San Antonio Water System and BexarMet started injecting fluoride into their combined 34 pumping stations Aug. 1. By Aug. 15, or a few days after, fluoride will pour from every tap in the city.
Groups like the American Medical Association, the American Dental Association, and the Texas Natural Resource Conservation Commission say citywide fluoridation is the most equitable way to prevent tooth decay across all socioeconomic lines, as well as the most cost-effective. In a city of more than 1 million people, the cost per person per year hovers around 50 cents. Yet with all of the fluoride already being consumed — 0.3 parts per million naturally occur in our local water supply, some toothpastes contain fluoride additives, and chewing gum is available with the ingredient — some say increasing this amount, especially for digestion, isn't only unnecessary, but dangerous.
Twice fluoridation measures were defeated in San Antonio, the first time in 1966 and again in 1985. The current ordinance passed in 2000, bringing San Antonio into the fluoride nation — the Center for Disease Control reports that 65.8 percent of U.S. cities fluoridate their water, and that number is on the rise. While topical treatments like the gum and toothpaste can be just as effective as the soluble type, the current thinking is that since you can't count on people to buy the paste or the gum, let alone use it, fluoride should be put into the water for everybody. Big brother will make sure you have good teeth.
The type of fluoride being added to our water, hydrofluorosilicic acid, is an industrial byproduct of the phosphate fertilizer industry. A pro-fluoride toxicologist with the TNRCC, Michael Honeycutt, says this fluoride becomes dangerous only at levels greater than 4 parts per million, and should ideally be kept below 2 parts per million. In San Antonio, SAWS is targeting a concentration of 0.8 ppm in the water supply.
Both the American and Canadian dental associations recommend fluoridation of this level up to 1.2 parts per million, but say infants from birth to six months shouldn't receive any. Preventing tooth decay, they say, isn't useful until permanent teeth have developed. Fluoride in infancy can also cause spotting years later, when permanent teeth come in.
In San Antonio, with 22,155 children born in 2000 (the latest information available), thousands of children are going to have to drink either non-fluoridated bottled water, or their families will have to invest in a reverse osmosis water filtration system. The problem is, how many low-income folks know not to reconstitute infant formula with tap water? Even if they do, the cost for filtering can be prohibitive.
Bill London, CEO of Culligan of San Antonio, says reverse osmosis filtration systems typically remove 90 percent of fluoride in the water, but cost between $300 and $1,200. Rentals, at $25 a month, still don't fit a low-income budget. Widely available filters, like Brita's faucet or pitcher filters, don't remove a significant amount of fluoride.
The dangers of fluoridation are most pronounced for the elderly.
Five separate studies have linked fluoride with an increased risk of bone fracture, especially for women, in populations age 65 and older. The TNRCC's Honeycutt says that when calcium is lost through osteoporosis, the body can replace it with fluoride: "The interesting thing about fluoride is that it can make bones much more dense, but also more brittle."
A 1990 survey of U.S. schoolchildren in 84 fluoridated and non-fluoridated towns is one of the most exhaustive studies on the oral effects of fluoridation. The study examined dental records of 39,207 kids ages 5 to 17 between the years of 1986 and 1987. San Antonio (non-fluoridated), Houston (fluoridated since 1982), and El Paso (fluoridated for more than 40 years) were all among the cities surveyed. Surprisingly, the results showed no significant difference in the decay rates for children in fluoridated versus non-fluoridated towns. The researcher, Dr. John Yiamouyiannis, concluded that mass fluoridation is a topic that needs further research.
Silicofluorides can also promote the absorption of other solubles. In 1999, the International Journal of Environmental Studies published a study showing that levels of lead in the blood were significantly higher in fluoridated than non-fluoridated areas, and a separate study published in the Journal of the American Medical Association, linked an increase in blood lead levels with an increase in dental problems.
Most telling, the Food and Drug Administration requires a warning statement on fluoridated toothpastes: "If you accidentally swallow more than used for brushing, seek professional assistance or contact a Poison Control Center immediately." Hardy Limeback, head of Preventative Dentistry at the University of Toronto, figures that "if you swallow the equivalent amount of fluoride found in one half liter of fluoridated water, `the FDA recommends` you contact a poison control center immediately" — a scary thought when it is generally recommended that people drink eight 8-ounce glasses of water a day, or nearly two liters of water.
Dr. John Maguire, deputy director of the Division of Oral Health with the Texas Department of Health, says the preponderance of information on fluoridation over the past 50 years shows that it has great benefits in the prevention of tooth decay. Information to the contrary, he claims, has been shown to be scientifically invalid.
"The only consistency in all of the research is the tremendous reduction in tooth decay," he offers. While U.S. tooth decay has decreased over the same period of time that fluoridation has increased, pro-fluoride groups fail to mention that decay rates have also decreased in countries without mass-fluoridation — including Belgium, Denmark, Finland, France, Germany, Greece, Iceland, the Netherlands, Norway, and Sweden.
Anti-fluoridationists, in efforts to stop the additive from being used in their town, sometimes take on desperate tones. The reason is simple — finding balanced information available to the consumer can be harder than plucking fluoride out of the water by hand. A chat on the Council.net Product Liability Chatboard — between a Texan and a German — provides an example:
"I am fighting to keep hydrofluorosilicic acid out of my water and am curious as to the best way to do this. The department of health claims it is safe but the EPA says it has never been tested for consumption. There has to be a legal way to stop the department of health from funding hundreds of thousands of dollars to those who put this in water supplies. There is no liability from anyone that I can see and no environmental impact studies from the TNRCC. Anyone interested in helping me please respond. Time is short," wrote Sheryl P. on April 1, 2001. The Kid, from Germany, responds:
"Look up the Alamo's (the one in New Mexico) chemistry division's periodic table of the elements and click on fluorine. Most interesting, and disturbing, is the hypothesis that 'fluorine can be substituted for hydrogen wherever it occurs in organic compounds, which could lead to an astronomical number of new fluorine compounds.' Simple logic dictates the aforementioned characteristic of fluorine would result in disastrous effects on the human body, genetic mutation being the most serious result."
Genetic mutation? Whether that's the case or not is yet to be determined, but it is clear that as of now San Antonio will be one of the cities involved in the national experiment to find out.