The current round of water fluoridation controversy in the U.S. has reached a crescendo as city councils in two major metropolitan areas voted in favor of the practice in a two-day period.
On September 11, the Phoenix City Council elected to continue its 20 year practice of fluoridating its water, and one day later the city council of Portland, OR, voted to shed the distinction of being the largest U.S. city to abstain from fluoridation.
Milwaukee acted similarly in July when its Common Council directed Milwaukee Water Works to continue fluoridation. And in a general election in November, voters in Wichita, KS, will decide whether the city should begin fluoridation or become the largest continental U.S. city without.
"Today, unanimous 'yes' vote on fluoridation," Portland Mayor Sam Adams announced September 12 on his Facebook page. "One of the nation's most researched -- over a half-century -- public issues ever."
While each city has grappled with its citizenry's respective concerns, vocal antifluoridation advocates have been a consistent driving factor in the debates.
"In the absence of solid information, the issue is too easily swayed by the spin machine of the dental lobby," Paul Connett, PhD, executive director of the Fluoride Action Network (FAN), wrote in an email to DrBicuspid.com. "Phoenix was bad, but it was even worse in Portland. I have just watched the most incredible 'shock and awe' tactics by the spin machine and political operators that have led five councilors (in Portland) to vote this stupid practice in with little consultation with the public and with most of the effort going on behind closed doors."
FAN has doubts about the conclusions stemming from a long history of fluoridation, and takes issue with the way fluoride is distributed without consent from consumers.
"What other drug have we ever delivered through the public water supply?" Connett asked. "None. And for obvious reasons: 1) You cannot control the dose, 2) You cannot control who gets it, and 3) It violates the individual's right to informed consent to medicine."
Adams, who was one of the five unanimous votes in favor of fluoridating Portland's water, was not swayed.
"I do not find Dr. Connett or his organization, Fluoride Action Network, a credible source of information," he wrote in an open letter to Portland citizens. The 11-point letter outlined his support for fluoridation addressed myriad concerns -- from cost-effectiveness and fluorosis risk to fluorides impact on IQ and the taste of water and beer brewed with it -- and cited supporting data from the U.S. Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the World Health Organization, and several research papers.
On August 5, Phoenix hosted a public debate on the issue, where Connett debated Howard Farran, DDS, MBA, a Phoenix dentist who also founded Dentaltown.com. San Diegans for Safe Drinking Water, a fluoride and water additive opposition group, posted videos of the full debate and estimated that the event was attended by more than 700 people.
Ultimately, three Phoenix City Council members voted in favor of ongoing fluoridation, while one abstained. "I can only assume that the councilors who voted for this measure have neither read my book nor watched the Connett-Farran debate," Connett stated. "There was one very significant moment for me in the presentations of the pro-fluoridation lobby that came when Dr. Howard Pollick, who poses as an academic, held up two books: one by the ADA and the other by Freeze and Lehr, The Fluoride Wars. If this man was an objective and balanced observer of this debate, he would also have held up our book, The Case Against Fluoride, but he didn't. But I am sure the councilors thought they were dealing with an impartial expert."
Wichita and Milwaukee
Meanwhile, on August 21, Wichita gave opponents and supporters the opportunity to debate whether the city should adopt fluoridation after 11,333 Wichitans signed a petition in favor of it. A report by Kansas ABC affiliate KSN described the meeting as "heated."
Subsequently, a unanimous vote by the council put the final decision in the hands of voters.
“The decision to put it to a vote was largely based on timeline,” Sara Meng, DDS, a general practioner, co-chair of fluoride advocacy group Wichitans for Healthy Teeth, and current president of the Wichita District Dental Society said in an interview with DrBicuspid. “Had they passed it, the opposition could have had their own petition to overthrow the decision, forcing a special election that would have cost the city money. I think it was a financial decision.”
Council members and Vice Mayor Janet Miller urged voters to educate themselves on the topic and said that voters should be wary of the source of information they received, the KSN article noted.
In response, the Kansas Dental Association has highlighted the "Fluoride Voter Guide," brought forth by Wichitans for Healthy Teeth, the Wichita District Dental Society, the Medical Society of Sedgwick County, the Kansas Academy of Family Physicians, and the Kansas Chapter of American Academy of Pediatrics.
Antifluoridation groups Pure Water for Wichita and Fluoride Free Kansas are drumming up support for their position as well. No formal debate between the opposing groups is currently scheduled.
Dr. Meng noted that the odds appear to be in favor of voters approving fluoridation. “There is overwhelming support for it,” Dr. Meng said. “A local news station, KWCH, ran what they termed a 'scientific poll,' which showed a 2-1 swing in favor of it.”
Unlike in Portland and Phoenix, Wichita Mayor Carl Brewer and the city council have opted for a more neutral approach to the issue. "A public meeting took place at a city council meeting and the council decided then to put it in the hands of the people," Virdena Gilkey, executive assistant to the mayor and city council, told DrBicuspid.com. "The mayor and council's position will be voiced though the citizens come November."
When asked if Wichita was supplying the public with information about fluoridation, Gilkey said, "There has been no release of information from the office of the mayor. The council meeting heard voices both pro and con. But they're not making a statement on either side of the debate."
And in May of this year, Milwaukee Alderman Jim Bohl started an intense debate over fluoridation when he revealed his intention to introduce legislation to end the city's water fluoridation program. The matter was settled July 24 with legislation lowering the city's fluoridation levels from 1.1 parts per million (ppm) to 0.7 ppm, the new proposed recommendation from the U.S. Department of Health and Human Services.
The legislation also directed the Milwaukee Health Department to inform parents of infants younger than 6 months old of the "increased chance of mild dental fluorosis if the child is exclusively consuming infant formula reconstituted with fluoridated water."