Dr. Veasey Cullen Jr., sees an underlying irony in the push for fluoridated water.

Those who most support making it mandatory and universal are those who have the most to lose from that arrangement. To wit: dental professionals such as himself.

“If you have fluoridated water, dentists are the ones who won’t see the patients as much,” Cullen said.

Cullen’s periodontology practice is in Hanover, serviced by one of the water systems in York that does have enhanced levels of fluoride.

Cullen said he has never sat down and analyzed the respective records of his patients from Hanover vs. those from the non-fluoridated municipalities. But he has no doubt that the presence of fluoride in the water helps ward off tooth decay.

And the way he sees it, fluoridated water is one way to help people who have trouble affording other forms of health care.

“We can do an awful lot to help people who don’t have other means,” Cullen said.

The access that people with lower incomes have to dental care and the fluoridation of public water were two topics that several state and county officials addressed during a recent panel discussion on York County’s oral health delivery system.

The discussion took place Tuesday afternoon at Family First Health, on South George Street in York, before an audience of about 70 health and human services providers.

Participating were Estelle Richman, secretary of the Pennsylvania Department of Public Welfare; state Sen. Mike Waugh, R-Shrewsbury; state Rep. Eugene DePasquale, D-West Manchester; Robin Rohrbaugh, executive director of the Healthy York County Coalition; and Dr. John Bush, a dentist who serves on York County’s Head Start Health Advisory Board.

Several public water systems in York County provide fluoridated water. But York Water Co., which provides water for more than 150,000 county residents, does not.

Rohrbaugh said the Healthy York County Coalition would like to change that.

“It’s something we’ve been working on since 1994, when the coalition was created,” Rohrbaugh said.

York Water President Jeff Osman said that his company has polled customers in the past, and the majority of them stated they did not want fluoridated water. He declined to speculate on their reasons.

The issue has been controversial in York County. People who don’t want fluoride in their water have said it’s either unnecessary or ineffective, and others say it may even cause some health problems.

Osman said his company would add fluoride to the mix if mandated to do so by a government entity. But until and unless that mandate comes along, Osman said York Water Company won’t take that step because it isn’t the company’s decision to make.

“The company’s position is that this is a public health issue, and somebody in that field should make the call,” he said. “We purify and distribute water, and we’re pretty good at it, but we’re not public health officials.”

At the panel discussion, both DePasquale and Waugh expressed their support for proposed legislation in the state House of Representatives that would mandate the fluoridation of public water in Pennsylvania.

DePasquale cited figures he said he got from the Women, Infants and Children program of York County. WIC is a federally funded, state-administered program that provides nutrition service for Pennsylvania children up to the age of 5.

According to those figures, children participating in that program within York County have a far higher incidence of recognizable dental problems in York County than they do in Allegheny County or Philadelphia – with respective numbers of 5.45 percent, 0.38 percent and 0.74 percent. Both Allegheny County and Philadelphia have fluoridated water supplies. Statewide, that figure is 2.49 percent.

DePasquale said he knows those respective percentages don’t amount to a scientific assessment of the relative water supplies’ effect of dental health. Still, he said, any likely health advantage for the county would be worth it.

“All York County children should have the same access to healthy teeth as they have in Philadelphia and Pittsburgh,” DePasquale said.

How we fare

A national grading project from the advocacy group Oral Health America gave Pennsylvania an overall grade of C minus.

The U.S. Department of Health and Human Services named Hanover as one out of 67 “dental shortage areas.” An estimated 8,000 people in the Hanover area are eligible for Medicaid, but only one dental office is participating in the program and is not currently accepting new patients.