The state’s dentists are decrying that New Hampshire ranks 43rd in the country in terms of access to fluoride in public drinking water, although that ranking does not seem like it’s going to improve any time soon.
The Centers for Disease Control and Prevention said that as of 2012, the most recent year for which results are available, just 47 percent of the 834,000 people on New Hampshire’s public water systems had access to fluoridated water, which dentists say can greatly reduce cavities and other dental problems.
The figure for the overall population is much lower, since private wells are not fluoridated and about 36 percent of New Hampshire residents get their water from such wells, one of the highest figures of any state in the country.
That means only about one-quarter of the state’s population has access to fluoridated water supplies. By contrast, about 73 percent of the people in the United States are on public water supplies that are fluoridated, according to the CDC.
In a statement, Peter Welnak, president of the New Hampshire Dental Society, wrote that New Hampshire cities and towns and other places with public water systems should add fluoride: “If we increase access to fluoridated water across our state, we could decrease the rate of tooth decay in children by as much as 40 percent.”
There are no signs that increased access is likely, however, due to public opposition.
Manchester was the last New Hampshire community to add fluoride to its public water supply, which happened in 2000 after a hotly contested referendum that led to court battles by opponents. No other community has even tried to add fluoride since then.
The state’s second-biggest city, Nashua, does not add fluoride; a 2011 article in the Telegraph indicated that officials with the private water system that serves the area had no plans to try including it, largely because of public opposition.
Concord has added fluoride to its city water system, in the form of fluorosilicic acid, since 1978; it also fluoridated water from 1952 to 1960, but stopped for a period of time. It is one of a dozen communities and public water supplies in the state that fluoridate, by adding either fluorosilicic acid or sodium fluoride to the community drinking water.
New Hampshire is not alone in rising concern about fluoridation. Worcester, Mass., has tried five times to get public permission to fluoridate its public water, and all have failed, and several Massachusetts towns have seen referendums in recent years seeking the have fluoridation removed from the water – although those have failed, as well.
The issue may arise in Concord next month as part of a legislative Commission to Study Pathways to Oral Health Care in New Hampshire, although the group’s main purpose is to analyze barriers to and coverage for dental care, including the impact of giving more authority to dental assistants and certified public health dental hygienists. That group will report Nov. 15.
Opponents of fluoridation often argue that it is a form of government overreach, medicating residents without their permission, and that placing the chemical in water supplies makes it difficult to control the amount people ingest, particularly since fluoride is added to toothpaste and a number of foods. Ingesting too much fluoride leads to stained teeth or, in extreme cases, skeletal problems.
A number of New Hampshire municipalities, including Concord, have in the past year reduced the amount of fluoride they add to the public water supply to about 0.7 parts per million, or 0.7 milligrams per liter of water, from around previous levels of around 1.0 ppm because of health studies about the amount of fluoride ingested by people.
The Environmental Protection Agency this spring lowered its recommendation for public water fluoride to a maximum of 0.7 ppm from its previous recommendation of 0.7 to 1.2 ppm. Some fluoridation opponents had been urging such reductions for years.
The original standard was set as a range rather than an exact limit partly as a function of air temperature, said Paul Riendeau, instructor and education coordinator with the New England Water Works Association in Holliston, Mass.
“The thinking was that when the weather was warmer, people would drink more,” he said.
Some opponents also raised concern about other aspects of the chemicals used to add fluoride to drinking water.
Oral-health professionals generally support fluoridating water supplies, not only because it is effective at reducing cavities, but because it’s cheap, costing as little as $1 per person in a city the size of Manchester.