As Bans Spread, Fluoride in Drinking Water Divides Communities Across the US

MONROE, N.C. — Regina Barrett, a 69-year-old retiree living in this small North Carolina city southeast of Charlotte, had been dissatisfied with the tap water for some time.

“Our water has been cloudy, bubbly, and looks milky,” Barrett said, blaming fluoride. Prevent cavities and improve dental health.

“I don't want fluoride in my stuff!” said Barrett, echoing the sentiment of a growing number of people who not only doubt the mineral's effectiveness but also believe it can be harmful despite decades of The data show its benefits to public health and economic benefits.

In February, the Union County Board of Commissioners, where Monroe is located, voted 3-2 to stop adding fluoride to drinking water at the Yadkin River Water Treatment Plant, the county's only fully owned and operated water source. . But the decision came after intense discussions between residents and county officials.

“My children have the good fortune to grow up with fluoride in the water… and they have very few dental problems,” Commissioner Richard Helms said before the vote. A fellow commissioner saw it differently: “Let's stop putting things in the water that are meant to treat us and give people the freedom of choice,” said David Williams.

Barrett gets its water from the city of Monroe, not the Yadkin facility. Therefore, for now, she will continue to drink water with added fluoride. “I'm very skeptical about why they're adding this to our water,” she told KFF Health News.

This is a scenario playing out across the country. Hundreds of communities from Oregon to Pennsylvania have either stopped adding fluoride to their water supplies or voted against adding it in recent years. Supporters of such bans argue that people should have the freedom to choose. They say the widespread use of over-the-counter dental products containing the mineral has eliminated the need to add it to public water supplies. The Centers for Disease Control and Prevention says that while store-bought products can reduce cavities, they offer the greatest protection when combined with water fluoridation.

The outcome of an ongoing federal case in California could force the Environmental Protection Agency to enact a rule regulating or banning the use of fluoride in drinking water nationwide. At the same time, the trend is raising alarm bells among public health researchers, who worry that, like vaccines, fluoride may have become a victim of its own success.

The Centers for Disease Control and Prevention believes that community water fluoridation is not only safe and effective, but can also lead to significant savings in dental treatment costs. Public health officials say removing fluoride could be particularly harmful to low-income families — for whom drinking water may be the only source of preventive dental care.

“It’s a completely different story if you have to go out and get care on your own,” said Myron Allukian Jr., a dentist and former president of the American Public Health Association. Millions of people have used fluoridated water for years, and “we've had no major health problems,” he said. “It’s much easier to prevent disease than to treat it.”

Since 2010, more than 240 communities around the world have removed fluoride from drinking water or decided not to add it, according to the anti-fluoride group Fluoride Action Network.

Just look at Union County to see how heated the discussion is. Typically, when commissioners meet on the first floor of the Government Center in downtown Monroe, there are more empty seats than attendees. But the meeting on banning fluoride from public water supplies was packed and residents who signed up to speak were divided.

On February 5, one person who came to the microphone compared water fluoridation to seat belts. He said this would not “prevent crashes, but it would limit the damage”. Another argued that there is no evidence that fluoride is safe or effective. “This is an important potential milestone in reversing more than 60 years of poisoning the public,” he said, using an unsubstantiated claim often made by fluoridation opponents.

Fluoride opponents claim the mineral is responsible for everything from acne to high blood pressure, thyroid dysfunction and bone cancer.

The National Institutes of Health acknowledges that when large amounts of fluoride in dental products or dietary supplements are ingested, it can cause nausea, vomiting, abdominal pain, diarrhea, bone pain and, in rare cases, death.

Babies and children who get too much fluoride may have discolored or small pitted teeth. In adults, excessive fluoride intake over a long period of time can lead to skeletal fluorosis, a very rare disease that causes joint pain and stiffness, brittle bones, muscle loss and nerve problems.

However, the recommended dose in drinking water has always been small. In 2015, the Department of Health and Human Services lowered the optimal fluoride concentration from 1.2 mg/L to 0.7 mg/L.

The city of Juneau, Alaska, voted in 2007 to remove fluoride from its drinking water. and teen dental records to stop adding fluoride to water. The study found that the costs of cavity-related surgeries and treatments were significantly higher for the latter group.

Portland, Oregon, the largest city in the United States, has refused to add fluoride to its drinking water. Voters have rejected adding the measure several times, first in 1956 and most recently in 2013.

Voters in Wichita, Kansas, have repeatedly rejected adding fluoride to the water, most recently in 2012, despite strong recommendations from local doctors and dentists.

The Brushy Creek Municipal Utility District in Williamson County, Texas, had been adding fluoride to its water system since 2007 but ended the practice in December.

In 2016, commissioners in Collier County, Florida, chose not to remove fluoride from the water system. But they unanimously reversed that decision “to protect the health care rights and freedoms of Collier County residents” in the wake of the Health Freedom Bill of Rights of 2023 county ordinance in response to covid-19.

The Pennsylvania State College Borough Water Department stopped adding fluoride to the water of its 75,000 customers in March 2023. Possible adverse health effects, such as faint white lines that may appear on teeth and reduced IQ in babies.

A 2019 study in six Canadian cities published in JAMA Pediatrics found that exposure to fluoride during pregnancy was associated with lower IQs in children. But the study was based on self-reports and has been criticized for its methodological flaws.

In 2016, several consumer advocacy groups, including the Fluoride Action Network, Food & Water Watch, and Moms Against Fluoride, petitioned the EPA to end water fluoridation under the Toxic Substances Control Act, claiming important research suggest that fluoride is neurotoxic at current doses. The next year, the group filed a federal lawsuit against the EPA after the agency rejected their citizen petition.

During the 10-day bench trial that ended in San Francisco in mid-February, both sides argued over the risks and areas of uncertainty. If Senior U.S. District Judge Edward Chen determines that water fluoridation poses an “unreasonable risk” to human health, the EPA would be forced to create a rule that would regulate or ban water fluoridation in the United States. A decision will be made.

Currently, decisions about whether to fluoridate community water systems are still made primarily at the local level, and Barrett hopes to change that.

“Most importantly, they want our teeth to be healthy when the basic needs of shelter and food are lacking.”

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