Every few years, a small-but-mighty group of Iowans lobbies their city to stop adding fluoride to the public water.
Most recently, the city council for the northwest Iowa town of Ida Grove voted 3-2 to end the town’s water fluoridation program, shortly after the majority of respondents to a survey — distributed through utility bills — voted to end the decades-old practice.
“As a scientist and public health professional, it’s not the way I would conduct a survey,” said Sara Carmichael-Stanley, the state water fluoridation coordinator at the Iowa Department of Public Safety, noting many people do not fully read their bills.
To Carmichael-Stanley, what played out in Ida Grove illustrates the disproportionate influence of anti-fluoridation campaigns by particularly vocal residents.She cannot mandate municipalities to treat water with fluoride, so, she said, her goal is to educate people about how and why the state believes fluoridation works.
“One person was very vocal and I talked to her many times,” said Carmichael-Stanley of the monthslong debate. “We tried to educate as best as we could… and unfortunately, it didn’t go our way this time.”
Last summer, the Ida Grove city council voted unanimously to stop adding hydrofluorosilicic acid drops to the water after learning the equipment to do so needed to be replaced, according to the Sioux City Journal. The city council reversed that decision last fall, but the drops were still not being added to the water for lack of new equipment, the water fluoridation coordinator said.
Ida Grove resident Christie Van Houten started to share her concerns about the chemical on social media last year. She and others have spoken out to the city council and in letters to the editor of the Ida Grove Courier.
In an email to the Register, Van Houten said she was “one of the louder voices” of the 461 residents that voted “no.” About half of the town’s eligible voters responded to the survey, with approximately 70 percent voting against fluoridation, according to the Ida Grove Courier.
“There is enough research out there to call into question the adverse health impact that adding chemical fluoride to water could have on citizens, and that is what we as citizens lobbied for,” Van Houten said. “The topic was brought up in a lot of everyday
conversations that citizens in our community were having.”
Van Houten said Carmichael-Stanley “informed us that even if the water was not optimally fluoridated, that you would still consume fluoride in your everyday living routine” through the water’s natural fluoride, toothpaste, food and drinks.
Ida Grove’s natural fluoride level averages 0.4 milligrams per liter — lower than the recommended level of 0.7 milligrams per liter that prevents tooth decay and cavities, according to the Centers for Disease Control and Prevention. The CDC promotes community water fluoridation with scientific research that it reduces tooth decay by 25 percent in children and adults.
“It’s a little disheartening,” Carmichael-Stanley said. “Because we did work so hard, and it impacts a lot of people and they have been fluoridating for a long time.”
After nearly 50 years of fluoridating the water without much debate, the city flagged the issue only because of the failing equipment, said Dawn Ericson, a dental hygienist and coordinator for Mid-Sioux Opportunity, Inc., a nonprofit community action agency serving northwest Iowa. Ericson is one of several health officials, including from Ida Grove’s Horn Memorial Hospital, to publicly support fluoridation in Ida Grove.
“It was disappointing, the way it all came out,” said Ericson of reading the news of the latest city council vote. “The funny thing is, they took for granted that it had been there for all that time.”
Ericson, along with Carmichael-Stanley and other public health officials, offered to help the city apply for a grant through Delta Dental to pay for the new equipment. Ericson is unsure if the city ever applied because they didn’t ask for assistance, she said. The Ida Grove city clerk’s office did not immediately respond to requests for comment.
The bottom line, in her view, and Carmichael-Stanley’s, is that the optimal amount of fluoride in water — 0.7 milligrams per liter — is the most cost-effective way to prevent tooth decay, especially in children and older adults.
A similar story played out in Iowa’s biggest city as recently as 2013. Des Moines Water Works solicited public comments on the issue, which “drew significant interest and elicited many emotional responses,” the public water utility said in December 2013. It decided to continue water fluoridation at 0.7 milligrams per liter.
Carmichael-Stanley said she understands the hesitancy to trust the government to make health decisions, but noted that the CDC’s fluoride recommendations have been tested and approved by non-governmental agencies. The American Dental Association, American Medical Association, American Water Works Association and the World Health Organization also support community water fluoridation.
The biggest concern with public health is prevention, she said, “and we know this is one way to prevent a disease.”
“They’re very vocal and we’re trying to be vocal as well,” Carmichael-Stanley said. “If more cities decided to stop, we would see an increase with kids with more cavities and tooth decay,” she said.
Those interested can check their city’s fluoride level at the CDC’s My Water’s Fluoride website.