8.14.08
Fluoride still a key issue in Nebraska
By Rick Ruggles, Omaha World-Herald
American cities began adding fluoride to their water supplies more than 60 years ago to cut down on cavities, but many towns in Nebraska and elsewhere continue to grapple over whether fluoridation is good or bad.
The Nebraska Legislature passed a bill this year that ordered towns and cities with populations of 1,000 or more to fluoridate their water or take the matter to their voters.
Checks with about one-third of the 64 communities affected indicate most will put it on their communities' November ballots.
That disappoints Dr. Jessica Meeske, a pediatric dentist in Hastings, Neb., and board member of the Nebraska Dental Association.
"We have over 50 years of good science that shows that fluoridated water is the most cost-effective way to prevent tooth decay in people," Meeske said. "We would like city councils just to step up and vote it in."
That appeared unlikely in many cases. Some people express concerns that fluoridation could be harmful, or worry about the cost of equipment, operation and maintenance involved in fluoridating a town's water supply.
Generally, city councils that refer the matter to the voters act wisely, said Beatrice, Neb., Mayor Dennis Schuster, whose own council will put it on the November ballot. "Yeah, it is politically the safe move," Schuster said.
As the story is told by Schuster and Steve Kelley, Beatrice water superintendent, Beatrice fluoridated its water in the early 1950s. An elephant in a Beatrice carnival died, and fluoride was blamed. Fluoridation then was placed on the city's ballot in 1954 and voted down, Kelley said.
"Historically, it's been a hot-button issue in Beatrice," Schuster said.
Fluoride is a hot-button issue nationwide. Despite the fact that many health organizations and agencies have endorsed fluoridating public water systems, many oppose it. The Internet contains plentiful allegations that fluoridated water can lead to cancer, kidney problems, brain and bone disease and other problems.
Battle Creek, Neb., Mayor Matthew Johnson, a community college instructor, said fluoridation is of questionable value. If it was so important, he said, communities wouldn't have an option and towns of fewer than 1,000 would be required to fluoridate, too.
Battle Creek will put it on the November ballot. "If the people don't want it, we're not going to do it," Johnson said. "I will vote no."
Numerous Nebraska communities have voted down fluoridation in the past. Beatrice, Grand Island, North Platte and York have voted against fluoridating more than once.
Yet the federal Centers for Disease Control and Prevention calls fluoridation one of 10 great public health achievements of the 20th century, along with vaccinations and recognition of tobacco as a health hazard.
The American Dental Association has compiled a long list of health groups that endorse fluoridation, including the American Medical Association, American Cancer Society and World Health Organization.
The American Dental Association says fluoridation is "safe and effective in preventing dental decay in both children and adults."
Omaha has fluoridated its water system since 1968, Lincoln since 1970 and Kearney since 1975.
The percentage of Nebraskans served by community water systems who receive adequately fluoridated water -- about 70 percent -- is just above the national percentage. Iowa's percentage is about 92 percent, putting it 13th-highest among states, according to the Centers for Disease Control.
Iowa has no law mandating fluoridation, said Dr. Bob Russell, public health dental director for the State of Iowa. But the Iowa Department of Public Health has staunchly endorsed fluoridating community water supplies since the 1950s, Russell said.
"Iowa just really kind of jumped on board," he said. The State Health Department also helped fund community fluoridation costs with federal money until the late 1990s, he said.
In Atkinson, Neb., the City Council decided in a close vote to fluoridate. Gerard Winings, a councilmen who voted for it, said it will cost the town about $20,000 in equipment, plus modest costs for the chemical.
"It's way cheaper than going to the dentist," Winings said of fluoridating. The American Dental Association estimates that fluoridating water costs about $3 per person annually in small towns, 50 cents per person in cities. Overall, for every $1 spent on it, $38 is saved on dental treatment, the ADA says.
Meeske, the pediatric dentist, said she has treated kids in Omaha, which fluoridates, and in Hastings, which does not, and the dental health of Omaha children is far better.
"Not even close," she said.
The CDC says initial studies of fluoridation found reductions of cavities at 50 percent or more. Now the estimates are 18 to 40 percent because fluoridation, which strengthens enamel, is available from other sources, such as toothpaste.
The notion that fluoride is a poison is silly, Meeske said. The amount of fluoride in the water system should be kept at one part per million, she said, but that allows a big margin for error. Fluoride in huge doses can be harmful. So can huge quantities of water or oxygen, she said.
Dr. Steven Levy, a University of Iowa dentistry professor, said the only genuine concern involving fluoridation is a condition called dental fluorosis, which occasionally stains the teeth.
State Sen. Joel Johnson of Kearney, who introduced the fluoridation legislation, said fluoridation saves money and improves the quality of life.
"I spent many miserable hours in a dentist's chair when I was young," said Johnson, a retired surgeon.
Johnson encouraged communities to weigh the scientific evidence before declining to fluoridate their water systems. "If that's the will of the people," he said, "I guess that's the way it is."
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About fluoride
What is it? Fluoride is a naturally occurring compound that can help prevent dental decay. All water sources contain some fluoride because minerals in rocks and soil contain fluoride compounds. Groundwater usually has a higher concentration of fluoride than surface water.
How does it help with dental health? Fluoride keeps teeth strong and solid by preventing the loss of important minerals from the tooth enamel.
Does bottled water contain optimal levels of fluoride? No.
Fluoridating water
More than 60 years ago, Grand Rapids, Mich., became the first American city to fluoridate its water supply.
Fluoridating water costs about $3 per person annually in small towns, 50 cents per person in cities. For every $1 spent on it, $38 is saved on dental treatment, according to the American Dental Association.
Source: American Dental Association, World-Herald archive