Montrose’s medical and dental community brought a public health concern to the Project 7 Water Authority board last week — the dentists and doctors want fluoride treatment returned to Project 7’s water.
Project 7 provides potable water to municipalities and rural areas throughout the Uncompahgre Valley, including the City of Montrose. As of July 31, the water authority ended its supplemental fluoride treatment of delivered water, due to a supply constraint.
At a meeting of the Project 7 board of directors last Thursday, Oct. 23, a group of representatives from the dental and medical fields in Montrose voiced concern with the decision to end fluoride treatment, calling it a significant public health issue.
“The overall concern is really about the public health impact of removing fluoride,” Dr. Dorcha Boisen, a Montrose oral surgeon and liaison for the group, said.
According to the Colorado Dental Assocation, studies conducted for more than 65 years have shown fluoridation of community water supplies to be safe and effective in preventing dental decay.
Boisen explained fluoridation is particularly important for the dental health of children.
“The way the fluoride works is it actually binds with the make up of the teeth as the teeth are developing, when kids are young, and makes the teeth stronger so they’re more resistant to cavities,” Boisen said. “There’s a window of time and opportunity that that can happen.”
Topical fluorides, such as those found in hygiene products, are not effective in strengthening children’s teeth, Boisen added.
“Topical fluorides, like in toothpaste and mouthwash, don’t really do what systemic fluoride does; they’re not able to provide that bond like the systemic fluoride does,” she said.
Fluoride occurs naturally in Project 7’s water supply in ranges from 0.15 to 0.25 milligrams per liter; the U.S. Department of Health and Human Services recommends fluoridation of water to 0.7 milligrams per liter.
Project 7 had supplemented fluoridation to the recommended level for about 33 years, according to Adam Turner, plant manager. The facility used a sodium silica fluoride but domestic supply of the dry fluoride product has virtually halted.
Turner said Project 7 searched for an alternative fluoride product to replace the plant’s previous method of fluoridation — but with no success. Acidic forms of fluoride would add to the water source’s natural acidity and potentially make the water aggressive to customers’ pipes.
A Chinese dry fluoride product was available, but Project 7 had concerns for its quality control.
While Boisen said the dental community understood these challenges, the group felt other options were available.
“There was a feeling from the dental community that maybe there wasn’t a due diligence done on trying to find an alternative source and that this is a bigger public health impact than they may have appreciated,” Boisen said.
After hearing the group’s concerns at its board meeting, Project 7 has committed to further research an alternate source of dry fluoride, and failing a solution there, to explore the costs associated with switching to an acidic form of fluoride.
“If we had to switch to an acid-based feeding system, we would have to neutralize that (acidity),” Turner said. “We would basically be looking at adding two systems – fluoride and pH.”
While there are costs associated with changing fluoride systems, dental and medical practitioners warned of other costs.
“The concern from the medical, as well as dental, community is that with removing fluoride you’re increasing, obviously, basic cavity risk in all the populations — but most heavily in children. That, in turn, increases need for treatment and oftentimes it’s very expensive treatment,” Boisen said.
“It significantly impacts how we treat patients — our pediatrician colleagues and our general dental colleagues — with knowing the fluoride is gone, are going to have to start to prescribe fluoride for their patients,” she added.
Prescription fluoride treatment costs about $10 a month for children old enough to chew a tablet, and $25 a month for those too young for a chewable, according to Boisen.
“From our standpoint, it’s going to hurt a lot of people and a lot of people who don’t have a voice — kids, for example,” Boisen said.