Fluoride fears inhibit city’s dental health

For once I glanced at the furrow in my dentist’s brow and felt relieved – this time it wasn’t my own personal molars that were causing her to frown.

A member of Spokane County’s Oral Health Coalition, Dr. Janine Johnson, met me for a glass of iced tea recently to describe instead the miserable state of Spokane’s dental health.

In July the Centers for Disease Control announced that nearly 70 percent of Americans on community water systems now drink fluoridated water. The CDC called fluoridation “one of the 10 great public health achievements of the 20th century.”

Meanwhile, back in Spokane, even though it’s now the 21st century, we still haven’t fluoridated our water. And last spring Men’s Health magazine ranked Spokane 98th out of 100 U.S. cities for its poor dental health, just after Lubbock, Texas, and Philadelphia. Too few of us saw a dentist last year or flossed our teeth. Too many of us had our permanent teeth pulled. And none of us could drink fluoridated city water.

We’ve let paranoia and a fear of controversy overrule sound science. It’s been a costly error. In 2006 alone Washington paid a whopping $109.7 million in state and federal dollars for dental care for people who can’t afford it.

Last year new laws and strong leaders brought fluoridated water to millions more California residents. But in Spokane, we’ve been held captive by anti-fluoridation groups who rely on anecdotes and weak research. We’ve ignored the considerably more valid scientific evidence that has so impressed both the American Dental Association and the Centers for Disease Control.

Back in the 1930s, dentists noticed that children who drank naturally fluoridated water had less tooth decay. The best researchers have since concluded that not only is water with optimal levels of fluoride perfectly safe to drink, it reduces childhood decay by 20 to 40 percent, even though fluoride toothpastes are now widely available. The benefits to adults continue to accrue over a lifetime.

Of course, my dentist notes, it’s easy for anti-fluoridation advocates to pass around scary stories and junk science when they’ve never set foot behind a dentist’s chair.

“They’re not dentists; they aren’t doctors,” Johnson says. “They’re not going in the office and seeing people’s teeth every day.”

She is. Her stories are enough to make you hop out of bed in the middle of the night to grab the fluoride gel.

She’s seen many mouths that have suffered from too much paranoia and too little preventative care. City water naturally contains small amounts of dissolved minerals, which are now labeled as contaminants. Johnson believes that label unnecessarily alarms parents.

One couple brought their 4-year-old into her office. They were so worried about the quality of the local tap water (even though Spokane’s is especially safe) that they fed their son only sugar-filled Pepsi instead.

The preschooler’s teeth were so rotted that he had to be hospitalized, costing taxpayers at least $4,000. And the boy wound up needing every tooth covered by a stainless steel crown.

The strongest argument Johnson’s heard against fluoridation has been that it takes away personal choice.

But, she argues, that one’s a fallacy, too.

Some communities install a public tap for unfluoridated water. Rural homeowners often dig their own wells; others can buy inexpensive distillers or filters if they prefer their water without fluoride.

Besides, the amount of fluoride Spokane’s drinking water needs is minuscule, around 0.9 parts per million. Most toothpastes, Johnson says, contain 1,000 parts per million of fluoride.

My dentist has made a number of convincing arguments over the years, most them of them regarding the use of braided dental floss and a Sonicare. But she’s saved her best, it seems, for the sake of the community’s dental health.

She points out that while taxpayers balked at spending $2.5 million four years ago to bring fluoride to Spokane’s drinking water, they’ve since spent that amount on replacing a tramway with a new gondola ride at Riverfront Park. Now Spokane County plans to spend $4.4 million to buy a racetrack.

“We might want to value fluoridation as much as we do gondola repair or racetracks,” Johnson says.

On Aug. 13 the University of Washington’s Dental School will begin training eight dental students at Spokane’s Riverpoint Center. This new program is designed to lure young dentists into Eastern Washington where they can serve more rural and low-income patients.

If we stay on the same path in this community, they’ll have plenty of work to do.

We’d better hope they ace their training. Because, when it comes to dental health, we as a community are flunking.