Martinsville City Manager Leon Towarnicki will recommend that the city continue to add fluoride to its drinking water — if the issue comes up for a vote at Tuesday night’s city council meeting and he is asked for his opinion.

His stance is based on scientific studies concluding that fluoridated water helps prevent tooth decay and dental diseases, especially in children.

High unemployment and poverty levels locally “suggest that certain segments of the population are struggling with basic necessities in life,” Towarnicki said.

Therefore, “I’d have to speculate … that dental care for children would have to be put on the back burner” by some families so they can pay for necessities such as food and shelter, he said.

Fluoride in water seems to reduce the risk that kids without regular access to dental care will have problems requiring a dentist’s services, according to Towarnicki.

Martinsville City Council in recent months has heard many comments from residents and health care providers on both sides of the issue of water fluoridation. The issue is not on the agenda for Tuesday’s council meeting, but Councilwoman Sharon Brooks Hodge – a fluoridation opponent – has said that if nobody else brings up the issue during the meeting, she will make a motion for the city to discontinue the practice.

Communities nationwide have added fluoride, a derivative of the element fluorine, to their drinking water since the 1940s to help prevent dental problems among residents. The American Dental Association (ADA) determined that about 75 percent of Americans connected to public water supplies have fluoridated water.

Martinsville has fluoridated its water since the 1960s. The city spends about $15,000 a year to do so.

Some studies have indicated that exposure to too much fluoride could lead to dental and health problems such as white spots on teeth, thyroid conditions, brain disorders and hyperactivity.

Yet scientific evidence is overwhelming that the practice is safe if fluoride in water does not exceed a certain level, according to Dr. Jody Hershey, director of the Henry-Martinsville Health Department.

The U.S. Public Health Service currently recommends that drinking water contain 0.7 milligrams of fluoride per liter. That is the level of fluoride being added to Martinsville’s water, city officials have said.

However, water fluoridation is voluntary. It is not regulated by either the U.S. Food and Drug Administration or the U.S. Environmental Protection Agency.

The city has received “about a half a dozen” letters from accredited dental, medical and scientific organizations asking that fluoride continue to be added to Martinsville’s water and providing reasons why, Towarnicki said.

For example, American Academy of Pediatrics President Dr. Sandra Hassink wrote that although it is “largely preventable,” tooth decay has become “the most common chronic childhood disease, five times more common than asthma.”

Tooth decay can lead to “severe health problems, including serious infection, debilitating pain, dietary and speech problems, and in rare cases, even death,” Hassink said in her letter.

“Fluoridated water is the cheapest and most effective way” of preventing the decay, with the “lifetime cost per person equaling less than the cost of one dental restoration,” she wrote. She did not provide specific figures.

Dr. Michael Link, president of the Virginia Dental Association, made similar comments in his letter. He wrote that studies done around the time when water fluoridation became common show that it reduced the number of cavities in baby teeth by as much as 60 percent and reduced decay in permanent adult teeth by 35 percent.

“Today, studies prove water fluoridation continues to be effective for both children and adults by reducing tooth decay by 25 percent, even in an era with widespread availability of fluoride from other sources,” such as toothpastes, Link wrote. And, “new studies indicate optimally fluoridated water (around the 0.7 milligrams level) prevents decay of root surfaces (in teeth) in the elderly.”

The Virginia Dental Association is an ADA affiliate.

Towarnicki said the city has received no letters from accredited medical or scientific sources urging that water fluoridation be stopped, although council members and other city officials have received correspondence from a few people to that effect.

In an email to city officials, which she also provided to the Martinsville Bulletin, area resident Donna Whitlow asked that “hydrofluorosilicic fluoride” be removed from city water because it is a “toxic waste from the fertilizer industry.”

According to Jane Koppelman of the Pew Charitable Trusts’ Children’s Dental Campaign, that is not true. In a letter to Mayor Danny Turner and Vice Mayor Jennifer Bowles, Koppelman wrote that “all fluoride additives are required to meet strict quality and safety standards.” She added that results of an investigation by a political fact-checking service revealed that a claim that fluoride additives are toxic was deceptive.

Dr. James W. Reeves, a retired civil engineering professor in Lafayette, La., wrote to Martinsville officials that several years ago, concerned citizens in his city convinced the council there to reject fluoridated water.

Information on the Internet indicates that Reeves also has tried to convince various other localities to do so.

In his letter, Reeves stated that “the world has mostly rejected fluoridation with only 5 percent of all populations drinking fluoridated water; in Europe it is only 3 percent.”

That also is not true, according to Hershey. In a response that he provided Martinsville officials, he wrote that “over 405 million people in more than 60 countries worldwide enjoy the benefits of fluoridated water.”

Water fluoridation is extensive not only in the United States, Hershey mentioned, but also in Australia, Brazil, Canada, Chile, Colombia, Hong Kong, Ireland, Israel, Malaysia, New Zealand, Singapore and Great Britain.

If a vote to remove fluoride from Martinsville’s water is not successful when the council meets at 7:30 p.m. Tuesday, that does not necessarily mean the issue is dead forever. For instance, a future council comprised of different members could reconsider it.