Guest column: The science on fluoride
As a homeowner and part-time resident of Snowmass Village, I would like to share the essence of a recent letter that I sent to the board of the Snowmass Water and Sanitation District regarding fluoridation of the drinking water in our community.
First, my credentials: I hold a doctorate 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.
I vigorously support the fluoridation of drinking water in Snowmass Village and, indeed, throughout the country. We have been fluoridating public drinking-water supplies for about 75 years. Virtually every major dental and medical organization in this country supports this practice. Those opposed use essentially the same arguments that I have witnessed for 50 years — many of them half-truths or misrepresentation.
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 exists as a gas — hence it usually is 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. This standard was last reviewed in January 2014 and approved for publication by the U.S. Environmental Protection Agency. These standards contain the “requirements for all drinking-water treatment chemicals that are directly added to water and are expected to be present in the finished water.” Literally dozens of chemicals are regulated by this standard, including fluorides, chlorine, bromides 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 ranging from Teflon to refrigerants (chlorofluorocarbons) to new, safer dielectric compounds (replacing polychlorinated biphenyl). Indeed, one use is that of uranium tetrafluoride in the nuclear-fuel cycle, but this has absolutely nothing to do with the production of sodium fluoride for drinking-water supplies.
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. The statistics on people’s dental-care practices are irrefutable — they are less than ideal. And the 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. Fluoride-pill supplements also are not deemed to be effective. It is unrealistic to expect parents to have their children suck on fluoridated lozenges. In some European countries, fluoridated milk and salt are available, but not in the U. S.
7. 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. To quote the 2014 study on the health effects of water fluoridation performed by the New Zealand Royal Society of Science, “There is no appreciable risk of cancer, cognition or bone fractures arising from community water fluoridation.” Further, “fluoridation does not pose appreciable risks of harm to human health,” including “endocrine function, reproduction, cardiovascular and renal effects, and effects on the immune system.” This report is consistent with an earlier report by the National Research Council — an arm of the National Academies of Sciences, Engineering and Medicine — as well as hundreds if not thousands of peer-reviewed research studies.
8. For more than 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.
9. A multitude of dental and medical organizations support the fluoridation of public drinking-water supplies. The World Health Organization, the U.S. Centers for Disease Control and Prevention, the American Medical Association, the American and Canadian Dental Associations, the EPA, the U.S. Public Health Service 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.
10. 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.
11. The opponents of fluoridation prefer to listen to people such as Dr. Joseph Mercola, who purports to be an expert on all sorts of alternative medical advice from no vaccinations to cancer cures. Along the way, he seems to have built a great business selling water filters, health supplements, etc.
The residents of Snowmass are being given a chance to express their views on fluoridation of our drinking water in a survey being distributed this week. I urge all to support fluoridation as the most effective way to provide good oral hygiene to all our residents, especially the young and those less fortunate.
Gerry Schwartz is a part-time resident of Snowmass Village.
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