IT’S IN THE WATER: The fluoridation debate lives on

Many people take for granted the addition of fluoride into public drinking water systems that aims to prevent tooth decay. It’s a seven-decade-old public health effort. But it’s not nearly as universally accepted as one might think.

At least seven cities or towns across the country debated it just this summer.

For example, Wellington, Fla., decided to add fluoride back into the water in July after the city council voted two years ago to remove it. Across the country in Healdsburg, Calif., voters will revisit a ballot question in November regarding whether to stop adding the mineral to the water supply.

“There has always been periodic discussion,” said Steven

Levy, a dentistry professor at the University of Iowa. Levy is involved in an Iowa-based longitudinal study that tracks fluoride intake and its effects on children’s bones. “We are seeing more challenges now because of the communication explosion with the internet.”

The debate started well before 1945 when Grand Rapids, Mich., became the first U.S. city to add fluoride to its water supply. In the decades since, opposition usually stems from studies linking fluoride intake by children with lower IQs, higher rates of attention deficit/hyperactivity disorder and potential toxicity.

Still, fluoridation has become a fairly common practice, with about 74 percent of the population receiving fluoridated water from community water systems, according to the Centers for Disease Control and Prevention. But the intervention, which is considered by the CDC to be one of the 10 top public health achievements of the 20th century and backed by the American Dental Association and the World Health Organization, also continues to raise grass-roots concerns. These arguments range from casting fluoride as unnecessary and ineffective to efforts to paint the mineral as “mass medication” and a “damaging environmental pollutant.”

“Fluoridation is not safe or cost-effective,” said Bill Osmunson, director of the

Fluoride Action Network, a national organization against fluoridation of water supplies, adding that

people should be given the freedom of choice so they can avoid ingesting excess fluoride.

In Wellington, Mayor Anne Gerwig often fields angry emails on this issue.

“I watch the videos that they email me, I read the information they send me,” Gerwig said. Gerwig has no background in science, but she read studies and fact-checked the claims being made by the town’s residents. Gerwig said she decided to support fluoridation after she found scientific consensus about the benefits of fluoridation in preventing tooth decay.

The CDC, for instance, considers water fluoridation to be the most cost-effective method of delivering fluoride to all, reducing tooth decay by 25 percent in children and adults. Tooth decay is still one of the most common chronic conditions among children.

“A big thing about community water fluoridation is that it’s a passive intervention, you don’t really have to do anything other than drink tap water,” said Katherine Weno, oral health director at the CDC. “You don’t have to buy a product or access to a dental professional. It benefits people who don’t have money to go to a dentist or don’t have any insurance.”

But some question the need for continued fluoridation, especially as products such as toothpaste and rinses containing fluoride are available, and because the chemical’s levels vary and indications of harm are not always clear.

Philippe Grandjean, an adjunct professor at Harvard University School of Public Health, has authored a couple of studies questioning the need for the added fluoride.