Wednesday, April 23, 2014

Don’t let fluoride opportunity go down the drain

By Delaine Eastin; Rick Baker, M.D.; Constance J. Caldwell, M.D.; and Bette Hinton, M.D.

Public health work, at its best, goes largely unnoticed; hand-washing campaigns and crusades for more sidewalks do not warrant front-page news coverage.

However, issues occasionally come along that pull public health to the surface. One such issue is coming down the pipeline — our water pipeline, to be precise. Now that the two largest cities in Yolo County, Davis and Woodland, have elected to move forward with a surface water project, the time is right to fluoridate our public water supply. In doing so, we would join the more than 200 million Americans who reap the oral health benefits of drinking fluoridated water.

The positive health effects of fluoride have been recognized since the 1930s. Epidemiologists found that populations with higher concentrations of the naturally occurring mineral in their water had a lower prevalence of tooth decay — more than 50 percent lower, which from a scientific perspective is enormously significant. When case studies soon thereafter provided the causal link between fluoride and good oral health, communities began fluoridating as early as 1951.

It was found that fluoride benefits not only the body, but the budget as well. With respect to cost savings, the intervention is unparalleled: Every $1 invested in fluoridation saves $38 in dental costs. Despite increasingly dilute opposition, fluoridation has garnered a flood of support as a safe and valuable public health measure from scientists and health experts the world over.

Much of the polemic surrounding fluoride is too shallow to encompass the core issue: Fluoridation is clear-cut social justice. Fluoride in the water improves the oral health of everyone with teeth, regardless of age, income or access to dental care. Recent statistics highlighting 26 percent of Yolo County children with untreated dental decay reveal a sizable population among us with mouths less than excited to smile. Many of these children are absent from school and adults with similar afflictions miss work. Extrapolating from national rates, more than 41,000 work hours and 21,000 school hours were lost last year in Yolo County due to oral health issues.

West Sacramento made the decision to fluoridate its water supply in 2008 and, since that time, preschoolers have seen a 17 percent reduction in frequency rates of visible or urgent decay — a faster rate of decline than in any other city in the county. Now that’s something to smile about.

In addition to children, senior citizens present another priority population. As we age, performance of self-care tasks like tooth brushing declines, and receding gums expose more of our tooth surface to the risk for decay. Research validates that fluoride helps to protect the elderly against these demographic-specific risks.

It gets better. Water fluoridation also serves those living in our cities who do brush twice daily, floss regularly and visit the dentist every six months. The American Dental Association cites peer-reviewed studies indicating that water fluoridation contributes to a 20 to 40 percent decline in tooth decay even in populations with widespread exposure to fluoride from other sources. These other sources include fluoride in toothpaste, food and dental varnish.

Yet, not all people brush their teeth equally, have the same diet, can afford to visit the dentist or remember to take prescribed fluoride pills. Because we all must drink, fluoridating a community’s water supply offers the highest level of protection for the largest number of people. All 120,000 residents of Davis and Woodland stand to win.

We are all currently exposed to fluoride because of the naturally occurring fluoride in the existing water supply and foods — but not the optimum amount to prevent cavities. While many would survive comfortably if optimum fluoride remained a privilege of the wealthy, many in our midst would not.

By supporting community water fluoridation, we are not imposing a danger upon unwilling people, as opponents may claim. In 1973, the California Court of Appeals case Beck v. City Council of Beverly Hills concluded that: “Courts through the United States have uniformly held that fluoridation of water is a reasonable and proper exercise of the police power in the interest of public health. The matter is no longer an open question.”

Not only is fluoridation a legal governmental exercise, it is responsible one. Rather, it is by neglecting fluoridation that we are imposing risk and cost on those who can endure it least, such as children of low-income families and seniors. Indeed, of the liberties at stake, the more imperative is surely the emancipation from illness and suffering. The public health community and Supreme Courts have unwaveringly adopted this stance.

To ignore an opportunity as cost-effective, health-protective and scientifically supported as community water fluoridation would be to send a great public health opportunity for Yolo County, quite literally, down the drain.

— Delaine Eastin is a retired California superintendent of public instruction; Rick Baker, M.D., is a First 5 Yolo commissioner; Constance J. Caldwell, M.D., is Yolo County’s current health officer; and Bette Hinton, M.D., is Yolo County’s former health officer.

Special to The Enterprise


Discussion | 4 comments

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  • jwillie6June 23, 2013 - 7:25 am

    It is illegal for a doctor or a dentist to force anyone to take a drug. Some want you to rely on the government to specify a drug (Hexafluorosilicic acid) for you to be forced to take. It is the only drug on the market not tested and approved as safe and effective for human consumption by the FDA (in the USA) or any other government agency. 50% of fluoride consumed is retained in the body, in the bones and in the brain resulting in cancer, thyroid & pineal gland damage, broken hips from brittle bones, lowered IQ, kidney disease, arthritis and other serious health problems. Only 5% of the world and only 3% of Europe fluoridates drinking water.

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  • DarwellJune 26, 2013 - 10:04 pm

    >> not all people brush their teeth equally, have the same diet, can afford to visit the dentist or remember to take prescribed fluoride pills. Because we all must drink, fluoridating a community’s water supply offers the highest level of protection << Odd to mention that not all people brush their teeth equally. Because... (drum roll) not everybody drinks the same amount of water either. And if the "optimal" level of fluoride is needed to do any good - how is the dose determined? So many people in Davis drink bottled or filtered water and some people are not drinking local water at all! How are we getting that optimal dose to everybody by dumping some amount of the product into a water supply that is used by residents in wildly differing amounts?

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  • DarwellJune 26, 2013 - 10:06 pm

    Gaah. That wasn't supposed to be a reply to the comment, but to the article of course!

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  • b lambertJune 27, 2013 - 12:46 pm

    lots of misinformation here. But will the decision makers consider the following: What is the difference between the inorganic sodium fluoride (fluorosilicic acid) we add to our water and natural calcium fluoride that occurs in the earth’s crust and water? How toxic is the compound sodium fluoride (fluorosilicic acid) in it’s concentrated form and where does it come from? Who is prescribing sodium fluoride (fluorosilicic acid) to our population and do these persons have any medical or pharmacy training? What authority do they have to do this and by whom was the authority given to them? Is there any known human condition of being fluoride deficient? Has the US Food and Drug Administration (FDA) ever approved any fluoride product designed for ingestion as safe or effective? Are people’s human rights or constitutional rights being violated if they don’t want to participate in drinking sodium fluoride (fluorosilicic acid)? If a segment of the population (infants) does not want to ingest sodium fluoride (fluorosilicic acid) and can not afford the money to buy bottled non-fluoridated water is the city willing to do anything for them? Can I be guaranteed in writing that my family (young children) will suffer no negative health effects from fluoridated water (including fluorosis) and if so who would be responsible for damages if it was determined that people have suffered adverse health effects? What is the ecological impact of dumping 3.5 million+ pounds per year of a highly toxic non-biodegradable environmental pollutant (fluorosilicic acid) into our state’s waterways? Since much of the United State’s processed food supply; juices, sodas, fruits, teas, and vegetables has sodium fluoride (fluorosilicic acid) in it or on it, do we still need to add more to our water? How can a person tell how much sodium fluoride (fluorosilic acid) he’s taking in on a daily basis through food and water, and what would be an unacceptably high level? Will I receive a cumulative negative effect on my health if I consume sodium fluoride (fluorosilicic acid) for several years? Since most of the civilized world has rejected or stopped water fluoridation, why does the United States insist on continuing, and why does it aggressively advocate and market the practice? Should our nation be concerned about a correlation between the growing number of diseases and health afflictions (diabetes, kidney disease, thyroid problems, autism, Alzheimer’s, ADD) and industrial pollutants such as fluoride? Is fluorosilicic acid absorbed into the skin when bathing or showering? When one of the biggest fluoride institutional advocates (The CDC) concurs that most of the benefits of fluoride occurs at the topical level, should we reconsider ingesting it as a way to prevent cavities? Is it wise to rely on advice from an association of dentists to put a toxic byproduct into our water supply? Since the #1 rule of medicine is first do no harm, should we not be consulting with doctors of toxicology as to the safety of this practice? Is it possible that the portion of the dental/scientific community that advocates water fluoridation would not want to reverse itself due to embarrassment, vanity, potential law suits, or loss of government/corporate research funding? And is it also possible that there is pressure from Big Industry to maintain thousands of widely dispersed paying outlets for it’s waste disposal when a policy reversal would dramatically effect it’s bottom line?

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