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Benefits, drawbacks of adding fluoride to water debated

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Is fluoridated water a health hazard or a health benefit?

The question was debated Wednesday before the local water utility, which is considering adding it to Albuquerque’s drinking water.

“Fluoride is a deadly poison,” Dr. David Kennedy, a San Diego dentist, told about 60 people at a hearing before the Albuquerque Bernalillo County Water Utility Authority.

Kennedy, a leading opponent of fluoridation, cites studies contending that fluoride can make bones more brittle, leading to an increase in hip fractures, and can cause genetic damage that can lead to cancer.

Most in the audience applauded after his PowerPoint presentation.

Dr. Howard Pollick, a professor of dentistry at the University of California, San Francisco, said the benefits of fluoridation in preventing cavities have been shown by seven decades of experience in the United States.

The water utility is expected to vote April 23 on a measure that would raise the fluoride level in drinking water to 0.7 parts per million – a level recommended by the U.S. Department of Health and Human Services.

Fluoride levels today in the city’s drinking water average 0.5 parts per million, though they vary slightly in different areas, according to utility data.

Pollick said fluoride’s benefits were evident early in the 1960s when one study found a 40 to 60 percent decline in tooth decay in children ages 12 to 14 after fluoride was added to the drinking water.

He did not directly respond to Kennedy’s claims but said that fluoride as an effective way to prevent tooth decay would save Albuquerque residents about $4 million a year in costs of dental care.

“The (Centers for Disease Control and Prevention) estimates that for every dollar invested in fluoridation, you get a $38 return in terms of reduced dental costs,” Pollick said in a telephone interview before the hearing. “Even now, when most people are using fluoride toothpaste, you still see that benefit of water fluoridation.”

Forty-four of the 50 largest cities in the United States are fluoridated, he said.

Kennedy, meanwhile, contends that the American Dental Association has never done large-scale studies showing that fluoride is effective in preventing tooth decay.

The American Dental Association supports community water fluoridation as a cost-effective way to prevent tooth decay, according to its website.

One harmful effect of fluoridation is dental fluorosis, which damages and discolors tooth enamel and can cause teeth to become brittle and break, Kennedy has written on the website www.nofluoride.com.

Kennedy’s website cites numerous sources and reports, from entities as far flung as Natick, Mass., and Brisbane, Australia. There are reports or letters from the British Medical Journal, UNICEF, the American Medical Association, and studies conducted by a number of universities. Not all of these address his claims.

Pollick responded that 80 percent of Americans ages 6 to 39 show no effects of fluorosis, despite the fact that 210 million Americans – about 75 percent – drink fluoridated water.

Communities with recommended levels of fluoride have only rare cases of severe fluorosis, Pollick said.

“We wanted to have the minimal amount of tooth decay and the minimal amount of dental fluorosis,” he said.

Members of the audience took to the microphone after the presentations.

“Since the city stopped fluoridation,” said Dr. Leslie Hutchins, a dentist, “I’ve seen an increase in cavities, not just in children but also in adults. Tooth decay is a disease. We’re fighting that with fluoride.”

“I have worked in communities that are fluoridated and others that are not,” said Barbara Poster, a dental hygienist, “and I can tell you the difference is like night and day in the cavity rate.”

But the audience showed it was strongly anti-fluoride when it was asked by one member, Ramseys De La Cruz, to clap if it opposed fluoridating water. He received a rousing round of applause.

“Supporters of this tell me why we need a toxin to reduce tooth decay,” said Fabby Flores. “Don’t force us to ingest a toxin that we obviously don’t want to ingest.”

The proposal to add fluoride, said Peter Nathanson, “represents the water authority practicing medicine without a license and that’s a crime. … The authority should stick to its mission, and that is to remove contaminants, not to put contaminants in.”

Pollick also said in the phone interview that a panel of epidemiologists recently reviewed studies performed in the past 15 years and concluded that fluoridation does not cause cancer, hip fractures or other illnesses.

“There are no known health effects from fluoridation other than the benefit of preventing tooth decay and a slight increase in dental fluorosis of the very mild and mild forms,” he said.

Fluoride is a mineral that occurs naturally in water supplies, including Albuquerque’s.

The water authority stopped adding fluoride to the city’s water supply in 2011 based on a staff recommendation, a utility spokesman said. Utility board members heard a presentation but did not vote on the move.

“The decision to stop adding fluoride was based on the fact that sufficient fluoride occurs naturally in our water supply to provide some dental protective benefits without exceeding the 0.7 ppm level,” the utility said in a written statement.

However, since then, treated river water has been incorporated into the city’s drinking water, diluting the fluoride levels.

Rudy Blea, the state Department of Health’s director of oral health, said in a phone interview the state agency supports supplemental fluoridation as a cost-effective way of preventing tooth decay.

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