The evidence that fluoridating drinking water is safe and prevents tooth decay is overwhelming and widely embraced. The Centers for Disease Control and Prevention, the U.S. Environmental Protection Agency, the American Dental Association, the Florida Department of Health and the Pinellas County Dental Association stand behind it. Yet these four county commissioners voted last fall to stop spending $205,000 on fluoridating water to improve the dental health of 700,000 residents. The annual savings per resident works out to 29 cents.
The first U.S. cities began adding fluoride to their water supplies in the 1940s. Now 196 million Americans drink fluoridated water, including 13 million Floridians. St. Petersburg, Dunedin, Gulfport and Belleair are on separate systems and continue to fluoridate their drinking water. So do Tampa, Temple Terrace and Hillsborough County. Plant City expects to start adding fluoride to its water by September, and the Pinellas Park City Council voted this year to start adding fluoride back.
Pinellas now operates the largest water system in the nation to discontinue fluoridation in recent years. Antifluoride activists use the commission's decision to lobby local governments across the country to stop adding fluoride to drinking water. That's not good for a county eager to be seen as a sophisticated destination for recreation, the arts and high-tech jobs.
The fluoride fight raises larger questions about our values: Are we going to let scare tactics trump established science? Are we going to risk public health to shrink government's role in society? Are we going to allow distortions and misstatements to drive political debate?
Pinellas should reverse course and add fluoride into the drinking water again. The opponents are small in number but vocal, determined and ready with distortions, half-truths and misstatements. Commissioners Bostock and Brickfield are up for re-election this fall, and voters should hold them accountable. Our community has long valued pragmatism and the greater good over extremism and selfish interests. It would take only one vote to change on the County Commission to reaffirm those values.
5 fears, facts on fluoride
Claim: The federal government cannot cite a double-blind/peer-reviewed scientific study that proves the health benefits of fluoride. Kurt Irmischer, a Clearwater financial planner and president of Citizens for Safe Water, recently sent a mailing calling removing fluoride in drinking water "the health care imperative of the 21st century" and listed "the Lies we have been led to Believe."
Fact: Studies comparing the dental health between communities that add fluoride in drinking water and those that don't are numerous and peer-reviewed. Dr. Barbara Gooch, director for science for the Centers for Disease Control and Prevention's Division of Oral Health, said studies show there is generally a 25 percent reduction in tooth decay in the fluoridated communities. The reduction was higher before fluoride toothpaste.
There is a good reason there are no double-blind studies, where residents in the same community wouldn't know if they were drinking water with added fluoride or without it. Dr. William Bailey, the CDC's acting director for oral health and the chief dental officer for the U.S. Public Health Service, said it is impossible to conduct such a study. "You cannot deliver (fluoridated) water to one house and not the other,'' he said.
The double-blind/peer review argument doesn't hold water.
Claim: Fluoridated water causes widespread fluorosis, a discoloring of the teeth; skeletal fluorosis, which causes pain in bones and joints; a risk of cancer; and thyroid damage. A November 2010 CDC study found more than 40 percent of kids ages 12 to 15 have dental fluorosis.
Fact: Most of those were mild cases of dental fluorosis, which are often hard to diagnose and barely recognizable as flecks on teeth. Severe dental fluorosis occurs in less than 1 percent of the general population. The CDC cites another study that mild fluorosis has risen, but the portion of low-income teens with tooth decay decreased from 73 percent in 1988-1994 to 65 percent in 1999-2004.
Kip Duchon, the CDC's fluoridation engineer, said there have been a handful of skeletal fluorosis cases in the decades since fluoride was introduced into drinking water, and they generally aren't tied to routine drinking of potable water. Some studies show fluoridation can help strengthen the bones, and repeated studies have not established a clear link between fluoridation and cancer or thyroid damage. Over the decades, fluoridation has not posed any significant health risk in the United States.
Claim: It is unnecessary to add fluoride to public water supplies since it is available in toothpaste and other supplements.
Fact: There are sources other than drinking water for fluoride, which is why the U.S. Department of Health and Human Services recently recommended lowering fluoridation levels to 0.7 milligrams per liter of water instead of a range of 0.7 to 1.2 milligrams based on the community's climate. The Pinellas level was only 0.8 milligrams per liter. But even with toothpaste containing fluoride widely available, fluoridated water still can result in 25 percent reduction in tooth decay. It benefits children as well as the elderly, who are living longer and keeping more of their teeth. Fluoride, combined with other fluoride products such as toothpaste, enhances oral health.
Claim: There are plenty of conspiracy theories regarding the federal government and fluoride, such as alleged connections to the Manhattan Project or secret coordination with sugar growers or heavy industry. Tom Nocera, a Pinellas resident and longtime fluoride opponent, cryptically suggests a link between the introduction of fluoride into the Pinellas County water system in 2004 and former Pinellas County Commissioner Steve Seibert.
Seibert joined the Mosaic Co.'s board of directors in 2004 and served as secretary of the Department of Community Affairs under Gov. Jeb Bush. Mosaic, one of the world's leading producers of phosphate, from which fluoride is a byproduct, provided Pinellas County's fluoride.
Fact: Seibert left the County Commission in 1999. He was on Mosaic's board of directors at the time the Pinellas commission voted to add fluoride to the drinking water. Now a Tallahassee lawyer, he said he had "absolutely nothing" to do with the decision.
Mosaic spokesman Russell Schweiss said fluoride sales represent about 0.02 percent of the company's estimated $6.7 billion in annual revenue. The implication there was a conspiracy to win the Pinellas contract is baseless.
5. Bottom line
Claim: The federal government will not vouch for fluoride.
Fact: The EPA, which is responsible for the safety of the nation's drinking water, sets the standards for fluoride in drinking water. The CDC is unequivocal in its support. "We promote water fluoridation as effective," Bailey said. "We would say absolutely it is safe."