Fluoride debate simmers

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Portland remains the largest city in the nation that does not add fluoride to its drinking water. But, next month, a water fluoridation measure will appear on the ballot, giving Portland voters the chance to accept or reject the City Council’s unanimously approved fluoridation plan.

Ballot Measure 26-151 comes on the heels of an opposition petition that garnered more than 30,000 signatures, leading to a referendum on the City Council’s vote.

A September 2012 Survey USA poll of Portland voters found a deep divide in public opinion, with 45 percent of respondents opposing the measure, 43 percent supporting it and 12 percent undecided.

While proponents find community water fluoridation to be safe and effective based on what they say is a mountain of research that proves its efficacy in safely preventing dental problems, a number of groups disagree.

Opponents find fluoride to be a potential health and environmental hazard with unpredictable effects, pointing to studies that claim fluoride is a corrosive chemical that disrupts body functions.

Representatives from Healthy Kids, Healthy Portland—a group that supports water fluoridation—and Oregon Sierra Club’s Columbia Group, which recently officially opposed the measure, spoke to the Vanguard about their concerns.

Dr. Virginia Feldman, a spokesperson for Healthy Kids, Healthy Portland and an adjunct professor of pediatrics at Oregon Health and Science University, represents the pro-fluoridation group, while Antonia Giedwoyn, a spokesperson for Oregon Sierra Club’s Columbia Group, takes the opposite stance.

Vanguard: How would Portland be affected by water fluoridation?

Giedwoyn: If the water fluoridation measure passes, Portland will take a giant step backwards, to the 1940s, when asbestos was thought to be harmless, the American Medical Association encouraged smoking, ads told the public DDT [dichlorodiphenyltrichloroethane] was good for us and government began artificially fluoridating water supplies. Many chemicals we once thought were safe have been linked to myriad health problems over the past 50 years.

We have some of the purest drinking water in the country. This would be a major threat to the clean water Portlanders have worked to protect for decades. Portland should focus on real solutions to improving dental health, such as increasing access to dental care for low-income kids and providing oral hygiene education.

Feldman: Community water fluoridation at the level of 0.7 parts per million, as recommended by the Centers for Disease Control and Prevention and the Environmental Protection Agency, will benefit all Portlanders, regardless of age or socioeconomic status.

Many people do not know that we have 40 percent more untreated tooth decay here in Portland than [in] Seattle, where they fluoridate. Locally, many dentists call it “Multnomah mouth”—they can tell if a patient has grown up elsewhere, in a fluoridated community, because they have stronger and healthier teeth and need fewer expensive and painful interventions.

Poor dental health hurts and contributes to poor overall health for a lifetime—it leads to heart disease, and it can adversely affect speech and self-esteem. It harms our economy through increased health care costs and lost productivity.

VG: What is the single biggest misconception about water fluoridation you’d like to address?

Feldman: There are so many, it’s hard to choose just one. Perhaps one misconception that symbolizes the other information promulgated by those who opposed fluoridation is that there is “new science” that tells us there is a cause to doubt the safety and efficacy of community water fluoridation. Over 65 years and 3,000 credible, peer-reviewed studies have demonstrated that water fluoridation is safe.

The opposition is prone to cite studies that have either been proven to have faulty methodology or did not study community water fluoridation at the optimum level of 0.7 parts per million, but rather areas of the world where there [are] naturally occurring levels of fluoride far beyond the recommended amount of 0.7–1.2 parts per million. The anti-fluoridationists also cherry-pick from large reviews of studies to support their position, choosing to ignore the conclusions.

Giedwoyn: Perhaps the single biggest misconception surrounds what would actually be added to the water. Fluoridation promoters like to claim that fluoridation chemicals are just “natural minerals,” but nothing could be further from the truth. The fluoridation chemical fluorosilicic acid is a byproduct of industrial fertilizer production, and even the fluoridation promoters have admitted this. This is one of the reasons [the] EPA’s scientists’ union has formally opposed water fluoridation and why most European countries do not fluoridate.

Fluorosilicic acid is entirely different from the mineral calcium fluoride, which occurs naturally in some water supplies. Fluorosilicic acid is not even the pharmaceutical-grade fluoride found in toothpaste.

VG: What is the single most compelling piece of evidence that supports your position?

Giedwoyn: The single most compelling evidence that supports Sierra Club’s position that these chemicals should be kept out of our water is The National Academy of Sciences’ 500-page report, titled “Fluoride in Drinking Water,” published in 2006. The academy reviewed hundreds of recent scientific studies that link fluoride exposure to a wide range of serious human health threats.

Following this study, the federal government, in 2011, called for a 40 percent reduction in the maximum allowable fluoridation levels, and issued warnings that infants drinking formula mixed with fluoridated water face increased risks of excessive fluoride exposure.

There is a large body of strong scientific evidence supporting the position that it does not make sense to add fluoridation chemicals to our drinking water. It’s 2013; we should be working to decrease our exposure to chemicals, not increase the amount of toxins in our environment and bodies.

Feldman: [More than] 3,000 studies and 65 years of experience have shown that fluoride in the water helps make teeth stronger. Fluoride is a natural mineral, like calcium or zinc, that exists in some levels in all water supplies. Fluoride is not a toxic byproduct. Fluoride added to drinking water is extracted from rocks, and is highly purified, more pure than even pharmaceutical grade fluoride used for tablets and drops that many children already receive.

There is complete agreement among the trusted health and science organizations that fluoridated water is healthy and safe for everyone. The Centers for Disease Control and Prevention, [the] World Health Organization, [the] American Dental Association and the American Academy of Pediatrics and hundreds of other credible health organizations support water fluoridation for better oral health.

VG: One specific concern I have heard is the notion that putting fluoride in water doesn’t follow standards of “informed consent.” Can you address this?

Feldman: This premise is based on a misunderstanding about what is a drug. Water fluoridation is not an example of community or mass drugging. Instead, water fluoridation is an important public health tool that has been hailed one of the top 10 public health achievements of the 20th century by the CDC. Water fluoridation at the optimal level makes teeth stronger and [more] resistant to decay. This is particularly important for people who can’t afford fluoride supplements or are unable to afford to go to the dentist for regular care.

VG: Fluoride proponents use the approval of fluoridated water by organizations like the CDC as an argument for their position. How would you address this?

Giedwoyn: The CDC, dentists and others have been endorsing fluoridation for many decades despite their own admission that fluoridation chemicals contain arsenic, lead and other toxic byproducts of fertilizer production. The CDC and others have based their professional reputations on supporting fluoridation and now that the science shows [the] real risks of fluoridation, they have been slow to admit that what they’ve been telling the public for decades was not correct.

Experts once insisted that numerous chemicals and drugs, from pesticides like DDT to leaded paint, were safe, only to learn years later that those chemicals are actually dangerous. There is good reason to protect our drinking water and reduce, not increase, the number of chemicals we are adding to our water.

VG: Tell me something most people may not know about water fluoridation or the debate surrounding it.

Feldman: While the nature of the political argument has changed over time, the charges that opponents make have only small variations: We have heard everything from this being a communist plot, that fluoridation was used as a form of Nazi mind control, and that it causes a host of diseases including [attention deficit disorder] and mental complacency so the government can control our minds. This hysteria is a result of fear, which has resulted in an attempt to mask the truth: Community water fluoridation is safe, effective [and] affordable, and it works.

Giedwoyn: Most people are unaware that fluoridation chemicals are waste byproducts of the phosphate fertilizer industry, or that even fluoridation promoters admit that these chemicals are known to contain toxins such as arsenic and lead, which pose serious health threats to kids even in very small amounts.

Most people also don’t realize that the so-called “dental health crisis” in Portland is a gross distortion of the fact that Portland actually has a much better dental record than many cities that have been fluoridated for decades. Every city should do more to protect kids’ teeth, but there is no evidence that Portland has a higher cavity rate than fluoridated cities. Portland, in fact, has the 15th-best dental health record in the United States when compared to the CDC’s statewide data. Like other cities, Portland has an obligation to help kids’ teeth by increasing access to care and improving dental health education.

VG: Where do you think the other side is coming from?

Giedwoyn: Most fluoridation promoters are well-[intentioned], but are often unaware of the large body of recent scientific evidence demonstrating serious health risks, such as increased bone cancer [risk] and potential association with Down syndrome. Those who are aware of these studies dismiss them, but these are studies from some of the top research institutions in the U.S.

This is a contentious issue because Portlanders take pride in [the city’s] clean water and have rejected fluoridation in the past in order to keep our water clean and pure. As a community, we need to vote no to fluoridation chemicals once again. No means no. Forced fluoridation violates the basic right to decide what we put into our bodies for alleged medicinal purposes.

Feldman: The opposition comes from misinterpretation of scientific information and a misunderstanding of the scientific method, in an attempt to create public fear for something that has been going on across the U.S. and the world for [more than] 65 years with no credible evidence of negative effects.