Both sides of Bellingham’s fluoridation debate agree Proposition 1 on the Nov. 8 ballot will have a dramatic impact on the community’s health.

But they disagree vastly on what that impact could be.
Bellingham Families for Fluoride – with the financial backing of the Washington State Dental Association, the Washington Dental Service Foundation and dozens of local doctors and dentists – is proposing to add small amounts of fluoride to Bellingham’s water supply.

Supporters say the resulting reduction in tooth decay would be dramatic, particularly for children whose families can’t afford regular dental care. A study of Bellingham School District third-graders released earlier this year found 22 percent had cavities in seven or more teeth, compared with 8 percent in King County, which is partially fluoridated.

If the measure passes, Bellingham would join roughly two-thirds of U.S. residents served by fluoridated water. Supporters say children who drink fluoridated water would develop tooth enamel that is more resistant to decay, and that everyone could combat tooth decay every time they drink tap water.

“It’s a no-brainer if you’re in the prevention business,” said Steve Kimberley, a pediatric dentist in Bellingham.

But critics say water fluoridation poses health risks greater than the cavities it could prevent.

“Credible scientists are coming up with links to problems with fluoride,” said Terry Poth, a Bellingham chiropractor and co-chair of Citizens Against Forced Fluoride, one of three groups registered with the state’s Public Disclosure Commission to oppose the fluoridation measure.

Here are some commonly asked questions about the proposal:

HOW MUCH WOULD FLUORIDATION COST?

Bellingham Families for Fluoride says fluoridation would cost $600,000 to set up, which would be paid for by a grant promised by the Washington Dental Service Foundation, and $33,000 annually after that. City officials have said ongoing operating costs of about 10 cents per month for each of its 25,000 water customers would be absorbed by the utility.

The estimates come from a conceptual report prepared by an engineering company earlier this year for the Washington Dental Service Foundation. The study, from CH2M Hill, found that the existing water treatment plant isn’t big enough to house the fluoridation system, so an adjacent building is proposed.

The foundation has employed the firm CH2M Hill to study fluoridation in other communities, and “their estimates worked out very well,” said Curt Smith, co-chair of Bellingham Families for Fluoride. “I’m confident it’s going to be very close.”

But opponents counter that the cost estimates are low, saying the similar-size Lakewood Water District near Tacoma found its costs would be much higher when directors were studying fluoridation recently. Bellingham taxpayers would have to bear the additional cost, critics argue, and all the costs if the foundation rescinds its grant offer.

Lakewood’s directors learned in August 2004 that capital costs would be at least $827,000, and ongoing costs would be about $140,000 a year, said Christie Butler, executive assistant to Lakewood’s general manager. The district would have had to remodel 17 of its 31 well sites to accommodate the fluoridation system, Butler said, which would have increased the cost.

But Bellingham’s water system, with just one source of water, isn’t comparable to Lakewood and is the “ideal setup” for fluoridation, Smith said. The foundation also has sent a letter to the city promising the $600,000 grant if voters pass the fluoridation measure.

Poth thinks the city should conduct its own study rather than relying on one paid for by the Washington Dental Service Foundation, which is funded by an insurance company.

“They’re funding it, I’m sure, (because) they’ll have less claims,” Poth said. “I’m suspicious of that right off the bat.”

WHAT ARE THE RECENT DEVELOPMENTS IN THE FLUORIDE DEBATE NATIONALLY?

This summer, Harvard University announced it would investigate whether the chairman of its Department of Oral Health Policy and Epidemiology downplayed research by one of his doctoral students that indicated a link between fluoridated drinking water and an increased risk of osteosarcoma, a rare bone cancer, for boys.

Soon after, a group of 11 labor unions representing more than 7,000 people who work for the Environmental Protection Agency called for a national moratorium on water fluoridation.

Opinions vary dramatically on the importance of the doctoral thesis, by Elise Bassin. The Environmental Working Group called it “the most rigorous study of its kind to date.” The American Dental Association calls it “a single, unpublished, non-peer reviewed student thesis.”

“It’s hard to know what that’s going to amount to,” Smith said. “Obviously, if there’s some great enlightenment all of a sudden, that will change what we do with fluoride. But it’s hard for me to believe that’s going to happen.”

One study that says something different than many others isn’t enough to persuade Smith, he said.

“Scientific method says you look at the overwhelming weight of evidence, and that’s where the answer lies,” he said.

The Centers for Disease Control have named fluoridation one of the top 10 public health achievements of the 20th century. The practice is also endorsed by the American Dental Association, American Medical Association, the U.S. Surgeon General and the U.S. Public Health Service.

Poth believes scientific skepticism of fluoridation is gaining national momentum. Some scientists who were early questioners of hormone replacement therapy, which scientists now believe increases some health risks for women, also have questioned fluoridation, he said.

“It took time to accumulate the data for (the government) to make this determination,” Poth said.
Bassin’s thesis will be included in the body of fluoridation literature reviewed by the National Research Council of the National Academy of Sciences, which is studying health effects of fluoride for a report due early next year.

The National Research Council last issued a review of fluoridation risks in 1993, and reported “no credible evidence” linking fluoridation to cancer. The committee did recommend more research on the relationship between fluoridated water and broken bones, citing some studies showing a “weak association” between fluoridated water and hip fractures.

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