HARWICH —The board of health is weighing the benefits of fluoridating the public water supply as a means of improving, promoting and protecting the oral health of the community.
For five decades the American Dental Association has endorsed fluoridation of community water supplies to prevent tooth decay, said Dr. Alfred Hurst, a member of the board of health, when making a recommendation last week to study the potential health benefits.
“Thanks for bringing it up, it’s an excellent topic,” Board of Health Chairman Dr. Stanley Kocot said.
The health board chairman said he’s talked to a dentist who has an office in the Worcester/Shrewsbury area where one community has fluoridation and the other does not. “The dentist said give me 10 children and I will tell you where they are from,” Kocot said of the dental decay in the community without fluoridation.
Hurst said he spoke with one local dentist about fluoridation and was told it is a good idea, but the dentist was hesitant to get involved. Kocot recommended getting the local dental society involved in seminars, if the board decides to move forward with fluoridation.
Hurst said 139 communities in Massachusetts fluoridate their water supplies and most of them are in the Boston area. None of the Cape communities do it at this time, he added. Discussions about fluoridation in the town of Yarmouth over the summer brought lively debate.
There were mixed reactions to the proposal among board members. While the benefits of dental health were touted, board member Dr. Robert Insley urged caution and recommended looking at alternative forms of application.
“When you put fluoride in the water supply everybody is susceptible and what I know is it makes the bones of the elderly brittle,” Insley said.
Board of Health Director Paula Champagne said the benefits to a specific population versus the whole community must be understood, including cost. Champagne said different modalities of fluoride application must also be examined.
“We can’t talk about any of this without a clear and distinct understanding of what it means to the water department,” Champagne said.
She pointed out the Harwich public water supply comes from a series of wells and multiple distribution centers. Champagne said the board must look at the population they are seeking to serve, citing the community’s 1,400 school-age children.
She said that is a small target, and the value of distribution of fluoride through the water system needs to be assessed against the benefit. State law requires daily testing of fluoride application by a public water supplier.
“Education might be the best way to reach the target population,” the health director said.
There are a number of products containing fluoride available, Champagne said, citing toothpaste, mouth rinse and pills that could be made available to the target population. She said fluoridation was implemented through state grants in communities in the early 1990s.
The health director said she had done some research, looking at a 44-page report done by the Center for Disease Control, but it does not get into the long-term impact of ingestion. There are other studies, such as one by the federal Environmental Protection Agency’s Union of Scientists, which opposes fluoridation and cites the potential for brain and kidney damage, she said.
“You can go back and forth all day long on the pros and cons.” Champagne said. “It’s well studied, but there is no definitive conclusion.”
“It was predominantly used in low income communities where children had less opportunity to visit dentists,” Water Department Superintendent Craig Wiegand said this week.
The superintendent was invited to attend the next board of health meeting to discuss it the proposal. He said a cost analysis will have to be put together, and added that the water commission was not even aware of the proposal.
Wiegand said he had looked at the issue in anticipation of it being raised. Its cost effectiveness must be examined, he said, given the small population of children in the community. He also said there may be better alternatives, such as dentist application, toothpaste and pills.
“There are so many products on the market that provide it, and too much can destroy teeth,” the water department superintendent said. “If something happens, the first one they’re going to look at is us.”
A lot of issues need to be looked at before putting fluoridation in the water supply and the town should move slowly, Wiegand said. On Tuesday, Wiegand met with the water commission and they asked him to run numbers on the cost of fluoride application and report back in two weeks.
It’s incumbent upon the board of health to do its research and find out what’s out there, Champagne said. It is within the board of health’s jurisdiction to weigh this issue as a public health problem, but Champagne admitted she does not know whether there is a serious health issue in Harwich.
Instead of five members of the board of health making this decision, Hurst said the question should be put to the residents through a ballot question. Kocot agreed the question should be put before the community, but he also said it should require longterm study and next year’s annual election ballot is too short a period.
The board of health will meet with the water department superintendent on Monday, Oct. 22 at 6 p.m. at the community center.
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