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Fluoride, Part 2

The City Council has rescinded its vote to stop fluoridating Santa Fe’s water — not because of a sudden return to reason but after being advised by the City Attorney that the decision may have violated the state Open Meetings Act. But now Pandora’s Box has been opened, and a hearing is scheduled for August 28. An issue that has already been decided on its scientific merits will be thrown into the arena and subjected to the jousting of populist politics.

This is so much like what happened with the great cell phone debates (please see the Santa Fe Review series Electromania). Once again we have an established body of scientific research supporting a technology — in this case fluoridating drinking water. After considering the evidence, the American Dental Association and the Centers for Disease Control continue to recommend that a level of 0.7 milligrams per liter prevents tooth decay without causing harmful effects.

But what if the ADA and the CDC are part of an evil plot? As with the cellphone issue, a small, loud group of “citizen activists” distrust the experts and are putting their faith instead in a fringe group: the Fluoride Action Network, which is dedicated to the proposition that adding fluoride to drinking water is “a violation of the individual’s right to informed consent to medication.” Much of the anti-fluoridation sentiment the Councilors will hear in coming weeks will be peeled directly from the group’s website.

There is no shortage of research showing that too much fluoride can lead to a cosmetic condition called enamel fluorosis (spotting of the teeth) and possibly in some people to a weakening of the bones. Acute fluoride poisoning may even cause neurotoxicity — the killing of neurons — and the EPA sets the maximum safe amount of naturally occurring fluoride at 4.0 milligrams per liter. Studies in Chinese villages with high fluoride levels have found suggestions of a negative effect on children’s IQs. (A recent meta-analysis summarizes the findings.) All of that was taken into consideration when the safe and effective standard for preventing tooth decay was set. As with anything, the dose makes the poison. Putting your head inside a microwave oven is a very different phenomenon from talking on a mobile phone.

Since the Councilors have decided to second guess the ADA and the CDC, we can only hope that they will each look beyond the Fluoride Action Network for their information. The best overview is the summary of the National Academies of Science report, Fluoride in Drinking Water.

George Johnson
The Santa Fe Review