Recently, my husband’s cardiologist was not joking when he told him, “They should put Lipitor in the water supply.” His explanation of the benefits he saw with his patients in lowering their cholesterol had convinced him that this was the way to go.

But in another doctor’s office, a patient was complaining about the side effects she was experiencing from Lipitor, and the internist prescribed an alternative medication.

Two patients, both needing medication to control their high cholesterol, but receiving different prescribed treatment.

The American Dental Association thinks fluoride should be in everyone’s water supply. Many pediatricians, general practitioners and allergists disagree. Making the leap from convenience to mass medicating is one that the public should never take unless all consequences are taken into account.

First, do no harm. When a doctor prescribes medication, the patient usually receives oral and written side effects to watch for. Patients with pre-existing conditions are cautioned about problems that can occur and sometimes told not to take the drug at all. When fluoride is prescribed to a child, the dosage is recorded and available in case of a medical event.

Recently, the National Academy of Sciences released a study done by the National Research Council (March, 2006).

While the [NRC] study focused on drinking water supplies that have naturally occurring fluoride at levels of 4 ppm and higher, the study is highly relevant to municipalities that “add” 1 ppm fluoride to water supplies. What the NRC study shows is a “disappearing” margin of safety for fluoride ingestion.

The NRC found that the current 4 ppm standard for fluoride is too high and asked the U.S. Environmental Protection Agency to make the standard more stringent in order to protect children against severe dental fluorosis and all age groups from bone fractures. The NRC report reviewed other animal and human studies that show adverse effects in adults and children when exposed to even low levels of fluoride. These included lower IQ in children; increased hip fracture rates in the elderly; and impaired thyroid functions.

Even if there are low levels of fluoride in drinking water, whether added or naturally occurring, people might be concerned that they could be getting too much fluoride. Certainly adding additional fluoride should be reconsidered, as water and dental care are not the only source. Many other sources such as processed beverages and foods (e.g., Gerber’s white grape juice, Coca Cola Classic, green and black tea, rice, peas, shrimp, chicken with broth, sugar, and table salt) and pesticide residues on food can easily make you exceed a “safe” intake of fluoride.

The NRC study revealed another alarming fact. While there have been numerous studies showing the adverse health effects of naturally occurring fluoride in drinking water, huge data gaps exist in meaningful research on the practice of water fluoridation – a process that adds a fluoride compound to drinking water called hydrofluosilicic acid. This type of fluoride is a waste byproduct of the pesticide industry that also contains contaminants such as arsenic, lead and mercury.

This lack of research regarding the safety of fluoride as an additive in drinking water is startling, considering the United States has been fluoridating water supplies of up to 162 million Americans in its 56-year history of usage. Even more alarming is that the United States has continued its usage without adequate research on its safety, while Europe has taken on a “better safe than sorry” approach to water fluoridation. Ninety percent of European countries have decided to take precautionary measures by actually banning (and in some cases stopping) water fluoridation. According to World Health Organization figures, European children’s teeth are just as good if not better than ours.

The bottom line is that topical applications of fluoride in toothpaste and fluoride rinses are a much more effective tool for preventing tooth decay than ingesting it. In fact, no other preventative medication is delivered to our residents by a drinking water additive.

The ethical questions surrounding mass medicating the public through the water supply should also be raised. For the sake of convenience, one’s health should not be compromised.

We don’t promote the drugging of the nation’s youth because a large percentage of them suffer the angst of teenagerism. Nor do we condone antihistamines to be introduced into everyone’s orange juice because allergens are everywhere.

The benefits of drugs like fluoride, Prozac and Benadryl are many, to be sure. Their availability for the treatment of many conditions is a testament to medical science.

Water companies don’t have and should not have license to administer medication. They will not be sending side-effect leaflets to all their customers along with the water bill and won’t ask about the accumulated daily amount of fluoride from juice boxes, yogurt, toothpaste, chewing gum, vitamins or baby food the consumer has ingested. Water companies will not be required to publish an 800 number for a fluoride overdose.

The opportunity for bad outcomes such as overdosing or ill side effects requires that patients, in consultation with their treating physician, be informed. That doesn’t happen if we’re all just drinking the (fluoridated) Kool-Aid.

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Peggi Sturmfels, a summer visitor in Maine, is the program organizer for New Jersey Environmental Federation (State Chapter of Clean Water Action) in Belmar, N.J.