Method safely, drastically reduces dental decay rates

In 1944, the city commissioners of Grand Rapids, Mich., took a bold step: They voted to add fluoride to the public water supply. A year later, Grand Rapids became the first city to add fluoride to its drinking water.

How in the world did that happen?

It happened because in 1906 a young dentist came west to start a practice in Colorado Springs. He found townsfolk with ugly brown teeth that were extraordinarily resistant to cavities. He wanted to know why.

It happened because a chemist couldn’t believe the test results and made his assistant repeat them. There was fluoride in the drinking water, and high levels of fluoride at that.

It happened because a bigwig at the National Institutes of Health, intrigued by the apparent protective qualities of fluoride, set out to determine the safe level of fluoride in drinking water.

And finally, it happened because the city commissioners were willing to collaborate with the Public Health Service, the NIH and the Michigan Department of Health in a study to prove that fluoride could safely prevent tooth decay in a city the size of Spokane.

Today, more than 70 percent of American cities with populations over 100,000 fluoridate their public water supplies (Spokane does not). In 2000, 58 percent of Americans drank fluoridated water. Worldwide, more than 200 million people benefit from fluoridation. There now are loads of good-quality scientific data to support the safety and effectiveness of water fluoridation.

Tooth decay is caused by those nasty, but normal, bacteria that live in our mouths. They happily munch on the sugars and carbohydrates that linger in our mouths after a good meal or a drink of soda. The byproduct of that munching is lactic acid, which begins to dissolve tooth enamel and leads to decay.

Fluoride can thwart that process. It inhibits the etching process started by the bacteria and helps remineralize the teeth, so it can reverse the decay process early on. And it reduces acid production by the bacteria. Fluoridated drinking water cuts dental decay rates by 30 to 60 percent.

Unfortunately, we can’t brush or floss away all those nasty germs. When we drink fluoridated water some of that fluoride ends up in our saliva, so our teeth are continually bathed in minute levels of fluoride. Yes, toothpaste is effective, but its benefits depend on how frequently we brush our teeth and the teeth of those we care for. And no amount of brushing or flossing will get rid of all that bacteria-containing plaque.

Those of us who can afford good dental care may be OK without water fluoridation, but just barely. I know I can use all the help I can get to avoid that nasty drill. But there are thousands of us who cannot afford any dental care at all. Some will qualify for public assistance, many won’t. In the short run and long run, we taxpayers spend billions of dollars to subsidize that care.

In a city the size of Spokane, it would cost about 50 cents a year per person to fluoridate our drinking water. Over a lifetime, that doesn’t even equal the cost of one filling.

I’ve heard people who are against fluoridation claim that it’s a conspiracy by the dentists so they’ll make more money. I’ve read on the Web that fluoridation is a mind-control plot. I’ve heard that water fluoridation poisons people. None of this is true. Period.

The American Public Health Association, the Centers for Disease Control, the AMA, the American Academy of Family Practice and the Academy of Pediatrics, along with some 90 other well-respected public health, medical and dental associations, support fluoridation of community water supplies.

We support it because an ounce of prevention is worth billions of dollars in saved health-care costs. We support it because all people, regardless of their income, deserve access to the protective effects of fluoride. We support it because there are 40 years of good science to back us up.

We support it because, public health-wise, it makes good, scientific sense.