KY 49th in oral health; fluoride in water proven to help teeth, but group of legislators tout law to ban it – NKyTribune

Deborah Yetter
kentucky lantern

As a dental hygienist for low-income schoolchildren in Louisville, Jennifer Hasch said the untreated dental disease she sees is alarming. Some teenagers have tooth decay so severe that all of their teeth must be extracted and dentures installed. Middle school students report being unable to sleep due to painful tooth infections and abscesses. Due to the severity of tooth and gum disease, first and second grade students require inpatient oral surgery under anesthesia.

“It's heartbreaking,” said Harsh, a member of the Kentucky Oral Health Alliance's steering committee.

The situation for adults isn't much better.

Kentucky ranks 49th in overall oral health and has one of the highest numbers of toothless seniors. Last year, an oral health doctor at the University of Kentucky described to lawmakers how patients with life-threatening dental infections were airlifted to British hospitals.

However, a group of lawmakers led by Rep. Mark Hart of Falmouth is pushing a bill that would make fluoridation an option for local water districts, despite the fact that HASH and including the American Dental Association and the Kentucky Dental Association Others, including those in the U.S., say there is overwhelming evidence that fluoride safely helps reduce cavities.

“This bill would eliminate an unfunded mandate and return the issue to local control,” Hart said while speaking at a meeting of the House State Government Committee in support of House Bill 141.

Hasch and other oral health professionals are fighting HB 141, a bill that would eliminate the 1954 fluoridation mandate.

CDC graphics

“There are kids who are already suffering,” Harsh said. “Water fluoridation can prevent it from getting worse.”

Dr. Stephen Robertson, executive director of the state dental association, urged lawmakers to reject HB 141, saying “Kentucky cannot afford to take a step backwards in oral health.”

“Please listen to our professional advice and continue to provide consistent fluoride to our patients through community water supplies,” urged Marianne Burch, representing the Kentucky Dental Hygienists Association.

they do not.

Instead, the committee voted 16-1 to approve HB 141, treating it as a home rule issue rather than a public health issue. The bill is currently awaiting consideration in the House of Representatives.

“This is a local control issue,” said co-sponsor Rep. William Lawrence, R-Maysville. In 1951, his city was the first in Kentucky to add fluoride to its drinking water supply.

“Local control — that’s what this bill is about,” said Rep. Steve Rawlings, R-Burlington and a co-sponsor.

“Let's leave it to local control,” said Rep. Kevin Bratcher, R-Louisville.

A total of six committee members cited “local control” as a reason for passing HB 141.

Bill has not moved since February 9

After leaving committee, the bill was referred to the House Rules Committee, which is controlled by House leaders. The bill has been around since February 9, which may indicate that its sponsors have yet to collect the votes to pass it in the House.

But at the same time, the prospect of allowing local water companies to eliminate fluoride from drinking water is driving Kentucky dental and public health officials crazy.

“I have no words, other than setting my hair on fire, to describe this vital step that, if taken by the state of Kentucky, will harm developing teeth, children's teeth and permanent teeth,” said Kentucky Deputy Public Health Officer Dr. Connie White said the commissioner recently said during a conference call with health advocates.

White says fluoride can reduce cavities by 25 percent.

Not only would it lead to more cavities than Kentucky already has, she said, but it would also increase costs for Medicaid, the government health program for low-income individuals that covers nearly half of Kentucky's children.

White said the Medicaid cost to fill a cavity in a child is about $250, which could add millions of dollars to the program's costs.

Harsh said the state already faces a shortage of dentists, especially pediatric dentists, and removing fluoride from community water supplies will mean longer delays in care.

“We don't have the resources to handle this kind of growth,” Harsh said. “All of these dental providers are working desperately to meet the current demand.”

Dr. Bill Collins, a longtime dentist in eastern Kentucky, said too many children in rural areas who use well or cistern water already lack access to fluoridated water are suffering from more cavities. Compounding the problem is the widespread use of sugary sodas and a lack of oral health care services across the state.

He said he was confused as to why lawmakers wanted to lift the fluoride mandate.

“They don't see the need for fluoride because they haven't experienced the tooth decay that we experience in rural areas,” said Collins, director of Red Bird Mission Dental Clinic in Beverly in northern Bell County. “If this happens, they go through it and they should be held accountable.”

“Based on science”

Advocates say Kentucky's statewide adoption of fluoridation, hailed by the U.S. Centers for Disease Control and Prevention as one of the major public health advancements of the past century, has made Kentucky a national leader.

Harsh says fluoride is a naturally occurring mineral added in small amounts to water to help strengthen enamel and prevent decay. It helps as children's teeth develop, but the main benefit is topical exposure to fluoride through drinking treated water.

Is there fluoride in the water? (Wikimedia photo)

Hasch said the recommended concentration is 0.7 parts per million, which is equivalent to adding one drop of fluoride to about 11 gallons of water.

Louisville Water Co., the state's largest public water company, has been adding fluoride to water it gets from the Ohio River since 1951, said spokesman Kelley Dearing Smith.

River water already contains some natural fluoride, she said, and the water company adds enough to bring it up to recommended levels.

“We are based on public health,” she said. “Everything we do is based on science.”

Louisville Water Co., along with Delta Dental of Kentucky, the Dental and Dental Hygienists Association, the Oral Health Alliance and the Kentucky Primary Care Association, sent a letter to lawmakers urging them to reject HB 141.

“Community water fluoridation is a safe, reliable, and cost-effective preventive measure that keeps teeth strong and reduces tooth decay by at least 25 percent,” the letter states. “We are passionate about making water fluoridation programs a viable option in our communities. Any efforts to do so are deeply concerning.”

“Forced medication”

Despite evidence to the contrary, doubts about the safety and effectiveness of fluoride have persisted for years.

Four rural water districts submitted letters in support of HB 141: Grayson County Water District, Irving Municipal Utilities, Martin County Public Utilities Commission and McCreary County Water District.

“Water fluoridation has been proven to be harmful to human health,” wrote Martin County Water Utility Division Manager Craig Miller. Eliminating fluoride will save Martin County about $14,000 annually, he said. The money would be better spent upgrading the troubled water system.

Public Utilities Board member Nina McCoy, a longtime activist for water improvements in Martin County, said she was not consulted on HB 141 and the board did not vote on it. She advised lawmakers to respect the opinions of public health officials. “I don't pretend to be an expert on this at all,” she said.

In a letter, Macree Water District Superintendent Stephen Whitaker cited potential “adverse effects of fluoridation,” including thyroid, tooth and bone problems.

Lawrence, a co-sponsor of HB 141, called adding fluoride to water “a mandatory medication.”

The Oral Health Alliance's Harsh dismissed research claims linking water fluoridation to health problems as “junk science” and said the vast majority of research supports its safety and effectiveness.

Collins, who has practiced dentistry in eastern Kentucky for more than three decades, said he doesn't understand the continued distrust of fluoride.

“I really don't understand why they were so adamant about removing this,” he said. “This is something that's been tested over time and proven to be a good thing and it's safe. It's just unbelievable.

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