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Who Knows

• Lewis Lampiris, D.D.S.
• Rep. Glenn Donnelson (UT)

An interview with Lewis Lampiris, D.D.S., Chair of the Fluoride Committee of the Association of State and Territorial Dental Directors.

In the field of public health, our goal is primary prevention-preventing disease before it happens. That is what community water fluoridation does from a public health perspective. It prevents disease before it happens. You don't get any better than that. As a public health professional and as a dentist, I strongly feel that preventing dental decay serves the common good. That is what community water fluoridation does-serves the common good. Particularly from my perspective as a public health practitioner, I feel it is the way to go.

I feel it should be done at the state level. In Illinois, we chose in 1967 to handle the question of reducing dental decay at the state level with a mandatory law. I think that is the best way to handle this issue. A state tends to be more immune to many of the emotional charges that are brought to the table by the anti-fluoridationists. A state has a greater capacity to garner the expert opinions necessary to develop policies that protect the health and safety of residents. I believe that it is part of the state's mandate to protect the health and safety of its residents.

Community water fluoridation does not damage health, it improves health. It improves dental health. Legislators continue to struggle with the issue of access to oral health services. They must consider in their deliberations that community water fluoridation benefits everyone in the community, both those who do and those who do not have access to benefits. Another counterpoint for legislators would be that reputable public health entities in the United States-the CDC, the Public Health Service, the Surgeon General-all support community water fluoridation.

There is absolutely no difference, despite what you might read on the Internet, between the different fluoride compounds-the acid versus the sodium fluoride or the silicofluorides versus the sodium fluorides.

I would recommend to state legislators that they work with their medical, dental and public health communities to make community water fluoridation available to everyone in their state. It is certainly not surprising that differences of opinion between scientists and professionals in research and medicine occur, but what you have here is near universal agreement on the safety and effectiveness of community water fluoridation. It is certainly the one thing a state can do to assure the dental health of its children.

An interview with Representative Glenn Donnelson of Utah.

All three areas are of great concern. However, my position places public health as a top priority. Most people do not realize that fluoride chemicals placed in water are not the same as those in toothpastes, mouth rinses and topical gels. More than 90 percent of chemicals used to fluoridate water in the United States come from the superphosphate fertilizer industry and are classified by the EPA as hazardous wastes. The FDA has never approved fluoride for safety or effectiveness. When a chemical is added to the public water supply for treatment or prevention of disease, it must have an approved health claim by the FDA.

The EPA has jurisdiction over chemicals to make water potable. The EPA has absolutely no jurisdiction in treating people. It is interesting that when the town of Wasilla, Alaska, chose to halt water fluoridation in 1984 it was told not to give away the remaining fluoride to a neighboring town, because it would be considered hazardous waste under EPA rules. The same rules, however, allowed the town to sell its remaining fluoride as a product. My question is why? It does not make sense!

Fluoridation issues will always concern the health, safety and welfare of the public. This is best dealt with by individual communities. However, the state must require that any substance added to water supplies for treating people, rather than for treating water, have FDA approval.

In Utah, the claim of low cost has proven incorrect. Before voting on the issue in November 2000, advocates claimed that fluoridation would cost less than 50 cents per family, per year. As of October 2002, the cost in Centerville alone will be $7.89 per person, per year. There are no long-term oral health benefits with fluoridation. States are reporting a "dental crisis," but in a March 2002 Oral Health America report, the two least-fluoridated states (Hawaii & Utah) were awarded the highest grade for oral health in the nation.

My recommendation is to add no chemical, fluorides or otherwise, to the public water supply for the intended purpose of preventing a disease unless that chemical has FDA approval as both safe and effective for its health claim. Also, I would suggest that other state legislators look at the full range of considerations-health and cost, moral and ethical, efficacy and safety-and insist on public debate. The more people learn about fluoridation, the more they will realize the only thing supporting it is its endorsements.

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