Fluoride has been cast as dental savior, toxic demon, part of a communist plot and an evil piece in an industrialist conspiracy.
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The hottest item on Juneau's Oct. 2 city ballot - whether to return fluoride to the city's water supply - has triggered an avalanche of conflicting information pounding down on the voters of Juneau.
With the debate on Proposition 2 as technical and complex as it is, people tend to turn to whomever they deem to be authorities, in this case, traditional mainstream medical experts or their counterparts in the holistic, naturopathic medical world. Few have pored over the technical information on fluoride themselves.
The Juneau Fluoride Study Commission, created to study the issue and offer the city an informed opinion, is one group that has scrutinized the data in great detail. From mid-2004 to mid-2005, the commission met at least once a month and studied hundreds of reports. It also listened to testimony from local residents and continued to meet on a less regular basis until it came to a conclusion in 2006.
Even the commission members, who studied the issue thoroughly, were divided on whether fluoride is safe. They voted 3-3 to keep fluoridation. The Juneau Assembly opted 5-4 to stop adding fluoride to city water.
The commission requested from fluoride advocates that they identify a study proving fluoride is safe. Such a study was never produced, according to William Bart Rozell, commission chairman.
The oft-cited March 2006 National Academy of Sciences fluoride report also shows inconclusive information about the substance's risks.
Fluoride advocates prefer to dismiss this report, saying its focus was not whether fluoride is safe at the levels commonly used by municipalities, but at a higher level more often found in communities with naturally fluoridated water.
That's true, but the report is still relevant to the overall debate because it includes information about fluoride in general and noted it did not have conclusive information about whether fluoride contributes to bone fractures or cancer.
"The committee concluded that the evidence to date is tentative and mixed as to whether fluoride has the potential to initiate or promote cancers, particularly of the bone," the report says.
If members of the National Academy of Sciences don't have enough information to say whether fluoride is safe, then who can?
Add to that the fact that fluoride is recommended at certain dosages for certain ages, and yet everyone who drinks city water would be given the same concentration of fluoride if it were restored to the water.
One of fluoride advocates' biggest concerns is that the poor will suffer from the absence of fluoride in the public water supply. But the poor are also likely to be the ones most hurt by the addition of fluoride to water because of the risk to infants.
The American Dental Association recommends against using fluoridated water in infant formula because of the potential for fluorosis, which discolors and streaks the teeth. But many low-income parents are not able to afford distilled water. The ADA even advises parents not to use fluoride toothpaste on kids younger than 2 years old.
There's no doubt that fluoride in the right amount is great at fighting cavities. But too many questions abound about how safe it is for the rest of the body.
The city has already gone through a thorough process once to determine whether fluoride should be added into Juneau drinking water. That process should be repeated in coming years as additional scientific information comes out.
But until science can show the true effects of fluoride, it's better for the city to play it safe. Voters should vote no on Proposition 2 and keep fluoride out of city water.