The State College Borough Water Authority is exploring if it should continue to put fluoride in its water, something it has done since 1954.
More information on the benefits and risks of fluoridation has come out in the past 70 years, as well as fluoride toothpaste. The board received a presentation on this information during its meeting May 19 from Vice Chair Rachel Brennan.
Fluoridation is a controversial topic, Brennan said. In 2019, the board began discussing why they were fluoridating the water. The board created an ad hoc committee to further explore it, but discussions were tabled because of the COVID-19 pandemic.
“Now we’re at the point where purchasing additional fluoride was problematic this last round due to supply chain issues. We still got it but it came back to the floor as being an important issue that we needed to go ahead and discuss,” Brennan said.
In 2019, the SCBWA budgeted over $70,000 for the purchase of sodium fluoride, equipment maintenance, labor and analysis, she said. Up to a full year’s supply of sodium fluoride is typically stored at the Woodside Drinking Water Treatment Plant. That potentially creates a risk to operators who are handling the material, but if there was an accident, others could potentially be at risk.
Less than 1% of the water that is produced is consumed by the public, Brennan said, so 99.2% of the fluoride that is purchased is just discharged into the environment.
“Out of our drinking water, we produce typically 5 million gallons per day, but people only drink about two liters of their consumption per day. We typically use about 67 gallons per person, per day, and so if you look at our 75,000 residents, that works out to be about 0.8% of the water is actually consumed,” she said.
The 3-person ad hoc committee of the water authority recommended 2-1 to cease fluoridating the water and follow the precautionary principle until more “compelling safety and efficacy data are available.”
The first community in the United States to put fluoride in its drinking water was Grand Rapids, Michigan, in 1945. This came after a physician said in 1942 that the optimal amount of fluoride to reduce tooth decay was 1 milligram per day, per adult.
Brennan stressed that the board wasn’t debating whether or not fluoride prevents dental cavities or tooth decay, because it does, she said. The board is only looking at current data and reviews on the risks and benefits of systemic fluoride application through drinking water to the entire population versus topical applications (like toothpaste, for example).
“One thing in all of these studies that is pretty transparent is that topical fluoride is just as effective as having the fluoride in your drinking water,” Brennan said.
The Centers for Disease Control and Prevention says that drinking water with 1 to 1.2 milligrams per liter of fluoride shows a 25% reduction in cavities over a person’s entire lifetime, she said. But with topical applications, after they became widely available, there was a 55% reduction of cavities in 15-year-olds in 2013 compared to 1973, before fluoride?containing toothpaste became available.
The American Dental Association recommends 0.7-1.2 milligrams per liter in drinking water. It also began recommending, in 2006, that infants should have their formula prepared with water that is fluoride free, Brennan said, to reduce the risk of fluorosis.
Fluorosis is a condition that leads to changes in the appearance of tooth enamel, the CDC says, which can occur when children regularly consume fluoride during the years their teeth are being formed.
“This is a fully developed country and 96% of our children in the US are using toothpaste, and the majority of that is fluoridated. And a lot of this is helped with the public school system and the health programs inside the public school system. So we’re not in a position really where we have children who do not have access to fluoridated toothpaste.”
Brennan reviewed several other recommendations from different agencies, including the U.S. Food and Drug Administration, Environmental Protection Agency and National Research Council.
Are there risks?
The SCBWA’s current operational goal is to maintain a fluoride residual of 0.7 to 1 mg/L, she said. The five year average, from 2017-2021, is 0.69 mg/L, which is close to the current U.S. Department of Health and Human Services recommendation of 0.7 mg/L, Brennan said. Pennsylvania does not require a minimum fluoride concentration in drinking water.
About two-thirds of the country’s population drinks fluoridated water, but between 2013 and 2018, 74 cities removed fluoride from their drinking water, including Bellefonte, she said.
Many studies in regions that have naturally high levels of fluoride in their groundwater show there are links between prenatal fluoride exposure and lower IQ levels in children.
“In the past, those have predominantly been in areas with high fluoride concentrations in the natural water. There’s been a very recent study … that was conducted in Canada with artificially fluoridated water,” she said. “… They did a controlled study with pregnant women drinking non-fluoridated water versus those drinking … fluoridated water by their authority, and they found a statistically significant drop in IQ in the children born to women who are drinking that fluoridated water.”
Fluoride can’t be removed from the water by boiling or home carbon filtration, Brennan said. There are expensive methods to remove fluoride from drinking water, such as reverse osmosis or specialty ion exchange resins.
“This is sort of a social justice issue. If you wanted to take it out, you couldn’t if your community was artificially fluoridating your tap water. I guess you could buy bottled water that doesn’t have fluoride in it, that would be an option. But we don’t want to promote that really, for environmental reasons,” Brennan said.
Is it necessary?
Brennan briefly gave an overview of what Europe is doing in terms of fluoridation. She said 97% of western Europe drinks non-fluoridated water. And, she said, despite that, their tooth decay rates over the past 50 years have declined just like they have in the U.S.
“From a logical, data analysis perspective, this indicates that water fluoridation plays a relatively minor role in the improvement of dental health in areas that have access to fluoridated topical treatments,” she said.
There’s a lot of disagreement over whether fluoride is a medicine, Brennan said.
“The ethical question then becomes if fluoride is a medicine, and that’s basically how we’re applying it through drinking water, people would argue all the evidence of its effectiveness should be subject to the same standards that we use for other medications,” Brennan said.
“The ethical implications of widespread application in drinking water is, we need to also consider the principle of informed consent if we do consider fluoride medicine.”
The committee’s recommendation is to follow the precautionary principle, Brennan said, which is, “when an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically.”
*Original article online at https://www.centredaily.com/news/local/community/state-college/article262134392.html