Guest column: Facts support fluoridation
September 28, 2015
I vigorously support the fluoridation of drinking water in Snowmass Village. My credentials: I have a doctaorate in environmental health engineering from the California Institute of Technology, I am a member of the National Academy of Engineering, I am president emeritus of both the Water Environment Federation and the American Society of Civil Engineers, and I have practiced the study, design and operation of water and wastewater-treatment systems for 50 years.
We have been fluoridating public drinking-water supplies for 75 years, and today about 75 percent of U.S. communities fluoridate their water. Virtually every major dental and medical organization in this country supports this practice. Those opposed have used essentially the same arguments for 50 years — many of them half-truths or misrepresentation.
Now let me set the record straight on some of these matters, beginning with some basic chemistry:
1. Fluorine is one of the five halogen elements in the atomic table, the others being chlorine, bromine, iodine and astatine. Under normal atmospheric temperatures and pressures, fluorine is usually found combined with other elements as a solid mineral, principally as fluorite or fluoride.
2. The most commonly used additive for water treatment is fluorosilicic acid, a valuable, liquid byproduct often obtained in the production of phosphate fertilizers. In Snowmass, I understand that the powder form, sodium fluoride or sodium fluorosilicate, is or was being used, as is common for smaller systems. Most importantly, fluorosilicic acid or sodium fluoride added to drinking water must meet American National Standards Institute Standard 60 for purity and be so certified. These standards contain the "requirements for all drinking-water treatment chemicals," including literally dozens of chemicals such as chlorine, bromine and chemicals for corrosion control, softening and pH control.
3. Statements reported in the press have claimed that the fluoride used in water treatment comes from nuclear wastes and pesticide manufacture. Nonsense. Fluorine and fluorides are used in an enormous number of industrial operations and products, but this has absolutely nothing to do with the production of sodium fluoride for drinking-water supplies.
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One may genuinely believe that Snowmass should not fluoridate the drinking water, but please let's get away from these scare tactics that have little or no basis in fact. The chemicals used in Snowmass meet international standards for safety — period! To continue:
4. Dental caries is a major oral-health problem, especially prevalent in lower-income families for whom regular dental care is expensive. Elimination of fluoridation will weigh most heavily on this population and the young. It is very easy to say that a family can get adequate fluoride treatment from one's family dentist, but the reality is that many of us do not see the dentist as frequently as we should. And dentists themselves overwhelmingly recommend fluoridating the water.
5. Most toothpastes in this country contain fluoride, but the concentration levels and contact times are totally insufficient to provide good protection. Fluoridated toothpastes are a good supplement to water fluoridation but not a substitute. That is, unless you wish to eat the toothpaste.
6. Fluoridation has been practiced in this country for about 75 years with virtually no adverse public-health problems. Yes, high fluoride concentrations do cause fluorosis, the discoloration of teeth. But talk of cancer, kidney disease, decrease in cognition and increased bone fractures at the fluoride concentrations in community water systems is totally without foundation. A 2014 study on the health effects of water fluoridation performed by the New Zealand Royal Society of Science stated, "There is no appreciable risk of cancer, cognition or bone fractures arising from community water fluoridation." This report is consistent with an earlier report by the National Research Council — an arm of the National Academies of Sciences, Engineering and Medicine — the 2015 U.S. Public Health Service Recommendation for Fluoride Concentration and hundreds if not thousands of peer-reviewed research studies.
7. For over 40 years, the U.S. Public Health Service drinking-water standard has been 0.7 to 1.2 milligrams per liter or parts per million. Recently, the government, with the concurrence of its science advisers, has decided to set the recommended dosage at the lower limit, 0.7 milligrams per liter. This change reflects continued scientific analysis and the recognition that some smaller fluoride uptake is common from toothpaste, oral rinses and some foods.
8. The World Health Organization, the American Medical Association, the American and Canadian Dental Associations, the Environmental Protection Agency, the U.S. Public Health Service, the U.S. Centers for Disease Control and Prevention and the American Water Works Association all strongly recommend fluoridation of community water supplies as the most effective way to reduce dental caries and improve the oral health of all our citizens.
9. For those Snowmass residents younger than 50, ask yourself and your children how many cavities they have experienced. Zero? One? Two? In my generation, the answer would be 10 to 20, and most of us have lost one or more permanent teeth. No wonder that the CDC states that fluoridation of water is one of the 10 greatest public-health achievements of the 20th century.
10. Finally, opponents of fluoridation cite specious arguments and "research" that lack scientific substance and that have been rejected overwhelmingly by the dental, medical and scientific community.
The Snowmass Water and Sanitation Board has distributed a survey to all residents, giving our community the opportunity to weigh in on this important issue. I urge everyone to respond and support fluoridation as the most effective way to provide good oral hygiene for all our residents, especially the young and those less fortunate.
Gerry Schwartz has a doctorate in environmental health engineering and is a member of the National Academy of Engineering. He lives part-time in Snowmass Village.