when it was first added to community water systems. Critics have questioned the credit fluoride should receive for reducing tooth decay. But about 184 million Americans — nearly 70 percent of the population — now drink fluoridated water, according to the U.S. Centers for Prevention and Disease Control.

The problem of late has been fluoride’s additional prevalence in toothpaste, mouthwash and other products. Environmental groups have said its overabundance may be causing widespread streaking and splotching of children’s teeth, known as fluorosis, and possibly more serious problems.

Those warnings were heeded this month. The U.S. Department of Health and Human Services announced plans to lower the agency’s maximum recommended fluoride level from 1.2 milligrams per liter of water to 0.7.

At least one nearby city has already complied. Asheville has fielded criticism for years about its use of fluoride in drinking water. It decided the federal government’s new suggestion was the tipping point, and lowered its fluoride amount from 1 milligram per liter to the recommended 0.7 milligrams per liter.

Water providers keep watch

In North Carolina, water providers primarily heed the advice of the state Department of Health and Human Resources, which has yet to endorse the new federal recommendation. The state now permits providers’ fluoride treatments to fall within 0.7 milligrams per liter and 1.2 milligrams per liter.

In Gastonia, Cross said three options are on the table. The city may keep its fluoride levels at the current level of 1 milligram per liter of water. It may drop fluoride treatments 30 percent to the new level suggested by federal officials. Or the city may discontinue fluoride treatments entirely.

To decide on the best course, the city will soon consult dentists, medical professionals and the Gaston County Health Department. The survey will take two to three months to complete, Cross said.

“Somewhere in collecting all that information, we’ll hopefully see a direction to go in,” he said.

A decision to stop feeding fluoride into drinking water would require an amendment to a local ordinance by City Council members, Cross said. The state would also have to lift the 0.7 milligrams-per-liter minimum requirement.

Belmont utilities director Chuck Flowers said his department has been following the recent fluoride debates closely. They now fall within the state’s allowable threshold for applying it, and don’t plan to change anything until the state changes its recommendation.

The American Water Works Association, which represents water utilities across the country, has also expressed concern.

“Their concern is the same as ours,” said Flowers. “They want to know if any new requirements are going to be based on a range or a set limit.”

Lee Hayes, public utilities director for Bessemer City, said he has met with a couple of residents who are concerned about fluoride levels in the drinking water. But the city is also waiting for the state to weigh in.

“We’ve talked about it and given some thought to it,” he said. “I do want to reduce it. But we really want to discuss it with our regional office before taking any action.”

Fluoride costs rising

Gastonia’s water system is the largest in Gaston County, serving about 100,000 customers. In addition to large users in the city, including CaroMont Health, it provides water to Cramerton, Lowell, McAdenville and Clover, S.C.

Gastonia buys about 5,000 gallons of fluoride at a time, about four times a year from its supplier. A tank pumps small amounts of fluoride into the water before it goes into the distribution system, Cross said.

The city’s overall water treatment operating budget is nearly $3 million a year. A few years ago, the purchase and application of fluoride only accounted for about $15,000 to $20,000 of that budget. But costs have increased to $40,000 or $45,000 per year, Cross said.

“It’s basically doubled twice in the last three to four years,” he said. “It used to cost 100-some dollars per ton. Now it costs four times that much.”

The city’s upcoming deliberations on what to do about fluoride will factor in both cost and public benefit, Cross said.

“You better believe that (fluoride) expense is something we’re looking hard at,” he said. “But it’s not the end all, be all issue.”

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