As a practicing dentist for 30 years, a former faculty member and researcher at OHSU’s School of Dentistry, and someone who has worked in public health dental clinics, I would like to address the recent opinion piece on fluoridating Portland’s water by Effie Greathouse (“Debating Portland’s water: When I check the research, fluoride makes sense,” Oct. 13). The author claims that the findings of the meta analysis of 27 studies, mostly in China, show that fluoride levels were higher than those experienced in the United States and that IQ differences were not significant. Greathouse placed more credence in the reassurance of her family doctor and family dentist than in the reports of specialist epidemiologists at the Harvard School of Public Health, who did find these results to be significant.

Whereas some of the studies included in the analysis examined IQ in regions with higher concentrations of fluoride than most children may be exposed to in the U.S., most of the individual studies found cognitive impairments associated with fluoride levels that many individuals in the U.S. are exposed to. The Harvard epidemiologists clearly stated that: “Children who lived in areas with high fluoride exposure had lower IQ scores than those who lived in low exposure or control areas.” Greathouse dismisses the cognitive impairment the study found as being exaggerated. I would suggest that any impairment in IQ is an unacceptable trade-off for the unproven possibility of “fewer” cavities.

While Greathouse correctly points out that the state of Oregon as a whole has a high rate of tooth decay, it is important to note that the city of Portland does not. According to the 2007 Oregon Smile Survey, the percentage of children with untreated tooth decay in the Portland metropolitan area was only 21 percent, well below the national average of 29 percent, which includes fluoridated and non-fluoridated areas. There is, however, a whopping 44 percent of untreated tooth decay in the rest of Oregon, which is far above the national average.

I have seen terrible cases of rampant tooth decay in children and adults in Oregon Health & Science University clinics that I have practiced and taught in, and I am the first to want to prevent it, but these statistics highlight the problems in rural areas across our state with poverty, nutrition and limited access to dental and medical care.

The money spent for fluoridating Portland’s water supply would not help the children who need it most and would be much better spent on preventive programs in underserved areas.

Jay Harris Levy lives and practices in Portland.