Cities pull tooth-protecting fluoride to save money

“Adding fluoride to drinking water is among the greatest public health achievements of the 20th century,” says the Centers for Disease Control and Prevention.  The benefit of fluoridated water is one of those issues that, until recently, seemed settled.  But in the right-wing-fomented political free-for-all that is 21st century America, many seemingly long-settled issues [women’s rights, collective bargaining, voting rights] are up for grabs. And fluoridation is one of them.

Pevely, Missouri offers the most recent example. Apparently, the tooth-saving benefits of fluoridation are outweighed by the $8,000 to $10,000 annual cost of adding it to the municipal water system. [Fluoridation costs about $1 per person-year.] According to the St. Louis Post-Dispatch, “the cash-strapped city ran out of fluoride at the end of May 2012, and isn’t buying more.”

That’s sad, because dentists and public health pros can cite decades’ worth of evidence that fluoride saves teeth—resulting in significant savings for families.

Fluoride basics

According to the Centers for Disease Control,

Nearly all naturally occurring water sources contain fluoride—a mineral that has been proven to prevent, and even reverse,tooth decay. Tooth decay is caused by certain bacteria in the mouth. When a person eats sugar and other refined carbohydrates, these bacteria produce acid that removes minerals from the surface of the tooth. Fluoride helps to remineralize tooth surfaces and prevents cavities from continuing to form.

Water fluoridation prevents tooth decay mainly by providing teeth with frequent contact with low levels of fluoride throughout each day and throughout life. Even today, with other available sources of fluoride, studies show that water fluoridation reduces tooth decay by about 25 percent over a person’s lifetime.

In the early years of water fluoridation, studies showed that adding fluoride led to reductions of 50–60% in childhood cavities.  More recent studies show lower reductions (18–40%), likely due to increasing use of fluoride from other sources, notably toothpaste, and also to the halo effect of food and drink made in fluoridated areas and consumed in areas where there was no fluoridation.

Fluoridation became an official policy of the U.S. Public Health Service in 1951, and by 1960 water fluoridation had become widely used in the U.S., reaching about 50 million people. By 2006, 69.2% of the U.S. population using public water systems were receiving fluoridated water, amounting to 61.5% of the total U.S. population.

Throughout its history, though, fluoridation has met opposition—typically from anti-government activists who call it “forced, mass medication,” conspiracy theorists, and people who doubt the validity of science and medical research. The reasons to oppose fluoridation seem to match the political climate—as exemplified by the Cold War meme that fluoridation was part of a world-wide Communist plot to control America.

Today, the conspiracy theorists are still out there, as are ideologically driven anti-government, anti-science activists. And they’ve won in many towns. Fluoride Action Network, an anti-fluoridation group, lists more than 100 towns in North America [interestingly, many of them are in Nebraska] that have voted to end fluoridation since 1990.

You can’t help but feel sympathetic to city councils whose revenues have tanked in recent years and who are looking for ways to balance their local budgets. It’s also a fact that, with the availability of fluoride toothpastes and mouthwashes, many people are getting some fluoride benefits from sources other than their drinking water. And both CDC and the Department of Health and Human Services have recently revised downward their recommendations for the most effective levels of fluoride in public water sources, but they’re far from recommending a cessation of fluoridation.

It just doesn’t seem right to balance a government’s budget on the dental health of the citizens it serves. Maybe fluoridation is low-hanging budget fruit that’s out of sight and easily cut—especially if you’re under pressure from local people with an anti-fluoridation agenda.  One can’t help but notice, though, that when the budget axe falls, it rarely chops publicly financed sports stadiums or tax-increment financing  for corporations and developers. And, of course, there’s never a discussion of raising revenue as a way of balancing the municipal budget–or the national budget, for that matter–in order to attend to government’s main reason for being–enhancing the common good and collectively doing for individuals what they can’t do individually. Like improving public health. But I rant.

I can’t say with any certainty that’s there’s a trend toward eliminating fluoridation. I can only observe that the arguments against fluoridation seem to fit the right-wing’s anti-government and anti-science agenda–a philosophy that turns individual citizens against their own self-interest and toward a rejection of the common good–in this case, public health and their own personal health.