As a member of the city Fluoride Study Commission, I would like to share some of the thoughts and conclusions that resulted from over two years of careful study of the water fluoridation issue. Our review convinced me that programs that provide topical application of fluoride to the teeth are more safe and effective in preventing cavities than the fluoridation of drinking water.
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It is clear that fluoride is beneficial in protecting teeth from cavities when it is applied directly to the surface of the tooth, and that fluoride taken internally such as in drinking water provides little if any benefit. It also became clear to me that the dental community is interested in protecting the teeth of disadvantaged youth through the use of fluoridated water. In fact, the notion that water fluoridation helps protect the teeth of poor children is the most powerful argument in its favor.
While I appreciate the sincerity of this argument, an important point is being overlooked: That the risks of fluoridation fall disproportionately on poor children. And those risks are not trivial.
Fluoride is a potent chemical that has demonstrated negative health effects on a number of body systems. Multiple scientific studies show that even in modest concentrations, fluoride can impact brain development and IQ, impair kidney and thyroid function, contribute to bone pathology, and inhibit enzyme systems. These health effects are of special concern for infants and children because chemicals are up to ten times more toxic to children since they are smaller in size and their developing organs are more vulnerable to the effects of toxins.
One group especially at risk is formula-fed infants. Last year the Center for Disease Control and the American Dental Association both issued an advisory to parents of bottle fed infants recommending they not use tap water to mix their infant formula. The reason: To protect infants against excessive fluoride consumption. Studies show that low-income families are more likely to feed their babies formula, and it goes without saying that families who are struggling to make ends meet can hardly be expected to purchase bottled water to mix with infant formula.
To compound this situation, in the case of infants, there is no benefit whatsoever to fluoride. It has been conclusively established that the decay preventing properties of fluoride come from application directly to the teeth. Since infants don't have any teeth, there is no benefit to them from taking fluoride. No benefit. Only risk. A risk that falls disproportionately on the least advantaged.
This example illustrates two primary problems with water fluoridation: That fluoride works to protect teeth only when applied to the tooth surface, and that there is no way to regulate the dosage so it is appropriate to the recipient.
Perhaps a more insidious problem is that the fixation on water fluoridation prevents us from thinking creatively about other ways to help protect our children from tooth decay.
If we are to be serious about protecting kids' teeth, we need to consider alternatives that target those who need protection. For example, a topical fluoride varnish could be applied twice a year to every elementary school student in the Juneau school district for less than it would cost to fluoridate the water. Another idea that could be explored is having kids brush their teeth in their classrooms at school after snacks and lunch. This alone would be beneficial, and would also instill good habits of dental hygiene that will last a lifetime. Perhaps local dentists or businesses would be willing to donate the toothbrushes and toothpaste for such a program, in which case it would cost the school district nothing. Programs such as these are the type that our entire community could get behind as they would ensure that populations at risk would be protected through the use of topically applied fluoride without haphazardly fluoridating everyone, including vulnerable groups like infants who shouldn't get any fluoride at all.
We all want our children and our community to be as healthy as possible. By combining our shared commitment to this goal with a little common sense, we can develop solutions that will unite our community rather than divide it.
Jamie Bursell served on the city Fluoride Study Commission from 2004 to 2006. She is a Juneau resident and proud mom of two boys.
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