This November, voters in Lebanon, Oregon will decide whether to keep adding fluoride to the city’s water supply.

Lebanon has fluoridated its water since 2001. It uses the federally recommended rate of 0.7 parts-per-million, and this costs the city about $25,000 per year.

Now, some community members are voicing concerns about the practice, and whether it’s necessary to continue paying for it.

Sabrina Mann is a Lebanon resident, and one of the chief petitioners of a previous attempt to get fluoride removal on the ballot.

“There are plenty of dental products that have fluoride in them,” said Mann. “I worry over whether or not we are (over-fluoridating) ourselves with it being in the water.”

Petitioners didn’t gather enough signatures in their most recent attempt. But earlier this year, Lebanon’s City Council voted to ask the public in this year’s general election.

This is the first time that Lebanon voters will directly weigh in on the issue.

“It’s something that we’re putting into our bodies,” said Mann, “and I feel that we should have a say in whether or not it’s in our water.”

The safety of fluoride

Fluoridated drinking water has been endorsed by the Center for Disease Control, the American Dental Association, and the World Health Organization.

According to the CDC, moderate fluoride exposure makes teeth more resilient, reducing cavity growth by around 25%.

Kurt Ferré is a retired dentist, and the Treasurer for the American Fluoridation Society, an advocacy group based in Portland. He said ingested fluoride works alongside topical applications, like from toothpaste.

“You swallow it, and a very, very small amount comes back in our saliva,” said Ferré, “becomes concentrated in the plaque over time, and serves as a reservoir for fluoridation.”

By placing fluoride into the water supply, Ferré said officials can reach children from lower-income families who lack regular access to dental healthcare.

However, there are potential side effects. When developing teeth are overexposed to fluoride, they can form with a condition called dental fluorosis.

Although severe cases can lead to pitted enamel, that’s rare in the United States. Instead, medical officials say the condition most often causes aesthetic discolorations, like white or brown specks.

“The questionable, mild and very mild degrees of fluorosis—it’s barely noticeable by anyone other than a trained dental professional,” said Ferré.

Mild-to-moderate fluorosis may be widespread, according to the CDC’s National Health and Nutrition Examination Survey. From 2011 to 2016, over 70% of the 6-to-19-year-olds studied were found with at least very mild cases.

However, a later CDC analysis cast doubt on this data, arguing that the progression of fluorosis from previous surveys was “not biologically plausible.“

Ferré said parents can help prevent fluorosis in young children by making sure they aren’t swallowing too much toothpaste. But he said even in a community with fluoridated water, he doesn’t see a significant risk.

“Fluoridation is probably the most studied public health measure, and it’s been around for 79 years,” said Ferré. “In Lebanon, they’ve had fluoridation for 20 years. Where are the victims?”

Mann said there is at least one Lebanon resident who has attributed health issues to fluoride exposure. She also said allergies can differ from person-to-person, and over time.

According to the American Academy of Allergy, Asthma, and Immunology, the rate of adverse reactions to fluoride application is less than one in a million.

Fluoride and IQ

Some communities across the world have higher rates of fluoride in their water supply due to volcanic ash, or other excess sources of the chemical.

Earlier this year, the National Institute of Health’s National Toxicology Program found that there was an association between high doses of fluoride—above 1.5 parts-per-million—and cognitive deficits in children.

The report recommended additional research on the cognitive effects of lower-level fluoride exposure.

The vote

By voting “yes” on Nov. 5’s ballot measure, Lebanon voters would be approving continued fluoridation of the city water supply. A “no” vote would mean the practice would be discontinued.

If the measure fails, Lebanon would join several other Oregon cities without fluoridated water, including major population centers like Portland, Eugene and Bend.

In 2022, Oregon was ranked the third lowest state in the nation by percentage of water customers with fluoridated water. Country-wide, over 70% of customers received fluoridated water. For Oregon, that figure was just over 25%.

Original article online at: https://www.klcc.org/npr-science-environment/2024-09-25/lebanon-voters-weigh-removing-fluoride-from-city-water-supply