Town employee suggests ending water fluoridation

Cambridge City is considering eliminating the addition of fluoride when treating water, but Indiana dental and health experts urge council to reject the change.

During council’s Aug. 12 meeting, town employee Chris Stapleton suggested removing fluoride. After a discussion, members decided to table the matter until their 6 p.m. Sept. 9 meeting at town hall, 127 N. Foote St.  

Stapleton said “lots of studies” say additional fluoride isn’t needed like it was in the 1950s and ’60s to prevent tooth decay and strengthen teeth, and would save the town money.

However, Doug Bush, executive director of Indiana Dental Association, and Connersville dentist Dr. John Roberts, a past IDA president currently serving on the American Dental Association’s Council on Government Affairs, disagree. 

Bush said the addition of fluoride to toothpaste (invented by researchers at Indiana University) is certainly important, but research indicates that it supports — not replaces — fluoride in drinking water.

The addition of fluoride costs much less than repairing tooth decay, Roberts said. Towns generally pay 50 cents to $3 per year per person for fluoride treatment, compared to each filling costing $100 plus tooth damage. Even when fluoride is available through toothpaste and supplements, optimal fluoride in drinking water is shown to reduce tooth decay by an additional 25%, Bush said.  

Roberts said his hometown of Connersville was part of the Crest toothpaste study because its water didn’t have fluoride at that time. One of the main reasons Roberts returned after dental school was to advocate for the addition of fluoride in town water.   

Roberts remembers providing dental exams for children in Fayette County’s Head Start program before fluoride was added to the town’s water. Out of every 40 exams, he’d only find one or two children who didn’t have cavities. 

However, several years after fluoride was added, the complete opposite was true. Roberts said nothing had changed, such as better brushing or drinking less soda. 

Roberts added that fluoride isn’t just important for kids because older people often have weak spots on their tooth enamel or exposed roots that are more susceptible to decay without fluoride. 

Bush noted there’s a correlation between dental disease and social and economic status. 

“Community water fluoridation has been cited in numerous studies as a strategy for reducing dental disease in vulnerable populations,” Bush said. 

Bush said some Indiana communities have discontinued or are considering eliminating community fluoridation, but he suspects it’s because of aging equipment that needs replacing. Roberts said that newer fluoridation equipment is much more efficient and less costly than earlier models. 

The Pew Charitable Trusts says research shows that community water fluoridation offers “perhaps the greatest return-on-investment of any dental care strategy.” 

The decision isn’t all about money. 

Stapleton told council that he’s concerned about the addition of a chemical to water that has “a big skull and crossbones” on the container. 

However, Bush said anything can be harmful in the wrong quantities, and he suspects similar warnings are on chlorine containers that are used to make drinking and pool water safe. 

Roberts said it’s not possible to ingest a poisonous amount of fluoride through tap water because the quantity of water consumed would prove fatal first. 

IDA, ADA and Indiana Department of Health are all strong supporters of community water fluoridation, Bush said. 

Ken Risch, Cambridge City’s superintendent of public works, said he agreed with Stapleton that it’s a good time to remove fluoride. 

Risch said the town’s water naturally has about 0.2 mg/L in it and daily tests of treated water usually show approximately .5 to .8.   

However, Bush said the Environmental Protection Agency recommends community water fluoridation be established at 0.7 mg/L. If the town’s fluoride was above 4.0 mg/L, defluoridation might be recommended. 

Towns have the right to remove fluoride without conducting public hearings, said attorney Bob Bever. He said he would prepare a written resolution that could be approved at September’s meeting if council favors that choice.  

Because removing fluoride is a change to the water treatment process, Adam Sitka from Wessler Engineering said Cambridge City would need to notify Indiana Department of Environmental Management as well as the public about why it’s making the change.