It’s safe, cheap and effective.
That was the message shared by several speakers at a forum on fluoridation at Hastings College Wednesday.
“Safe is what the literature tells us. It’s effective, we know it makes a difference and it’s efficient, too,” said Dr. Kim McFarland, the event’s keynote speaker.
McFarland, a practicing dentist and professor at the University of Nebraska Medical Center’s College of Dentistry, shared facts about fluoride, water fluoridation and benefits to the general public with the group of about 90 attendees.
“What we’re talking about is simply adjusting the fluoride level of water to a level that is therapeutic to the point where there is a dental benefit,” she said.
Fluoride is a natural element in water, air and soil, meaning that people breathe it in every day, McFarland said.
The fluoride level in the water in Hastings and Grand Island is .3 parts per million and neither community fluoridates its water.
Hastings voters will go to the polls on Nov. 4 to determine if the city should fluoridate its water supply or vote to opt out of the Nebraska Legislature’s decision to require fluoride.
According to dentists and other medical professionals, the optimum level for fluoride is one part per million. McFarland said this one part per million can be represented as one droplet of fluoride dropped into a tub full of water.
That one droplet of fluoride would help to prevent the demineralization of teeth, which leads to cavities in children and adults alike. McFarland said fluoride prevents the loss of enamel, or hard coating, which protects a tooth.
She said fluoride, if added to a person’s water later in life, also can help to re-mineralize the outer coating of a tooth and in some cases actually help to repair a small cavity.
Without fluoride, McFarland said people can get cavities and eventually need crowns to fill in the missing tooth area or simply have the tooth removed.
Nationally, she said 20.5 percent of people 65 years and older have no teeth. In Nebraska, that number is at 23.1 percent compared to the 45 percent of people missing six or more teeth.
Even though fluoride can be beneficial, McFarland agrees that too much fluoride can be harmful, causing fluorosis, a discoloration of the teeth that in most cases is simply a cosmetic problem.
She said this problem forms typically in babies who are given too much fluoride. In one example, she said a parent may give the child a fluoride vitamin, fluoride rinses and fluoridated toothpaste in hopes that the child will not get cavities.
Instead, McFarland said the Centers for Disease Control recommends that all people drink fluoridated water and brush their teeth twice daily with fluoridated toothpaste to prevent the formation of cavities.
During the question-and-answer portion of the forum, Dr. Kevin Wycoff, a Hastings family physician, explained further the benefits and possible consequences of consuming fluoride.
“In the one part per million range that is standard for fluoridation, there have been no demonstrated dangerous effects to the body,” he said.
When he first came to Hastings years ago, Wycoff said he was shocked to learn Hastings did not have fluoridated water. It was at that point that he started prescribing that babies 6 months and older got a fluoride supplement.
As for young infants, Wycoff said the American Dental Association agrees that babies who are breastfed or who drink ready-to-drink formula can have fluoridated water. Babies who are drinking formula from a powder mixed with water should use water without fluoride until at least 6 months of age as a precaution.
However, once a child is ready and starts to consume fluoride, McFarland said the child is really being benefited for a lifetime. That child will have 40 percent less decay over his or her lifetime if he or she continues to consume fluoride through the lifetime.
McFarland said fluoridated water is a benefit for a child in more ways than simply preventing cavities. She said more than 51 million school hours are lost each year in the U.S. because of dental-related illnesses. That doesn’t include the loss of productivity when a parent is away from work and the cost of fuel to drive the child to the dentist.
Nationally, 78 percent of children will have at least one cavity by age 17. In Nebraska, 60 percent of children have at least one cavity by the time they enter third grade.
The national health goal is for 75 percent of the U.S. population to have fluoridated water supply by 2010, McFarland said. That number is at about 70 percent now with more than 184 million people receiving the optimal fluoridation amount through their public water supply.
McFarland said there are three types if fluoride compounds that can be added to the water supply. The type used in Nebraska is the liquid form called hydrofluorosilicic acid. Other states use solid forms called sodium silicofluoride and sodium fluoride.
Andy Kahle, a drinking water program specialist with the Nebraska Department of Health and Human Services, said fluoride, in each of the forms McFarland mentioned, is a by-product of fertilizer production.
In a question regarding contaminants in the fluoride solution, Kahle said that the acid is not a pure solution.
“What Randy gets in Holdrege is 23-25 percent pure. The rest is water and some other things. You would have to contact the distributor or manufacturer to find out more,” he said, referencing Randy Bailey, a water operator from Holdrege who also spoke at the forum.
As for the stability of the fluoride injection systems, Kahle said these systems are manufactured by people and thus have problems.
He said he is not aware of any illnesses caused by a larger than recommended amount of fluoride going into the water supply, however.
Wycoff said there are times when too much fluoride is harmful, but the only times that is an issue is when the levels are greater than four parts per million.
At the one part per million levels, a person would have to ingest 80 to 200 gallons of water to reach the acute toxicity level. However, McFarland said it would be impossible to drink that amount at any one time.
McFarland reminded the group that the new state law only requires that fluoride up to the optimum level of 1.2 parts per million of fluoride be put into the city’s water supply.