Local dentists gathered at a board meeting last Tuesday to discuss the board’s recent decision to stop fluoridating the village’s drinking water supply, a practice that has been in place in since 1953.
And, they weren’t happy. Walden dentist Tim Hale summed up the feelings of about a half dozen dentists who were in attendance. “We were upset that we weren’t contacted,” he said.
Robert Kimball spoke about his 43 years of practicing as a dentist in Walden. “We’d see kids with decay on every tooth,” he said. “You don’t see that anymore.”
Dr. Kimball described a study which took place in the ‘40s and ‘50s, which laid the foundations for the widespread use of fluoride in the prevention of tooth decay. It was the Newburgh-Kingston Caries Fluorine Study, conducted over a period of 10 years which closely monitored the dental health of children in the cities of Newburgh and Kingston.
During the study, Newburgh’s drinking water was fluoridated at 1 part per million (ppm). Kingston was used as a control and its drinking water was not treated. After 10 years, it was found that the children in Newburgh had a lower incidence of tooth decay than those in Kingston. Even before the experiment was over, communities across the country began to fluoridate their drinking water.
“I think the board would do well to reconsider their action,” said Kimball.
Walden dentist Peter Masci acknowledged that children were now getting fluoride from more sources than in the past, including sodas, juices and toothpaste. Fluorosis, the staining and pitting of teeth caused by too much exposure to fluoride during tooth development, he said, was not nearly as pressing a problem as tooth decay.
Masci also highlighted a concern for senior citizens. “We see a severe increase of decay in senior citizens,” he said, explaining that certain medicines help to cause tooth decay.
“We actually recommend fluoride to seniors on a regular basis.”
In 2001, the Centers for Disease Control and Prevention, a longtime supporter of the fluoridation of drinking water, revised its recommendations to consider the fact that many beverages and dental products now also contain fluoride, describing “optimal” levels of between 0.7 and 1.2 parts per million (ppm) as a “safe, effective, and inexpensive method of preventing dental cavities.”
It also concluded that “additional research is required to resolve some questions regarding fluoride modalities.”
After listening to the dentists’ comments, Trustee Susan Rumbold, who first championed the idea of removing the fluoride, posed a question. “So, young children shouldn’t be fed formula with water that has been fluoridated?” she asked.
The answer was maybe. “You can get too much fluoride,” said Dr. Hale, adding that continuous monitoring of fluoride levels in drinking water supplies is necessary.
The CDC now states, “Recent evidence suggests that mixing powdered or liquid infant formula concentrate with fluoridated water on a regular basis may increase the chance of a child developing the faint white markings of very mild or mild enamel fluorosis.”
And the American Dental Association summarizes that “increased exposure to fluoride from any source increases the possibility that a child may develop enamel fluorosis.”
So, is the fluoride in drinking water any less safe than it was when it was first introduced? The evidence suggests that it is safe in most areas of the country, but the feds aren’t taking any chances.
In 2006, the National Research Council conducted a review of the data and concluded that the EPA’s limit of fluoride in 4 ppm of drinking water should be lowered to 2 ppm to reduce the risk of dental and bone fluorosis, which causes damage to joints and bones.
Groups like the ADA were quick to point out that the report only focused on naturally occurring levels of fluoride, which are high in the southwestern area of the U.S. As a result, the EPA adopted the standard of 2 ppm as a secondary, non-enforceable guideline.
New York State allows a maximum concentration of 2.2 ppm of fluoride in community drinking water supplies. Still, many municipalities across the state do not fluoridate their drinking water and never have. Some of these include the City of Middletown, the Town and Village of Goshen, and the Villages of Montgomery and Maybrook, which have never fluoridated their drinking water.
According to a 1989 study by the NYS Department of Health, about four decades after the Newburgh-Kingston study, the prevalence of dental cavities was only slightly lower in Newburgh than in the City of Kingston, where the drinking water has also never been fluoridated.
In the end, the debate was enough to persuade Brian Maher to reconsider the action.
“We do need further discussion,” said Maher.
Village Attorney Kevin Dowd said that if the choice was made to reverse the board’s decision to remove fluoride from the public water supply, a new local law would need to be adopted.