Does resuming the practice of adding fluoride to Albuquerque’s community water supply aid in the prevention of tooth decay or lead to a host of other health problems?
Public comments offered Wednesday before the board of the Albuquerque Bernalillo County Water Utility Authority were pretty much split between those opinions, and members of the water authority gave no clue how they will rule on the issue Aug. 23.
About 70 people showed up for the Wednesday evening meeting, and more than 25 of them were given two minutes to share their thoughts.
Among the speakers were a number of dentists, hygienists and representatives of dental and public health organizations. They were in agreement that supplementing the water supply with fluoride ought to resume.
Fluoride is a naturally occurring substance found in many water supplies, including Albuquerque’s. In the early 1970s, voters approved a referendum to supplement the fluoride levels and bring it up to what was then a national standard. In 2011, the water authority suspended the addition of fluoride pending new recommendations on optimal levels from the federal government. In 2015, that new standard was determined to be 0.7 milligrams per liter.
Building a facility to add fluoride to the water supply would cost about $250,000, and yearly operating and maintenance costs of $250,000.
Ron Romero, former state dental director, said tooth sealants and fluoride are important tools in fighting dental decay. Citing statistics from the Centers for Disease Control and Prevention compiled in 2012, about the time Albuquerque ceased adding fluoride to water, 75 percent of the U.S. population on public water was using fluoridated water. That included 44 of the largest cities in the country.
The cost of fluoridating Albuquerque’s water supply would be about 20 cents per person per year, Romero said, and for every $1 invested in fluoride, $30 is saved in dental bills.
Patrick Manzanaras, a graduate student in public health studying at New Mexico State University, said he spent the past decade doing outreach in rural communities and reservations throughout New Mexico.
“In that time I worked with communities that did not have fluoride in their water systems, and those that did,” he said. “What was clear was that there was an elevated incidence of tooth decay in those communities that did not have fluoride in their water systems, and a decreased incidence in those communities that did have access to fluoridated water.”
Tom Schripsema, a dentist and executive director of the New Mexico Dental Association, said fluoridation of water is safe, effective and affordable, and the practice is endorsed not only by his organization, but by the CDC, the World Health Organization, the American Medical Association, the American Dental Association and many more.
“We use evidence-based medicine, and that’s the standard by which we provide care,” he said. “The evidence shows overwhelmingly and consistently that it does prevent tooth decay and does not cause any health problems.”
The surface of a tooth is constantly dissolving and being re-mineralized, and fluoride aids in that re-mineralization process, he said.
However, not everyone was buying into the reported benefits of fluoride.
Albuquerque resident Debra Sapunar cited a March 2014 report in the Lancet medical journal that classified fluoride as a neurotoxin.
“This is the same category as arsenic, lead and mercury,” she said. “There is no way to control the amount of fluoride each citizen will get. We drink, bathe and eat food and beverages prepared in the fluoridated water” and mix baby formula with it. She also cited a recent national survey conducted by the CDC that said 40 percent of American teenagers exhibit visible signs of fluoride overexposure.
Another speaker, Mark Jurich, held up a chart using WHO statistics from 22 countries, some of which fluoridate their water and some that do not. Jurich said the chart shows there is no difference in the incidence rate of tooth decay among those countries.
“The assertion that there is any benefit to adding fluoride to the water is simply not statistically valid,” he said.
Karla Koch, a doctor of Oriental medicine, also came armed with statistics from the CDC and the WHO that indicated fluoride was effective against tooth decay when applied topically to the tooth surface, but there was no evidence of any benefit from systemic absorption from drinking sources.
Rather than spending money on supplemental fluoridation, we should invest those funds in school nutrition programs, in-school hygienist visits and low cost community-based dental programs, Koch said.
Albuquerque dentist and New Mexico Dental Association representative, Joe Valles said systemic absorption of fluoride is necessary.
“When an embryo is forming, the buds that form teeth are also forming, and topical applications have no effect on that,” he said. “It’s the ingestion of fluoride that makes the enamel hard.”