On July 14, Martinsville City Council will decide whether to remove fluoride from the city water supply for the first time in 50 years.
According to West Piedmont Health District Director Dr. Jody Hershey, there are no benefits – health-related or financial – to removing fluoride from city drinking water.
However, he said, there are plenty of downsides.
The health benefits of water fluoridation first were discovered in the 1930s, Hershey said, when scientists discovered that children in areas with naturally occurring fluoride in drinking water experienced less tooth decay than children in areas without naturally occurring fluoride.
“That discovery was important, because most children and adults at that time in the U.S. were affected by tooth decay,” Hershey said. “It was significant. Tooth decay causes toothaches, headaches, painful extractions. … Even teenagers at that time were losing permanent teeth.”
In 1945, he said, Grand Rapids, Mich. became the first U.S. city to fluoridate drinking water. Martinsville began fluoridating its water in April 1965, he said, and today, more than 75 percent of the U.S. is served by fluoridated community water systems.
“Fluoridation of community water supplies is the single most effective public health measure to prevent tooth decay,” Hershey said. “Early studies certainly showed that water fluoridation reduced the amount of cavities in primary baby teeth … by as much as 60 percent, and reduced tooth decay in permanent adult teeth nearly 35 percent. If
you look at studies today – and these are good, scientific-based studies – they prove that water fluoridation is effective for both children and adults for reducing tooth decay … anywhere from 25 to 40 percent, even in an era where we have widespread availability of fluoride from other sources, such as toothpaste.”
Simply by drinking water, Hershey said, people can benefit from fluoridation and prevent cavities “regardless of their age, regardless of their education, regardless of their race, regardless of their sex, regardless of their socioeconomic status.”
The federal Centers for Disease Control and Prevention has named fluoride as one of the top 10 greatest public health achievements of the 20th century.
However, Hershey said, Martinsville city staff recently received an email from an organized group that blames water fluoridation for a wide range of medical conditions. That new attention has brought the issue before city council.
“(The anti-fluoride activists) have very organized websites and they target politicians … community leaders,” Hershey said. “They make all these unproven claims, like fluoride causes an entire laundry list of human illnesses. They use a lot of innuendo, like ‘50 years ago doctors and dentists posed for cigarette ads.’ They’re sort of trying to make a connection that really doesn’t connect.”
Much of the anti-fluoride movement’s documentation relies on statements from respected medical officials and scientists who have spoken out against fluoridation, he said, such as Dr. Charles Gordon Heyd, a past president of the American Medical Association (AMA).
“What they don’t disclose in that information is that Dr. Heyd was president of the AMA in 1936, almost 10 years before any water fluoridation trials began,” Hershey said. “The quote is very old, and it doesn’t represent the current AMA position of support. … One of the other claims I’ve seen is that 14 Nobel Prize winners have opposed or expressed reservations about fluoridation. In fact, the vast majority of these individuals were awarded their Nobel Prizes from 1929 through 1958.”
What medical issues do anti-fluoride activists claim fluoride causes?
“What aren’t they claiming?” Hershey asked, laughing. “They have linked it to everything. … Alzheimer’s disease, heart disease … AIDS, allergic reactions, arthritis, asthma, behavioral problems, bone diseases, osteoporosis, cancer of all types, bronchitis, colic, Down Syndrome, enzyme effects, flatulence, GI problems, harmful interactions with medications, heart disease, increased infant mortality, kidney disease, lead poisoning, lethargy, low IQ, malpositioned teeth, early puberty, skin conditions, Sudden Infant Death Syndrome, thyroid problems.”
In truth, Hershey said, thousands of credible scientific studies over 70 years have failed to link water fluoridation to any of the aforementioned ailments.
Links have been found between negative health effects and the removal of fluoride from drinking water, however.
In 1960, Antigo, Wis. ceased adding fluoride to the town’s drinking water after first implementing water fluoridation in 1949, Hershey said. Five and a half years later, studies determined that second grade children in Antigo had 200 percent more tooth decay, fourth-graders had 70 percent more tooth decay and sixth-graders had 91 percent more tooth decay than those same age groups experienced in 1960.
“Residents of Antigo reinstituted water fluoridation in October of 1965 on the basis of the severe deterioration of their children’s oral health,” Hershey said. “I have studies from Cuba, I have studies from Japan, I have studies from Scotland, the Netherlands … they all show the same thing. You do away with the fluoridation and within anywhere from two to five years … you begin to see significant increases (in tooth decay).”
One of the reasons that the anti-fluoride movement has gathered steam in recent years, Hershey theorized, is that the Internet offers just as much space for good, peer-reviewed science as it does for junk science.
For example, he said, anti-fluoride activists often cite studies linking fluoride in water to low IQ. What the activists usually fail to mention, he said, is that those studies took place in China and Iran; the concentration of fluoride in the water sources was 10 times higher than in the U.S.; and the studies failed to account for high amounts of lead and other heavy metals in the water supplies, elements that are known to contribute to low IQ.
Anti-fluoride activists commonly claim that large parts of Europe do not fluoridate their water, Hershey said. While this is true, the reason many European countries do not fluoridate water is because their older cities do not have the necessary infrastructure to make water fluoridation practical.
Instead, he said, these countries routinely fluoridate other products, such as salt or milk, to make sure that citizens receive the necessary amounts of fluoride.
Activists also have claimed that water fluoridation no longer is necessary because most toothpastes sold in America contain fluoride.
“The benefits of community water fluoridation have been built on those from fluoride in toothpaste,” Hershey said. “There have been well done scientific studies that have been conducted in communities that fluoridated water in the years after fluoride toothpaste became common, and those studies have consistently shown a lower rate of tooth decay in communities that fluoridate, even with people using fluoride toothpaste. … Fluoride toothpaste alone isn’t enough.”
According to previous Bulletin reports, the city of Martinsville spends about $15,000 per year to fluoridate its water. According to Hershey, studies have shown that every $1 invested in community water fluoridation saves about $38 in unnecessary dental treatment.
If the person receiving that treatment is uninsured or on Medicaid, then those dental bills will be paid out of taxpayer pockets, he added.
“It’s coming out of our pockets one way or the other,” Hershey said. “So you may cut $15,000 out of the Martinsville city budget, but what is it going to cost us all several years down the line?”
City council is scheduled to further discuss and vote on whether to continue fluoridating Martinsville’s water supply at its meeting at 7:30 p.m. July 14, according to Martinsville City Manager Leon Towarnicki.
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