Public Health Debate

– August 29, 2012Posted in: Green, Health, News, Observer, Politics, Urban Life

Opinions are running high over a plan to add fluoride to Portland’s water supply in an effort to fight tooth decay and improve public health (photo by MIndy Cooper/The Portland Observer).

Should fluoride be added to our water?

By Mindy Cooper/The Portland Observer

A debate over whether or not fluoride should be added to the public water supply has taken center stage in Portland, after City Commissioner Randy Leonard scheduled a public hearing next week, Sept. 6, with a council vote scheduled less than a week later.

As the second largest city in the country to not have fluoride in its water, Portland also stands out with one of the highest rates of tooth decay among children and adults in the nation.

According to the Oregon Dental Association’s 2007 Oregon Smile Survey, more than 35 percent of Oregon children suffer from untreated tooth decay — more than double the rate in Washington (15 percent) and other neighboring states.

Although poor dental health outcomes can’t be directly pinpointed to the lack of fluoride in the water, many experts believe the missing ingredient is the number one reason for the metro area’s low rank for childhood oral health.

“This public health crisis is having devastating effects on our children, the poor, and the uninsured,” said John Snyder, DMD, dental director and chief executive officer of Permanente Dental Associates.

Access to oral health care is a critical problem for low-income, underinsured, and uninsured families, who are particularly vulnerable to tooth decay and associated health issues, he said. “This reality, coupled with an uninsured rate higher than 40 other states, has created an oral health emergency in Portland and all of Oregon.”

Although Portlanders have voted three times against the fluoridation in the past, Leonard, along with Commissioner Nick Fish and Mayor Sam Adams, have announced their support of the plan, in hopes to decrease the exponentially high level of tooth decay amongst resident children.

The support represents a majority on the Portland City Council.

Community supporters include the Everyone Deserves Healthy Teeth Coalition, which is made up of several groups, including the African American Health Coalition, the Oregon Health and Sciences University American Medical Student Association chapter and the Urban League of Portland, to name a few.

Other residents and activists, however, remain strongly opposed to the plan, which they believe imparts unnecessary health risks and violates an individual’s right to consent to medicinal intake.

The opponents point to numerous studies, which have shown serious, adverse health consequences from fluoride ingestion.

Oregon Citizens for Safe Drinking Water, a non-profit organization, is leading the charge against fluoridation. The group says its goal is to protect the drinking water of all Oregonians through education and advocacy work specifically aimed to keep fluoride compounds and toxic chemicals out of the public drinking supply.

Kimberly Kaminski, the organization’s executive director, calls fluoride a waste product of the phosphate fertilizer industry.

“It contains contaminates, such as lead and arsenic; it is highly acidic and there are concerns about it leeching lead and copper from plumbing,” she said.

The group’s website claims there have been cases of fluoride poisoning found in industrial workers.

According to Kaminski, fluoride treatments have yet to be regulated by the Food and Drug Administration, which comes as a surprise to many residents throughout the country.

She disagrees with the premise that fluoride in the water will help low income families.

“Families and individuals who lack a proper diet that is low in calcium are especially susceptible to the harm of fluoridation,” she said. “The other thing is that low income families don’t have the option of avoiding fluoridated water. They can’t buy bottled water, and transport bottled water—especially if taking public transportation.”

She adds that lower income populations don’t have the option of purchasing expensive filtration systems. “There is not a choice. When you put it in water—all of the water—we swim in it, we bathe in it, and we water our gardens in it.”

She also claims that fluoride would negatively impact salmon and other aquatic species because the compound doesn’t break down, and therefore accumulates in the environment.

“We only drink one percent of it, so 99 percent goes down the drain, where it enters our ecosystem. We know it has toxic effects on aquatic life,” she said.

The benefits of water fluoridation, however, have been known for more than 65 years, said Snyder.

In 1945, Grand Rapids, Mich., added fluoride to its municipal water system, which catalyzed rates of tooth decay in the area’s children to drop dramatically, he said. Since then, hundreds of studies have shown the effectiveness of community water fluoridation in reducing tooth decay.

According to the American Dental Association, evidence shows that water fluoridation reduces tooth decay by 18 to 40 percent, because it strengthens the teeth and protects them from bacteria growth.

According to the Everyone Deserves Healthy Teeth Coalition, dental decay accounts for 30 percent of all health care costs for children, and dental-related emergency room visits by Oregon’s Medicaid enrollees increased 31 percent in the past few years, taking a tremendous toll on healthcare costs.

“Dental decay affects all children, and low-income families and communities of color are hit especially hard,” said Joseph Santos-Lyons of the Asian Pacific American Network of Oregon. “Fluoridated water is the only way to ensure equal protection for all children’s teeth, and it’s safe and beneficial for everyone in our community.”

Still, opinions continue to run high throughout the city.

They say everyone is doing it, but most of the world doesn’t do it, said Kaminski.

Opponents are planning to file a ballot measure to slop the fluoridation effort. A City Council vote on the issue is planned for Sept. 12.

About Mindy Cooper