When he was raising his children in a South Jersey community that had no fluoride in its water, U.S. Rep. Jeff Van Drew (R-2nd) — a former dentist — said he gave them fluoride tablets along with a slate of vitamins.

Fluoride changes the molecular structure of teeth and makes them “at least fifty percent more resistant to decay,” Van Drew said in an interview with NJ Spotlight News after Election Day. Topical applications of the mineral can help, he said, but “when you ingest fluoride, you build a different tooth.”

His support for fluoride shows Van Drew — a vocal supporter of President-elect Donald Trump — differs on at least one point with Robert F. Kennedy Jr., Trump’s pick to lead the U.S. Department of Health and Human Services. Kennedy has advocated for a ban on the use in public water of fluoride, which he considers a toxin, voicing his concerns about its impact on human bone, brain development and the endocrine system.

A federal report raised questions about the impact of high amounts of fluoride on children, according to Axios, but multiple studies over many years indicate the levels in treated water in the U.S. are both safe and beneficial for oral health. The American Dental Association cites 70 years of research showing fluoridated water has protected adults and children against cavities.

“Fluoride has long been recognized for its critical role in preventing tooth decay. While fluoridated toothpaste provides significant benefits, combining it with fluoridated water offers enhanced and more consistent protection against cavities,” Orville Morales, director of advocacy and health affairs for the New Jersey Dental Association, told NJ Spotlight News in an email.

Local control

Regardless of what Kennedy recommends, experts note that local or municipal leaders — not federal officials — make decisions about adding fluoride to public water systems. State health leaders say that local control is part of why New Jersey — with its love for home rule — is 49th among the states for its percentage of fluoride-treated water, at just over 16%, versus a national average of 72%, according to the federal Centers for Disease Control and Prevention. Only in Hawaii, with 8.5%, do fewer people have access to fluoridated water.

“This low level of fluoridated water access may contribute to higher rates of dental decay among residents,” Morales said. Both the American Dental Association and the state dental association “highlight that water fluoridation is a cost-effective and straightforward public health intervention to improve oral health across all age groups,” he said.

Fluoride’s connection to oral health dates to 1901, when a Colorado Springs dentist noticed patients who drank from a spring with elevated levels of the mineral had teeth that were more resistant to decay, according to the Washington Post. Grand Rapids, Michigan was the first community to treat its drinking water. That led to a decline in kids’ cavities and by the 1980s half of Americans had access to fluoridated water, the paper said. But the drive to expand these public health measures also met resistance starting in the 1950s, with some suggesting water treatment was tied to a communist plot.

Water fluoridation has recently been an issue in Oregon, which ranks 47th among the states for use of the additive, the Washington Post reported. Portland Oregon is the nation’s largest city without fluoride-treated water and voters there have rejected its use multiple times, most recently in 2013. Anti-fluoride advocates said some 20 communities nationwide have voted recently to stop adding the mineral, the Post said.

Van Drew recommended fluoride for kids until they turn 16. He said broad fluoridation in the water supply covers children of all economic backgrounds, but the effects wear off over time. “It doesn’t do anything for you as an adult,” he said.

Incomplete NJ data

Recent and comprehensive information on which communities in New Jersey are treating public water with fluoride is hard to find. A list compiled by the state Department of Environmental Protection and revised in 2013 — which the agency said is the most recent such document available — identifies dozens of communities in 11 counties that have “fluoride-adjusted” or treated water. Another two dozen municipalities in nine counties — nearly half in Gloucester County alone — benefit from naturally occurring fluoride in their water systems, the DEP list notes.

While Rep. Jeff Van Drew (R-2nd) is a proponent of fluoridated water for oral health, he balks at widespread mandates for its use, noting some people may not want the additive.

Absent from the list are the state’s urban centers, including Newark, Jersey City, New Brunswick and Camden. In fact, no towns in Essex or Hudson counties have fluoridated water. Morales, with the state dental association, said several larger communities — including Atlantic City and Perth Amboy — ceased adding fluoride in recent years.

“While fluoridated toothpaste primarily offers topical benefits during brushing, ingesting fluoride through water provides continuous exposure, helping to strengthen tooth enamel throughout the day,” Morales said. When combined with a workforce shortage among dental care providers, he said these low fluoridation rates put state residents at risk. “Together, these factors place New Jersey’s oral health at significant risk of decline, making water fluoridation an especially low-cost and effective strategy to address these challenges,” Morales said.

Attempts to fluoridate NJ water

Efforts to expand fluoride use here date to at least 2009, when Assemblyman Herb Conaway (D-Burlington) — a physician and public health official, recently elected to the U.S. House of Representatives — joined other Democrats to propose legislation that would have required water systems serving more than 25 people year-round to be treated. At the time, public health leaders were also advocating for the change. The legislation cleared two Assembly committees and was reviewed by nonpartisan staff that found it would cost from 25 cents to $1 per person to implement, but it never advanced to a full vote in either the Assembly or Senate.

A similar proposal received attention several years later in the Senate, under the leadership of Sen. Joe Vitale (D-Middlesex), the longtime chair of its health committee. The bill to require fluoridation is now sponsored by Sen. Raj Mukherji (D-Hudson) alone and the measure (S-1179) has not received a hearing in several years.

While Van Drew is a proponent of fluoridated water for oral health, he balks at widespread mandates for its use, noting some people may not want the additive. “Should we do that with vitamins? Should we do that with antioxidants? All good things [but] where do we cut it off?” Van Drew said. “When do you give up personal freedoms for the good of the whole?”

Original article online at: https://www.njspotlightnews.org/2024/11/why-kennedy-plan-fluoridated-water-ban-likely-matters-little-nj/