My Turn: A physician calls for fluoridation

Posted: Sunday, September 30, 2007

During the past few weeks, I have been following the opinion articles and Letters to the Editor in the Empire with great interest. There seems to be an intense difference of opinion on the subject of fluoridation. I'm afraid that my remarks will not change many people's minds on this, but, as one who practiced family medicine and pediatrics in Juneau from 1960 until 1999, I'd like to write a few words.

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The public water was fluoridated while I was in practice there, and I was surprised that the city had stopped doing so, sometime after I moved away. Surprised, I was disheartened because I firmly believe that public water fluoridation is beneficial and harmless, when properly done in areas where natural fluoride is not present (In Great Falls, Mont., it is a naturally occurring substance, and does not need to be added to the water system.)

Dental caries is one of the most common disorders of children. It is not a "normal" thing or variation; it is a disease. Not only a child's dental health, but also her or his general health and nutrition is diminished with tooth decay and caries.

Water fluoridation, of course, is only a part, one tool, against decay. Good nutrition, proper diet, toothbrushing with parental supervision (with fluoride-containing toothpaste), and regular professional dental care are all important. And, most importantly, it is a tool that can be used to benefit those often most vulnerable: Those who may not be willing or able to afford total care. Just as Vitamin D added to milk has prevented rickets, as folic acid added to various foods has prevented congenital neurological defects, as iron added to infant formulas and to flour, etc., has prevented anemia; as iodide added to salt has prevented goiter, fluoride in water supply has prevented dental decay.

Fluoride is a chemical that is allied to others, halogens, in its chemical group: iodides, bromides, chlorides. They all are toxic when improperly used, but when appropriately used, beneficial. For example, bromides are used for cleaning pools and hot tubs, chlorides for purifying public water and swimming pools, iodides as an addition to table salt. Sodium fluoride, added to public drinking water, has a long-observed favorable experience. Millions of children have been followed over the past 80 years, and tens of millions of cavities prevented.

Those of us who have provided care of children - in family practice, pediatrics, family dentistry, pedodontics - are firm believers in public water fluoridation as a useful and beneficial policy.

When you vote Oct. 2, regarding fluoridation, consider the children's health. I doubt if I can persuade you, but I have always wished that my children, grandchildren, and their children have access to public water with fluoride. This is also my wish for all the young people of Juneau.

• Kenneth W. Moss, MD, is a pediatrician, who practiced for 39 years in Juneau, now retired in Montana

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