The Juneau Assembly won't get a clear recommendation on whether to continue fluoridating municipal water from a task force appointed in 2004.
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The Juneau Fluoride Study Commission turned in its final report Tuesday, with three members recommending the city's fluoridation continue and three members recommending it stop.
"Every place you look, you need more study," Chairman Bart Rozell said. "People just haven't done studies at the low levels (used by municipalities)."
Juneau fluoridates its water at about 1 milligram per liter in much of the community, Grant Ritter, superintendent of the water utility, said Tuesday. Fluoridation ranges from 0.7 to 1.2 milligrams per liter downtown and in Douglas, except in high-elevation areas. Mendenhall Valley water isn't fluoridated due to equipment failures.
Three members of the commission decided fluoridation in Juneau should continue, given that it has been demonstrated to be safe and effective in fighting tooth decay in the United States for 50 years, Rozell said.
"Two members reached the opposite conclusion," said the chairman, who also recommended fluoridation stop but did so for different reasons.
His position changed while serving on the commission, he said.
"I believe a preponderance of evidence supports fluoridation," but it isn't compelling, he wrote in the report. Believing the city should "first, do no harm," he recommended fluoridation be discontinued until further studies are done that specifically address the levels used in Juneau water.
The commission's final report was postponed for a report from the National Academy of Sciences' National Research Council, but that didn't answer questions, Rozell said. Instead of addressing issues related to municipal fluoridation, it found that the U.S. Environmental Administration's safety threshold for fluoride, at more than 4 milligrams per liter, was too high. It also found that fluoride at more than 2 milligrams per liter was probably unsafe, Rozell said.
With all the research findings included in the documentation to the report, there simply wasn't the right kind of information available to reach a conclusion, he said.
Among the documents in the commission's report, a letter to Rozell from Ron Nagel, area prevention officer for the Anchorage-based Alaska Native Tribal Health Consortium, said the "prevention tool" of fluoridation in fighting tooth decay is desperately needed in Juneau. He cited studies showing its effectiveness and wrote that no study had substantiated the claims that it was unsafe or ineffective.
In another appendix to the report, commission member Emily Kane wrote that research shows that fluoride is most effective when it is used topically, as with toothpaste. Kane, along with commission member Jamie Bursell, opposed fluoridation. In their findings they said tooth decay was not worse in Europe, where the water is not fluoridated.
Rozell said without water fluoridation, people would still get fluoride in their toothpaste, but he shares a concern for low-income people. The fluoridation question isn't easy, he said.
He pointed to two lists of communities in the report. One has communities voting to fluoridate since the late 1990s. The other has communities that have rejected fluoride since 1990.
"They're long lists," Rozell said.
Tony Carroll can be reached at firstname.lastname@example.org.