Neither side budging in fluoride debate

Mount Pleasant citizens have drank fluoridated water since the 1950s because the American Dental Association found fluoride to be beneficial, according to one city official.
"It was found to benefit people's teeth," said Malcolm Fox, superintendent of the city's water treatment plant, 4195 S. Lincoln Road. "It has high benefits and very low risks."
In February of 1956, the Mount Pleasant City Commission suggested a proposed ordinance to institute a fluoridation program. The proposal met with opposition from some city residents who then filed a petition to get an ordinance prohibiting the use of fluoride in public-drinking water.
The issue was put on the ballot for the Nov. 6, 1956 election, was voted down and the fluoride program was instituted.
Fluoridation of a water supply involves adjusting the level of fluoride, either increasing or decreasing the level. Fox said the naturally occurring level of fluoride in the Mount Pleasant water supply is 0.4 milligrams per liter.
Fluoride is added to reach 1.0 mg/liter, the level recommended by the Environmental Protection Agency to provide optimal dental protection. The EPA considers levels up to 4 mg/liter to be protective against crippling skeletal fluorosis.
According to the International Society for Fluoride Research's Web site, fluoride-journal.com, dental fluorosis is a disorder of enamel-forming cells, is irreversible and only occurs with exposure to fluoride when enamel is developing.
Signs of dental fluorosis include white specks or blotches, yellowish-brown spots or brown pits on teeth. In its more severe form, fluorosed enamel is structurally weak and prone to erosion and breakage, especially when drilled and filled.
According to the Web site, skeletal fluorosis is a chronic metabolic bone and joint disease caused by ingesting large amounts of fluoride either through water or through some foods.
Age, sex, calcium intake in the diet, dose and duration of fluoride intake are some factors that influence skeletal fluorosis. Bone-density measurement is a tool for early diagnosis.
According to the World Health Organization's Web site, www.who.org., skeletal fluorosis, with adverse changes in bone structure, is observed when drinking water contains 3-6 mg of fluoride per liter, while crippling skeletal fluorosis develops where drinking water contains over 10 mg of fluoride per liter.
According to the site, fluoride is excreted via urine, feces and sweat.
But some Mount Pleasant residents allege that expert certifications don't tell the whole story about fluoride.
A group of concerned citizens, called the Central Michigan Citizens Opposed to Water Fluoridation, worked to bring the issue to local voters in Mount Pleasant's 1997 general election. Voters supported fluoridation and it has remained in the drinking water.
According to the EPA, 10 states, require fluoridation of public-water supplies that serve communities with populations greater than 5,000. Fluoridation is decided by city in the rest of the states, including Michigan.
Mount Pleasant resident Alan Gamble, member of the citizen's group, said the group is still intact.
He said fluoride accumulates in bones and teeth overtime and leads to skeletal and dental fluorosis, despite EPA's standards, which conclude that 1 mg/liter is beneficial.
"Fluoride is a very potent poison, more so than lead and only slightly less than arsenic," Gamble said. "It replaces calcium in the bones, and it makes the teeth so hard that they get brittle."
Calcium serves as a softener, but fluoride replaces the calcium, he said.
The citizens group may try to put the fluoridation issue on a future Mount Pleasant ballot, he said.
"The dental community actively opposing it last time was too powerful."
Gladys Mitchell, also a member of the citizen's group, said local dentists appeared via radio stations before the 1997 election to tell people not to remove fluoride from the drinking water.
"We don't have the money to combat that effort," Mitchell said.
She also said she uses non-fluoridated toothpaste from Greentree Co-operative Inc., 214 N. Franklin St., or baking soda rather than fluoride-laden toothpastes.
Gamble said he drinks water that has gone through a reverse osmosis filter rather than unfiltered tap water. Fluoride can be removed by reverse osmosis or by distillation, but not through a standard carbon-water filter.
Fluoride is actually a chemical found in compounds, said CMU chemistry Professor Calvin Tormanen. He said the compound added to Mount Pleasant's water isn't fluoride, but hydrofluosilicicacid, which contains fluoride.
The compound breaks down in the water to form fluoride. The compound is a waste by-product from the phosphate fertilizer mining industry, which manufactures fertilizer, and from aluminum manufacturers, Tormanen said.
Hydrofluosilicicacid is too toxic to be released in the environment, so chemical companies separate and purify it and then sell it to communities for their drinking water, he said.
"Why not just put fluoride in the water? It's too difficult to do," Tormanen said. "By releasing hydrofluosilicicacid, the right amount of fluoride can be added very accurately. Because it's a waste product, it does not cost very much. Mount Pleasant isn't the only city that uses it. It's done nationwide."
The water-treatment plant offers annual competitive bids to chemical suppliers for the compound, Fox said. Mount Pleasant receives its hydrofluosilicicacid from KC Industries, based in Mulberry, Fla.
The compound is stored in a 5,000-gallon tank at the Mount Pleasant plant. This amount lasts between one and two years, Fox said.
He said the price of the compound depends on each bid, but 5,000 gallons generally cost between $2,000 and $3,000, or about 25 to 35 cents per person.
A 41-gallon tank attached to the larger tank is used in releasing the compound into the water supply. The small tank assures that if an overflow amount occurred it would not be harmful, he said.
State requirements of fluoride are the same as federal criteria, or the EPA-approved level, because the Michigan Department of Environmental Quality enforces the EPA requirements at the state level.
Mount Pleasant's water is ground water, which is replenished by the Chippewa River. The treatment plant softens, filters and disinfects the water for its customers.
The plant, which began service in 1995, is financed through user fees, Fox said. Water sales generate revenue needed to operate, so no public taxes are used.
Bob London, a professional engineer for MDEQ's Saginaw Bay District Office, said the department visited Mount Pleasant's water treatment plant in March to test procedures for adding and measuring fluoride in the water.
"We brought them two water samples. We didn't tell them the fluoride content in them," London said. "They ran the samples through tests and confirmed for us the amounts of fluoride in them."
"We passed with flying colors," Fox said. "We don't take waste. We only take American Water Works Association and EPA-approved chemicals. And we don't make money by taking any waste. That's illegal and unethical to buy waste and put it in the water."
London said, "The public-health folks in our department looks at both sides of the issues and still promote fluoride for dental health. We don't see the negative effects of fluoride as being a reason to remove it from drinking water."
Dr. Susan Smolinske, managing director for the Poison Control Center at Children's Hospital of Michigan in Detroit, said amounts of fluoride above the EPA-approved level can be harmful.
For example, a warning on the back of a tube of Colgate toothpaste containing fluoride reads: "If you accidentally swallow more than used for brushing seek professional help or contact a poison control center immediately."
"There is much more fluoride in one gram of toothpaste than in a cup of drinking water," Smolinske said.
Some foods with high amounts of fluoride can cause dental fluorosis or staining of the teeth, Smolinske said.
"But these things will not occur with ordinary consumption of water," she said.
Mineral water and herbal teas also have very high concentrations of fluoride, she said, and people are more at risk from drinking these than from consuming fluoridated water.
Fluoride is "great for the dental health of our children, and it is the primary reason why kids today are not having the number of cavities that we had growing up. It's very good for bones and for teeth," Smolinske said.
Virtually all foodstuffs and vegetation contain at least traces of fluoride. Foods with high levels include fish (0.1-30 mg/kg) and dry tea (3-300 mg/kg), with an average for the tea at 100 mg/kg.
Fox said the Mount Pleasant water-treatment plant would not do anything to put the public-drinking water in danger.
"We don't have to soften the water, or remove the iron, but we do. We have an obligation to be concerned about the public health," he said. "My kids drink this water, and I drink it. I'm not going to do anything to hurt them, or my customers or myself."
But Gamble said the effects of fluoridation are accumulative.
"Is one less cavity worth a hip fracture 40 years from now?" he asked.
Fluoridation of public water in the United States began on Jan. 25, 1945 in Grand Rapids in a U.S. Public Health Service experiment. The city was the test site for the effectiveness of fluoridation while Muskegon served as the control city, or the city without fluoridation.
The health service's aim was to track cavities and report a dramatic decrease of tooth decay in the fluoridated cities. The experiment was aborted five years early with the agency's endorsement of fluoridation in 1950.
Evidence on a decrease in tooth decay was unavailable.