Fluoride
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Web posted Monday, March 15, 2004
City: Fluoride was cut off to clean effluent
Dentists want it back
immediately; City Manager Swope says benefits of chemical additive are
debatable
By TARA SIDOR
The Juneau Public Works Department acknowledges it stopped adding
fluoride to public drinking water months ago without telling local doctors and
dentists, some of whom want it back immediately.
City Manager Rod Swope said he is prepared to keep the fluoride
out until city officials can determine whether the compound commonly used to
prevent tooth decay is causing the leaching of copper in residential pipes.
Public Works has been out of compliance with U.S. Environmental Protection
Agency copper standards for the Mendenhall Wastewater Treatment Plant.
"I think folks are going to have to hang in there with us for
a few months longer until we figure out what's going on here," Swope said.
If fluoride is found to be the problem, he suggested the city may
not restore it to drinking water. That move would give the public a choice, he
said, adding that fluoride benefits are a source of debate among medical
providers nationally.
Public Works turned off the fluoride June 26, 2003, after
reviewing research, Director Joe Buck said. Buck wants to keep the fluoride off
until July to study the effects of copper levels without fluoride in the
drinking water, he said.
But area doctors and dentists want the fluoride back on, saying
patients - especially children - are being deprived of fluoride's benefits.
"Our main position is we just want to see fluoride get back
in the water," said dentist Kristen Schultz, president of the Juneau Dental
Society. "It's just going to be better off for everyone's dental
health."
Schultz plans to send a letter to Mayor Bruce Botelho and the
Juneau Assembly later this week, asking that fluoride be put back in drinking
water.
Meanwhile, doctors and dentists are encouraging patients to take
fluoride supplements daily. This will mean added costs for parents, because
fluoride supplements are available only through prescription, Schultz said.
In response, Fred Meyer is ordering additional quantities of fluoride
supplements, and has put generic tablets on sale for $1.99 per 100 tablets for
1 and 0.5 milligram sizes, said Rob Boley, a spokesman for the retail chain
based in Portland, Ore.
Pediatrician Dr. Amy Dressel sent out a general letter on Friday
telling medical providers to administer fluoride supplements with suggested
dosage amounts.
Dressel tells breast-feeding mothers to drink city water so they
can get fluoride to their babies, she said. She administers fluoride
supplements to children who live at houses with well water. Also, only two
dental providers accept Denali KidCare - a form of Medicaid insurance for
dental care, Dressel said. If
"It's a huge issue because kids need fluoride in their teeth
to grow," Dressel said.
The issue started after the Public Works Department was trying to
find ways to reduce copper levels in the treated wastewater. Copper levels have
not exceeded water quality standards, but have been out of compliance with the
EPA permit at the wastewater plant, Utilities Superintendent Scott Jeffers
said.
Officials were researching ways to lower those levels and found
data that shows fluoride impacts lead pipe systems, Buck said. Public Works has
not found any data showing the impacts of fluoride on copper, he said. That is
why the department wants to conduct a one-year test of whether fluoride causes
the copper in residents' pipes to leach.
"It's a significant enough issue that (the state Department
of Environmental Conservation) and EPA have put limits on how much copper can
go into the
The strict copper standards, set by DEC, are because of the
damaging effects copper has on freshwater aquatic life in the
Copper can kill aquatic life, stunt its growth and cause decreased
fertility, said Rebecca Smith, an environmental specialist at DEC. Copper can
bond to the gills of fish, and cause problems with in chemical balance, she
said.
The copper limit in the EPA permit was set at 8.36 parts per
billion, Jeffers said. Since the city turned off fluoride, copper
concentrations in the treatment plant's effluent have dropped from an average
of 16.7 parts per billion in fiscal year 2003 to 13.9 parts per billion so far
for fiscal year 2004, he said.
Besides shutting off the fluoride, the city is trying to get EPA
to change the copper standards outlined in the permit, Buck said.
If EPA disagrees, Jeffers said the city is prepared to investigate
other water treatment options.
Water fluoridation provides a more frequent exposure of fluoride
to the teeth than topically applied gels, said Brad Whistler, dental officer
with the state Department of Health and Social Services. It costs about 98
cents per person for a community the size of
Community water fluoridation was recognized by the U.S. Centers
for Disease Control and Prevention as one of the top 10 public health
accomplishments of the last century, Whistler said.
Studies have shown a reduction in tooth decay due to water
fluoridation to be as much as 60 percent in baby teeth and 35 percent in
permanent teeth, Whistler said.
Fluoride makes the tooth enamel more resistant to acid production
and promotes repair of enamel after exposure to acids, Whistler said.
Buck said he was not required to notify the medical community but
said, in retrospect, that he should have. Eventually a medical provider noticed
that the fluoride levels were low.
On Friday, Buck sent a letter to health care professionals
notifying them the fluoride had been turned off. He said the drop in copper
levels so far would not be enough to recommend the removal of fluoride from the
system and it may be restored July 1.
Tara Sidor can be reached at tara.sidor@juneauempire.com.