Fluoridation Debate, Redux – a case of bad journalism
Remember all of that cold-war-era paranoia about fluoridation in drinking water? It is hard to believe, but decades after its value in preventing tooth decay was clearly demonstrated, questions are again being raised.
The Centers for Disease Control and Prevention has called fluoridation of water supplies one of the top 10 public health achievements of the 20th century. Yet in the last four years, some 200 municipalities around the country have stopped fluoridating their water. And now in New Jersey, where most residents do not have fluoridated water, there is a battle in the State Legislature over a bill that would require all public water systems to add fluoride.
Critics no longer contend that fluoridation is a Communist plot. Instead, they express concerns about the costs involved, improper government control over a personal decision, and potential health dangers.
Fluoride clearly protects against cavities and tooth loss, but it can cause bone weakness and tooth damage if ingested at high levels for many years. Federal regulators do need to provide consistent, more up-to-date guidelines for the best levels of fluoridation, reflecting the latest research. In 1986, the Environmental Protection Agency set the maximum safe concentration for fluoride in drinking water at 4.0 milligrams per liter. Along with the maximum standard, the agency also set a secondary, voluntary standard (nonenforceable against water systems) that fluoride levels be 2.0 milligrams or less per liter, balancing the benefits of tooth-decay protection against potential discoloration or pitting in children’s teeth.
In 2006, after reviewing new data at the E.P.A.’s request, a panel of experts appointed by the National Research Council concluded that the four-milligram maximum should be lowered (it did not say by how much) to prevent tooth enamel damage in children and bone fractures in adults. Six years later, the standard remains unchanged, and the E.P.A. is still pondering whether to revise it.
Meanwhile, the Department of Health and Human Services also offers advisory guidance for fluoride levels to prevent cavities without causing harm to teeth. In January 2011, it proposed setting its recommended level at 0.7 milligrams per liter. It originally planned to publish a final recommendation last spring, but it is still reviewing thousands of comments it received. The department and the E.P.A. need to clear up public confusion. Fluoridation has been a boon to public health. The agencies should issue final standards and guidance as soon as possible.