Added fluoride in Alabama’s drinking water is a given, right?

Not necessarily.

Eighty-two percent of Alabamians on public water are getting fluoride added at the water plant, reflecting the prevailing belief among health professionals that the practice is beneficial.

Yet every county in the Birmingham-Hoover metro area still has water systems that don’t add fluoride to some customers’ water, with 23 of 81 systems adding no fluoride at all, according to the Alabama Department of Public Health. About a third of those are in Shelby County.

Eight of Shelby’s 18 water systems, serving more than 12,000 households and businesses, add no fluoride, and five other systems provide fluoridated water only to certain areas, according to the state health department.

Meanwhile, Jefferson County may soon become the first county in the metro area where 100 percent of public water customers receive fluoridated water.

Some water systems don’t add the chemical because they believe it can be harmful, while others say it’s unnecessary because of the fluoride available from other sources. Some also say that customers who don’t want the fluoride shouldn’t have it forced on them.

According to Dr. Stuart Lockwood, state dental director for the health department, Alabama’s 82 percent fluoridation rate puts it among 26 states where more than 75 percent of the population on public water receives fluoride.

The reason advocates give for fluoridation is simple. “It reduces tooth decay by 20 to 40 percent,” Lockwood said.

No fluoride for 600:

In Jefferson County, only about 600 public water customers receive no fluoride in their tap water, and that could soon change, according to Stan Brock, general manager of the Warrior River Water Authority. Those customers, mostly in the McCalla area, get their water from wells acquired in 1998 when Warrior merged with the Roupes Valley Water Authority, which never fluoridated water.

When the authority’s board of directors meets on Feb. 6, Brock said, it will discuss spending $50,000 to upgrade some of the wells and begin offering fluoridated water to those customers.

Some metro-area water systems, however, continue to reject the idea. And statewide, some systems that add fluoride are looking at discontinuing the practice.

In Pelham, about 20 percent of the 19,450 residents receive fluoridated water bought from another system. Officials said there are no plans to add fluoride system-wide.

Ken Holler, director of Pelham Public Works, said one reason the city never made the switch was because in one instance a city worker was almost blinded by the acidic fluoride while adding it to the water several years ago.

Holler also maintains that children now have sufficient sources of fluoride, unlike when fluoridation began to be implemented many years ago.

Lockwood disputed the notion that people now receive enough fluoride from sources other than tap water.

“Water fluoridation is the single most effective public health measure against tooth decay,” he said. “It benefits everyone – children, adults and those who don’t have access to dental care.”

Many are still wary:

Two years later, the City of Ashville opted against adding fluoride after city officials said they determined the water had enough fluoride naturally, according to news reports.

Earlier this month, North Baldwin Utilities, which serves 6,900 households in south Alabama, began debating whether to stop adding fluoride to its water after more than 25 years because some residents wanted more control over their consumption of fluoride, according to a recent Associated Press report.

They were concerned, the story said, that an overabundance of fluoride could be harmful.

Lockwood said a few other communities in Alabama are considering similar plans, but he argued more scientific evidence points to the benefits of fluoridated water than to risks.

“Studies have continually supported the fluoridation of water,” Lockwood said.

CDC calls it safe, effective:

In 2006, the Centers for Disease Control and Prevention, which lists the fluoridation of water as “one of 10 great public health achievements of the 20th century,” issued a statement calling fluoridation “a safe, effective and inexpensive way to prevent tooth decay.”

The CDC report also stated that three potential health problems associated with overexposure to fluoride – severe tooth defects among children younger than 8, bone fractures and a crippling bone disease called skeletal fluorosis – were a risk only for the approximately one-half of 1 percent of Americans who live in areas where the chemical appears at more than four parts per million.

The ideal amount, according to the CDC, is approximately one part fluoride per million parts water.

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