Somebody put a dead rat in Curtis Smith's mailbox.
Someone else has made anonymous phone calls accusing him
of trying to poison his neighbors. And all around the
usually placid university town of Bellingham, Wash.,
activists from a group called Citizens Against Forced
Fluoride have planted lawn signs adorned with skull and
crossbones. "I had no idea it would get this intense,"
says Smith, 70, a retired dentist who is leading a Nov.
8 ballot initiative to add fluoride to the local
drinking water. "These are very angry people."
Angry indeed: fluoridation to fight tooth decay, a
hot-button issue from the 1950s--when it was attacked as
a communist plot--is back on the front burner and not
just in Washington State. Fueled by health concerns,
cancer fears and a grass-roots campaign that has flooded
the Internet with antifluoridation Web pages, citizens
across the U.S. are increasingly suspicious of what the
Centers for Disease Control (CDC) considers "one of the
10 great public-health achievements of the 20th
century." In the past three years, legislation to
encourage fluoridation has been defeated or tabled in
Oregon, Arkansas, Nebraska and Hawaii. New battles are
brewing in New Jersey, Massachusetts and across the
Canadian border in Montreal.
No one disputes the fact that fluoride, a natural
element found in rocks and groundwater, protects tooth
enamel. Since 1945, municipal systems serving 170
million Americans have added fluoride (mostly in the
form of hydrofluorosilicic acid) to their water, and the
prevalence of cavities in the U.S. has fallen
dramatically. "A community can save about $38 in
dental-treatment costs for every $1 invested in
fluoridation," says William Maas, the CDC's director of
oral health. "How many other investments yield that kind
of return?"
But much has changed since 1945, starting with our
toothpastes. Today fluoride is an ingredient in most
brands of dentifrice on the market. Because toothpaste
is designed to be spit out, it's a more efficient way to
get the decay-fighting ingredient where it is needed and
nowhere else. Even some dentists, who see firsthand the
benefits of fluoridation, wonder whether people who get
fluoride from toothpaste should get it in their drinking
water as well.
What has also changed is how much toxicologists know
about the harmful effects of fluoride compounds.
Ingested in high doses, fluoride is indisputably toxic;
it was once commonly used in rat poison. Hydrogen
fluoride is regulated as a hazardous pollutant in
emissions from chemical plants and has been linked to
respiratory illness. Even in toothpaste, sodium fluoride
is a health concern. In 1997 the Food and Drug
Administration toughened the warning on every tube to
read, "If more than used for brushing is accidentally
swallowed, get medical help or contact a poison-control
center right away."
The most recent--and controversial--charge links
fluoridation with bone cancer. In June the Environmental
Working Group (EWG), a watchdog organization, petitioned
the National Institutes of Health (NIH) to list fluoride
in tap water as a carcinogen. The group cited "decades
of peer-review studies" on fluoride's "ability to mutate
DNA and its known deposition on the ends of growing
bones, the site of osteosarcoma"--a rare, often fatal
cancer that affects mainly boys.
Federal health officials view those concerns as
exaggerated. Current standards rely on a 1993 review of
published studies by the National Academy of Sciences,
which found "no credible evidence for an association
between fluoride in drinking water and the risk of
cancer." The academy has launched a new review to be
released in February.
The stakes were raised in July when Harvard University
opened an investigation into whether a prominent
dentistry professor had suppressed research by one of
his doctoral students in a report to the NIH. The 2001
thesis showed a sevenfold increased risk of osteosarcoma
in preadolescent boys from fluoridated water. The
supervising professor, Chester Douglass, edits a
newsletter funded by Colgate--which makes fluoridated
toothpaste--creating "the appearance of a conflict of
interest," according to the EWG, which filed a charge of
"scientific misconduct" with the federal agency.
Douglass was unavailable for comment, but a Harvard
spokesman said the university takes the allegations
"seriously."
Meanwhile, unions representing 7,000 employees at the
Environmental Protection Agency (EPA) have waded into
the debate. The optimal level of fluoride in water,
according to the CDC, is between 0.7 and 1.2 parts per
million. In 1985 political appointees at the EPA raised
the acceptable level of fluoride in drinking water to 4
p.p.m., over objections from agency scientists. The
Natural Resources Defense Council sued the agency,
charging that the safety margin was inadequate, but in
1987 a U.S. district court ruled that the EPA
administrators had the authority to set fluoride levels.
EPA union representatives reopened the issue in August,
calling on EPA administrator Stephen Johnson to issue a
moratorium on fluoridation and to set a goal of zero
fluoride in tap water. "The EPA has an ethical duty to
send an effective warning immediately about this
hazard," they said.
All this makes for a potent mix, especially when
filtered through the Internet, where health-safety
concerns tend to get amplified. Much of the opposition
to the fluoridation initiative in Bellingham comes from
people like Lane Weaver, a fire-alarm technician, and
his wife Danelle, a housewife and mother of two. When
they first heard about the issue this summer, the
Weavers Googled the word fluoridation. Nine of the first
10 items that came up were decidedly antifluoride. "I
was horrified," says Danelle. "Why would I want to put a
toxic industrial chemical in my children's bodies?" She
joined Citizens Against Forced Fluoride, and now--with a
6-in.-high stack of scientific studies gleaned from the
Web--she staffs an information booth at the local
farmers' market.
If the risks of water fluoridation are hotly debated,
quantifying its benefits is also tricky. In the 1950s,
advocates claimed a 60% drop in cavities. But with the
spread of fluoride toothpastes and the use of plastic
sealants by dentists, decay has plummeted even in
regions where there is little or no fluoride in the
water. A 2001 CDC study found that by the time they were
12, kids in fluoridated communities averaged only 1.4
fewer cavities than those in non-fluoridated areas. And
even in fluoridated cities, severe decay remains rampant
among the poor--partly because some 85% of dentists,
according to state surveys, reject Medicaid patients.
Still, for those with little dental care, water
fluoridation makes a difference, contends Bellingham's
Curtis Smith. "Twenty percent of our kids account for
80% of the cavities," he says. "With fluoride in the
water, they would get a blast every time they drink."
But in parsing risks, Bellingham is also weighing an
undisputed side effect of ingestion. The CDC recently
announced that 32% of American children now have some
form of dental fluorosis, a white or brown mottling of
the teeth. U.S. health officials see it as a cosmetic
issue, largely caused by ill-advised swallowing of
toothpaste, while fluoride critics say it shows that
children are accumulating too much fluoride overall. The
World Health Organization sets a fluoride-safety
standard of 1.5 p.p.m.--well below the EPA's 4-p.p.m.
rule--partly to prevent enamel fluorosis. And in Western
Europe, where the drop in tooth decay in recent decades
is as sharp as that in the U.S., 17 of 21 countries have
either refused or discontinued fluoridation, contending
that fluoride toothpastes offer adequate protection.
(Only Ireland adds fluoride to most of its water
systems, while Switzerland fluoridates its salt.)
Those facts, recycled through Web-savvy organizations
like the Fluoride Action Network, are stirring up
activists. While city councils and water boards tend to
fluoridate when they have the power, the electorate is
far more divided. Over the past five years, the practice
was voted down in 38 of 79 referendums, from Modesto,
Calif., to Worcester, Mass. "The Internet is making it
light-years more difficult to fluoridate," says Smith.
The Washington State Dental Association is backing his
$300,000 pro-fluoride campaign. Danelle Weaver and her
friends, meanwhile, have raised less than $10,000. But
they are undaunted. "People think we are tinfoil
hatters," says Weaver, "but we're just average families
who take the time to research and want what's best for
our children." That goal is the only thing both sides
seem to share.
Please sign the petition supporting the EPA Unions'
request for a nationwide moratorium on fluoridation:
www.powalliance.org/petition/index.html
Provided by
New York State Coalition Opposed to Fluoridation, Inc.
www.orgsites.com/ny/nyscof
