NOTE FROM FAN:
The South Heartland District Health Department services Adams, Clay, Nuckolls and Webster Counties.

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With the Nebraska Legislature now ready to give final approval to a bill that would require all communities with more than 1,000 people to fluoridate their water, questions about the use and safety of this naturally occurring mineral have surfaced.

On Wednesday, the legislature gave second round approval to LB245, a bill introduced and prioritized by Sen. Joel Johnson of Kearney, who says fluoride is the single most-effective measure to prevent tooth decay.

The bill must be approved in three readings and be signed by the governor before it could become law. The legislature’s last day of debates is scheduled for April 17.

Michele Bever, executive director of the South Heartland District Health Department said agrees with Johnson’s views saying that fluoridation of a community’s water supply is considered to be one of the safest and most effective ways to prevent tooth decay.

In fact, she said fluoridation is considered by the Centers for Disease Control as one of the top 10 health achievements of the 20th century.

The benefits of fluoride were discovered by dentists who saw patients living in areas with higher levels of fluoride in the water had less tooth decay and fewer cavities, she said.

There are a variety of ways for a person to get fluoride to their teeth including through the water supply, fluoridated toothpaste and mouth washes.

Bever said the CDC determined that the best way for a person to get fluoride into his or her system is through fluoridated water.

She said swallowing the fluoride in water allows for the fluoride to go into the teeth themselves to help to strengthen the entire tooth from the inside out.

Fluoride only seals the outside of the tooth, protecting it from cavities temporarily with fluoridated toothpaste and mouthwashes, she said.

Water fluoridation can reduce tooth decay by as much as 60 percent among the general population, Bever said. She said fluoridated toothpaste and mouth washes can reduce it by 18 to 20 percent in children and up to 30 percent in adults.

“Those can help but the most cost effective in terms of health costs and the most beneficial in terms of health care is to have the community fluoridation. About two-thirds of the U.S. population enjoys that now,” she said of water fluoridation.

Bever said fluoride is truly a benefit for children especially when you consider the fact that tooth decay is the single most common chronic childhood disease.

She said children from poor families that may not visit the dentist on a regular basis have 12 times more restricted activities days because of dental related illness compared to those children that make regular dental visits.

Dental problems can leave a child with pain that leads to problems with speaking, eating and learning. Even a child’s self esteem and behavior can be impacted by dental problems, Bever said.

That’s why dentists like Howard Miller, in Superior, agree that fluoridated water is a great asset for children to have access to. The city of Superior has had fluoridated water since 1951.

“You can tell the difference between the rural versus the city population,” he said. “The kids that grew up in Superior seem to just have more decay resistant teeth. It truly makes a difference.”

The city of Minden started fluoridating its water in 1974. The fluoride is put into that community’s water supply through injection at a central water treatment facility, said city administrator Brent Lewis.

“It’s very easy to manage,” he said. “We’ve had no complaints from any of the citizens. It’s just there.”

And he said you can’t taste it in the water either.

Miller said he believes there really isn’t anything bad about getting the proper about of fluoride into one’s system.

He often prescribes fluoride vitamins to children living outside of Superior that don’t have access to fluoridated water.

“The situation in town is everybody gets some fluoride and that translates into dollars saved for the parents on their health care and it makes it a lot easier for the kiddies when they come in to see the dentist,” Miller said.

Growing up outside of Superior, Miller said some of his classmates didn’t have the best oral hygiene; however, they still had very few cavities. He attributes that to the fluoridated water.

He said there’s no doubt that fluoride is a health benefit for children, especially those that enjoy sweets.

“They don’t brush well and they eat a lot of candy and drink a lot of pop which they’re not supposed to do, but a kid’s a kid,” Miller said. “So fluoride is definitely a health plus.”

While Miller believes fluoride to be a healthy addition to any person’s life, Bever said it is true that too much fluoride can be a problem.

“Fluoride like many other things we consume or even need for our bodies to work has a level of maximum benefit but if you get to very high levels it can be harmful,” she said.

The same is true with other vitamins and minerals like calcium and vitamin A.

Bever said a person’s health can suffer if he or she gets too little or too much of any of these vitamins.

“It’s very important to realize there are many things that could serve as poisons or toxins or that can produce negative effects at too high of a level. You can have too much of a good thing,” she said.

When a person gets too much fluoride in his or her system, Miller said that can lead to fluorosis, a staining of the teeth.

He said he saw this during his time in the Air Force when he served as a dentist to many soldiers who grew up in areas with very high levels of fluoride naturally occurring in the water.

Miller said their teeth often had stains or brown streaks on them from the higher than optimum levels of fluoride.

“But their teeth were like rocks, they were so hard,” he said. “They never had decay, no cavities.”

Miller said the level of fluoride that the Nebraska Legislature is discussing would only be one part per million, much less than the amount that causes fluorosis in adults.

However, Bever said the state’s recommended level could cause fluorosis in babies that consume only formula with water

“If your child is exclusively consuming formula that’s been made from fluoridated water, you have to be careful about the levels of fluoride,” she said.

Bever said the fluoride would not hurt the child. Instead, it may cause only mild fluorosis, which is just a cosmetic issue. She said parents should contact their doctors or dentists if they have concerns.