York Water Co. neutral as fluoridation debate grips dentists, lawmakers
KATHY STEVENS The York Dispatch
Article Launched: 09/27/2007 10:46:45 AM EDTFamily First Health dental director Dr. James Patsis checks the teeth of Gloria Langs of York...«1»In its 150 years in business, The York Water Co. has not fluoridated one drop of water.
But that is expected to change next year when the county's primary water purveyor begins to serve 1,600 households in West Manheim Township, which earlier this year sold its water system to the company.
If some state lawmakers have their way, the move to fluoridate could be a sign of things to come. More than half of York Water Co.'s customers opposed fluoridation in ongoing surveys the company conducted.
But those residents might not have a say should lawmakers OK a bill that would mandate fluoridation of community water supplies statewide.
Company president and CEO Jeff Osman said he could not speak on behalf of customers surveyed about the issue, but said he assumes they are aware of an
ongoing debate about fluoridation.
Won't join debates: West Manheim Township's water has been fluoridated for decades, and the water company agreed to continue the practice. Osman says the company will not participate in fluoride debates.
"We're in the business of purifying and distributing water. We are not experts in public health," Osman said, adding the company is neutral on the issue. "We look to the experts to make that decision."
The decision could hinge on passage of proposed legislation that cites the Centers for Disease Control and Prevention's claim that community water fluoridation is one of the "10 most significant public health achievements of the 20th century."
Bill supporters say fluoridated public water is the cheapest and most effective method of curbing tooth decay. Through legislation, they aim to mandate fluoridation in community water statewide.
But a faction of dentists, doctors and environmentalists argue fluoridation does more harm than good. In recent weeks, 600 fluoride opponents petitioned Congress to halt fluoridation of public water supplies. Days later, another group filed a formal complaint against the CDC, claiming officials downplayed dangers of fluoridation.
They argue that too much fluoride causes discoloration of the teeth and also causes skeletal fluorosis, which is a bone disease caused by excessive consumption of fluoride via inhalation of dust or heavily fluoridated water. Skeletal fluorosis is problematic in India and China, where the World Health Organization estimates 8.7 million people are afflicted.
Aspirin analogy: Backed by the American Dental Association, the majority of dentists say fluoride opponents are using scare tactics, insufficient data and over-the-top examples to further their cause.
They argue that fluoridation of public water is the best way to combat the growing incidence of tooth decay that ruins smiles and eventually costs thousands to repair.
Aspirin makes a good analogy, says Dr. Craig Pate, director of York Hospital's Dental Center. Take two for a headache, it works; take too many, it will make you sick.
The same is true for fluoride. Pate says water must be tested for naturally existing fluoride before fluoride is added. Optimally, fluoride level should be 0.8 to 1.2 parts per million, according to the CDC. Those levels, he said, should be maintained and can be if water is monitored.
Pate and colleague Dr. James Patsis, dental director for Family First Health, sat recently in a new nine-chair facility on South George Street. They say even with recent additions of low-cost dental centers, low-income and uninsured children will wait on average three months for a dental appointment.
The men said there aren't enough dentists willing to take Medicaid in part because it doesn't cover costs for care. That means children often go without basic dental care such as exams and cleanings.
That's why dental students who've worked in Baltimore, Washington, D.C., and Philadelphia comment about extreme tooth decay of the York County children they examine. Fluoridated water in those areas reduces tooth decay, Pate said.
Pate and Patsis have long worked with patients who have limited access to dental care. They do their best to treat children, but say too often the dental problems are extensive enough to require surgery.
10 patients every morning: Pate says every morning 10 patients await care at the Dental Center, each of them referred the night before from York Hospital's Emergency Department.
"Fluoride is a very effective way to curb the problem," Pate said. "It's just a no-brainer."
Fluoride opponents disagree. They point out that fluoride added to community water is not under the purview of the Food and Drug Administration as is pharmacy-grade fluoride found in toothpaste, oral rinse and tablets.
Fluoride added to water is a byproduct of manufacturing a phosphate fertilizer called fluorsilicic acid. It is stored in cooling ponds prior to being sold and shipped to cities and states nationwide. The U.S. Environmental Protection Agency oversees the storage and transport of this phosphate by-product because it is considered hazardous waste.
That's one reason Dr. Donald Robbins of Exton, Chester County, opposes fluoridation. Robbins has worked in general dentistry since 1975. By 1980, he said he'd begun to see first-hand the effects of fluoride and began to rethink his stance on the standard practice of fluoridated water and fluoride treatments. Robbins is among a few dentists statewide who, along with the other signers, petitioned against water fluoridation.
Excess a problem: He points to studies that note too often infants and children receive one to four times higher fluoride doses than is safe for their body weight. The excess is partly blamed on use of fluoridated water to mix baby formula, powdered milk and other foodstuffs.
The CDC recommends using non-fluoridated water for such uses when given to infants and young children. The high doses cause discoloration of permanent teeth before they break the gum line.
Pate and Patsis revert to the aspirin analogy and reiterate their stance that fluoride's benefits far outweigh risks.
"A lot of individuals just can't afford the care," Patsis said. "Whether parents are really rich, or really poor, with children their feelings are the same: They want their children to be well."
State Rep. Eugene DePasquale supports mandated fluoridation and says he relies on the broad consensus that it is helpful in preventing tooth decay.
"Obviously, you don't want to take too much fluoride," DePasquale said. "The key is trying to find a healthy balance."
-- Reach Kathy Stevens at 505-5437 or kstevens@york dispatch.com.
Dental health professionals advise the public to research fluoridation of community water and provide these online references: www.health.gov/environment/ReviewofFluoride; www.fluoridealert.org. Additional information is available at the Centers for Disease Control and Prevention at www.cdc.gov.