Jim Nugent, Water Quality Laboratory Manager at our Monroe County Water Authority, graciously answered the questions I emailed about our municipal fluoride policy.
So allow me to share :-)
First, the more factual bits.
The county spends $88,000 on fluoridation annually.
None of the fluoride we use here comes from China. Nugent writes that “We require that all source material used for all of our treatment chemicals originate from the USA or Canada. This requirement was approved by the Board of Directors in wake of 9-11.”
As far as purity, he says that the MCWA specifies, as part of its procurement process, that our fluoride be certified by the National Sanitation Foundation or Underwriter’s Laboratory. So if there’s, ya know, dog hair in our fluoride that’s who to blame.
When we get to the stickier questions — why do we do it, and is anyone rethinking it in light of recent science — Nugent toes the pro-fluoride line (not surprising) and suggests that if I’m looking for an agency to pester, it’s not the MCWA but the NYS Department of Health:
MCWA looks to the NYSDOH, the U.S. EPA, the Centers for Disease Control, and the medical and dental communities for their information and research on medical and dental health. The NYSDOH strongly recommends the use of fluoride as evidenced by their new series of fluoride information bulletins (attached). Fluoride addition is currently part of our NYDOH approved treatment process (since 1966) which can not be modified without NYDOH permission.
Under the Safe Drinking Water Act, the USEPA is required to set drinking water standards for the protection of human health. The EPA is required to review and re-evaluate theses standards on a six year cycle or at any time if warranted by new information. The NRC study you reference was part of this ongoing evaluation process. Your interpretation of the results of this study are not consistent with the USEPA’s.
Drinking water utilities are highly regulated entities in the US. These rules and regulations are established by NYDOH and USEPA and it is to them you should address your concerns. The USEPA has been very conservative, i.e., protective of human health, in it approach to fluoridation. It should also be noted that California, one of the most aggressive environmental states, just recently began requiring all water systems to fluoridate.
I appreciate your interest in this matter. I believe the USEPA has looked at fluoridation as hard as any compound it regulates and it, as well as NYDOH, CDC, and the dental community, still support the practice and its safety.
Am I persuaded by this?
As just one point, I don’t agree that the USEPA has been “conservative” in its approach to fluoridation. A truly conservative approach would have been to leave the water alone with respect to fluoridation.
It’s that approach which is warranted, IMO. For starters, the assertion that fluoridated water leads to reduction in tooth decay doesn’t stand to scrutiny. It’s another correlation-but-not-necessarily-causation error that people so commonly make when they try to interpret health trends. See this round-up, for example, which includes bits like this:
“Graphs of tooth decay trends for 12 year olds in 24 countries, prepared using the most recent World Health Organization data, show that the decline in dental decay in recent decades has been comparable in 16 nonfluoridated countries and 8 fluoridated countries which met the inclusion criteria of having (i) a mean annual per capita income in the year 2000 of US$10,000 or more, (ii) a population in the year 2000 of greater than 3 million, and (iii) suitable WHO caries data available. The WHO data do not support fluoridation as being a reason for the decline in dental decay in 12 year olds that has been occurring in recent decades.”
SOURCE: Neurath C. (2005). Tooth decay trends for 12 year olds in nonfluoridated and fluoridated countries. Fluoride 38:324-325.
There’s more at the link.
To summarize my thinking at this point: on the one hand the value of fluoridation for its stated purpose (prevention of tooth decay) is questionable. On the other hand there are valid questions about whether consuming fluoridated water might cause health issues for some people (and maybe all of us, if fluoride concentrates in the pineal gland, like some researchers suspect — suppressed melatonin/serotonin production, anyone?).
I’ve read enough. I’m going to be conservative ;-)
I’m going to buy a distiller.