Dentists speak in support of fluoride

By ANNE KAZMIERCZAK and SUSAN LYNN
Register Reporters

Humboldt citizens have before them mail-in ballots to determine whether the city should add fluoride to its public water system.
Register reporters interviewed Iola dentists and other health care professionals on their opinions as to whether fluoride is safe or beneficial to the development of teeth. Iola has fluoridated its water supply since 1951.
“Fluoride helps make enamel more dense and decay-resistant,” said Iola dentist Vernon Lee when asked why the material is added to drinking water supplies in many cities in the United States.
Fluoride works by strengthening enamel and helping it remineralize. At recommended doses, Lee said, “I’ve never seen any negative effect I would attribute to fluoride use in Iola.” He has practiced dentistry here since 1970.
“When it’s used in the amounts proposed, it’s beneficial and doesn’t cause any harm,” Lee said. Proposed amounts are around 1 part fluoride per million parts of water. The EPA allows a maximum of 4 ppm in municipal drinking water supplies.
In response to suggestions that fluoride will cause discoloration of teeth or arthritis or bone irregularities, Lee said those arguments are presuming consumption of excessive amounts. “Most things used to excess will cause problems, so that’s not a real relevant argument,” he said.
“For children, it’s very beneficial to have topical fluoride applied when the teeth are cleaned,” Lee said.

DR. KELLY Richardson, of the Community Health Center of Southeast Kansas, agrees. She sees patients on a sliding fee scale. Many of her patients are from Humboldt.
Of those, “most have cavities,” she said. “I’ve seen families where the older children were raised in communities with fluoridated water, and the younger children are not, and the younger children definitely had more cavities.”
Richardson said three components are present when teeth decay: bacteria that cause the decay, an environment containing sugar, and a host that is susceptible to the effects of the decay-causing bacteria.
Fluoridated water washes the teeth, removing sugar, and helps remineralize the tooth surface.
“The fluoride makes enamel stronger so it can resist the formation of caries more,” Richardson said. “It makes the host stronger.”
Richardson agrees that there are no negative effects from water fluoridated to amounts set by the EPA . “The dose they want to put in is very small,” she said. “It really helps with teeth that are still forming.”
It also helps adults combat tooth decay, she said, but the amount in water alone isn’t enough. Using “fluoridated toothpaste or topical fluoride” is important for adults, she said.
Richardson hopes parents and other adults will consider the children when they vote in Humboldt.
“It especially makes a difference in kids, and they don’t have a choice.”

DR. JOHN Travers, an Iola dentist for more than 30 years, said he could “unequivocally” attest to seeing more tooth decay in children from the Humboldt area compared to children from Iola.
“This simple fact has reinforced everything I’ve ever learned about fluoride,” Travers said. Before attending dental school at the University of Missouri at Kansas City, Travers earned a degree in chemistry.
The important time for building strong teeth is long — from six months to 16 years, Travers said.
“By age nine, teeth have finished enamalizing,” the process of building good protection on teeth.
Many things in today’s world prevent children from getting adequate fluoride, including the prevalence of drinking bottled water, juices and soft drinks — all of which lack fluoride.
“I encourage all mothers to use fluoridated tap water when making formula for their babies,” Travers said. “It’s the best thing you can do for their developing teeth.”
Fluoride supplements are “a hassle,” Travers said, much like remembering to take any kind of vitamin. For infants, liquid fluoride can be added to formula with a dropper. For older children, sodium fluoride chewable tablets and pills are available.
“We’ve found that the cooperation by families to faithfully take these supplements is minimal,” he said. “But if it’s in the drinking water, it’s so easy to get the necessary protection.”
To grow stronger teeth, Travers recommended that infants get up to one pint of fluoridated water a day; those older, one quart.
“Since 1934, fluoridated water has been investigated over and over again. And every time it’s been determined that it helps prevent tooth decay by 30 to 50 percent over untreated water,” Travers said.
Jim Bauer, a pharmacist with Iola Pharmacy, said in a year’s time only three prescriptions have been filled for fluoride supplements.
“We don’t see it a lot,” Bauer said of requests for fluoride supplements. “It’s not expensive, but also not common.”
Dr. Moncy Matthew, clinical assistant professor at the University of Missouri School of Dentistry, the only school of dentistry for both Kansas and Missouri, said new guidelines for fluoride suggest that fluoride for infants begin at the age of 1 to guard against low-weight infants from receiving more than the recommended dosage.
“This debate has been going on since 1940,” Matthew said. In quoting a colleague, Matthew said, “If one ounce of what the critics say is true, then the streets would be littered with corpses.”
Sixty-five percent of U.S. cities fluoridate their public water systems, Matthew said, to no ill effect.

DR. KATHY Weno, a dentist and Oral Health Director with the Kansas Department of Health and Environment, said opponents to fluoridation often cite studies done with animals and not humans.
Such research is not supported by professional peers, Weno said, and is misleading to the public.
Fluoridating a public water supply also is cost-effective, Weno said.
“For Humboldt, fluoridation would cost 85 cents per person, per year,” she said. “Compare that to the typical cost of $150 for one filling due to a cavity.”
“Fluoride is not a toxic substance,” she said. “We have 60 years of evidence to prove it helps build strong teeth and prevent cavities.”

IN A LETTER to Humboldt citizens, 24 area physicians and dentists endorsed fluoridated water and urged its passage in this month’s vote.