[Insert date here]
[Name of Public Official]
[Agency, Council or Governing Body]
[Street Address]
[City / State / Zip Code]
Dear ______:
I am writing to express concern about a proposal that would end water fluoridation in [state/city/community]. Our organization is deeply concerned about the negative impact that such a proposal would have on the health of children and adults.
Although dental health has improved for many Americans in recent decades, tooth decay remains the most common chronic childhood disease—five times more prevalent than asthma.[1] Untreated tooth decay can undermine children’s ability to sleep, grow and learn. The ultimate impact can last for many years by hurting their ability to find jobs as adults. Decay and other dental problems can cause a person’s overall health to suffer.
As you may know, fluoride exists naturally in water. Fluoridation is simply the process of adjusting fluoride to the optimal level to prevent tooth decay. Fluoride counteracts tooth decay and strengthens teeth by fighting harmful acids and drawing calcium back into the enamel. Drinking water is an ideal vehicle for fluoride because it offers these benefits without requiring families to spend extra money or change their routine. Studies show that fluoridation reduces tooth decay by an average of 29 percent.[2] People of all ages benefit from drinking fluoridated water.
The proposal to stop fluoridating our water supply is informed by inaccurate and misleading information. Much of this unreliable information comes from a handful of websites. A 2012 New York Times report demonstrated that conspiracy theories about fluoridation “now thrive online, where anyone, with a little help from Google, can suddenly become a medical authority.”[3] The nation’s medical and health experts endorse water fluoridation.
The American Academy of Pediatrics, American Dental Association, Mayo Clinic, American Medical Association, and many other respected medical or health organizations recognize the health benefits of fluoridation. [4], [5], [6], [7] The U.S. Centers for Disease Control and Prevention called water fluoridation one of “10 great public health achievements of the 20th century.”[8]
The safety concerns raised by anti-fluoride groups ignore or misrepresent the science evidence. Here are two examples:
· Fluoride opponents often cite a 2006 report by the National Research Council (NRC) to purport that fluoridated water is dangerous. The focus of the NRC report was on people living in areas of the U.S. with natural levels of fluoride in water that are at least double or triple the level used to fluoridate a public water system. Nothing in the NRC report casts doubt on the safety of fluoride at the recommended optimal level.[9] The NRC explicitly stated that its concerns “do not apply at the lower water fluoride levels commonly experienced by most U.S. citizens.”[10]
· Opponents claim that fluorosis is a reason to oppose water fluoridation.[11] Fluorosis is a change in the appearance of the tooth enamel that occurs when children consume too much fluoride. Nearly all fluorosis in the U.S. is a mild, cosmetic condition that leaves faint white streaks on teeth. Mild fluorosis is so subtle that only a dentist is likely to identify it, and it does not cause pain and does not affect the health or function of the teeth. Dental fluorosis occurs among some people in all communities, even those that do not fluoridate their local water systems.[12] Experts believe that the main reason for fluorosis is that some young children swallow fluoride toothpaste,[13], [14], [15] which contains a higher concentration of than the level in water.[16] A study published in 2010 found that mild fluorosis was not an adverse health condition.[17]
As the U.S. Centers for Disease Control and Prevention notes, “For many years, panels of experts from different health and scientific fields have provided strong evidence that water fluoridation is safe and effective.”[18]
In these tough fiscal times, cities and states are increasingly looking for policies or programs that save money. Research shows that water fluoridation offers perhaps the greatest return-on-investment of any public health strategy. The reduction in just the costs of filling and extracting diseased teeth—not counting reductions in lost work time and dental pain—more than covers the cost of fluoridation. Consider these facts:
· For most cities, every $1 invested in water fluoridation saves $38 in dental treatment costs.[19]
· A 2010 study in New York State found that Medicaid enrollees in less fluoridated counties needed 33 percent more extractions and other corrective procedures than those in counties that were predominantly fluoridated.[20]
· Researchers estimated that in 2003 Colorado saved nearly $149 million in unnecessary costs by fluoridating public water supplies—average savings of roughly $61 per person.[21]
· By protecting the enamel of teeth, fluoridation makes it less likely that decay will develop into more serious dental problems that drive people to hospital emergency rooms (ERs)—where treatment costs are high. A 2010 survey of hospitals in Washington State found that dental disorders were the leading reason why uninsured patients visited ERs.[22]
Before you vote on a proposal to back-track on water fluoridation, we urge you to carefully consider the solid evidence that supports continued fluoridation. Please do not deprive children and adults in our community of a practice that has been documented repeatedly to improve health.
Sincerely,
[insert signature]
[Name / title]
[Your organization]
Sources
[1] Oral Health—Preventing Cavities, Gum Disease, Tooth Loss, and Oral Cancers: At A Glance 2010. U.S. Centers for Disease Control and Prevention website. 2010. http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm. Accessed November 21, 2014.
[2] The children who experienced this reduction in the median decay rate were aged 4 to 17. See: Preventing Dental Caries: Community Water Fluoridation. U.S. Task Force on Community Preventive Services website. 2013. http://www.thecommunityguide.org/oral/fluoridation.html. Accessed November 21, 2014.
[3] Zernike K. In New Jersey, a Battle Over a Fluoridation Bill, and the Facts. New York Times. 2012. http://www.nytimes.com/2012/03/03/nyregion/in-new-jersey-a-battle-over-fluoridation-and-the-facts.html?pagewanted=all&_r=0. Accessed November 21, 2014.
[4] Campaign for Dental Health Project. In Their Own Words: What Respected Organizations Say about the Safety and Effectiveness of Community Water Fluoridation. http://www.ilikemyteeth.org/wp-content/uploads/2011/03/RespectedOrgs-noPics_v2a.pdf. Accessed November 21, 2014.
[5] American Academy of Pediatrics Section on Pediatric Dentistry and Oral Health. Preventive oral health intervention for pediatricians. Pediatrics. 2008;122(6):1387-1394. http://pediatrics.aappublications.org/content/122/6/1387.full.pdf+html. Accessed November 21, 2014.
[6] Fluoride & Fluoridation. American Dental Association website. http://www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation. Accessed November 21, 2014.
[7] Diseased and Conditions—Cavities/Tooth Decay. Mayo Clinic website. 2014. http://www.mayoclinic.com/health/cavities/ds00896/dsection=prevention. Accessed November 21, 2014.
[8] U.S. Centers for Disease Control and Prevention. Ten Great Public Health Achievements – United States, 1900-1999. Morbidity and Mortality Weekly Report. 1999;48(12):241-243. http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm. Accessed November 21, 2014.
[9] National Research Council. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards,” Report in Brief. http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/fluoride_brief_final.pdf. Accessed November 21, 2014.
[10] National Research Council. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards,” Report in Brief. http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/fluoride_brief_final.pdf. Accessed November 21, 2014.
[11] New York State Coalition Opposed to Fluoridation. Top 20 Fluoride News Stories of 2011. 2012. http://www.prnewswire.com/news-releases/top-20-fluoride-news-stories-of-2011-138488989.html. Accessed November 21, 2014.
[12] Community Water Fluoridation: Safety. U.S. Centers for Disease Control and Prevention website. http://www.cdc.gov/fluoridation/safety/index.htm. Accessed November 21, 2014.
[13] Martin TW. Government Advises Less Fluoride in Water. The Wall Street Journal. 2011. http://online.wsj.com/article/SB10001424052748704739504576068162146159004.html;
[14] Micronutrient Information Center: Fluoride. Linus Pauling Institute, Oregon State University website. http://lpi.oregonstate.edu/infocenter/minerals/fluoride/. Accessed November 21, 2014.
[15] Roumeliotis P. The Facts: The Benefits of Fluoridation. Eastern Ontario Health Unit. 2011. http://www.eohu.ca/_files/resources/resource1355.pdf. Accessed November 21, 2014.
[16] Can Fluoride Help Adults? Colgate website. 2012. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-at-Any-Age/Adults/Adult-Maintenance-and-Care/article/Can-Fluoride-Help-Adults.cvsp. Accessed November 21, 2014.
[17] American Dental Association. Substantial Consumption of Fluoride Increases Chance of Mild Fluorosis. 2010. http://www.prnewswire.com/news-releases/substantial-consumption-of-fluoride-increases-chance-of-mild-fluorosis-105707873.html. Accessed November 21, 2014.
[18] Community Water Fluoridation: Safety. U.S. Centers for Disease Control and Prevention website. http://www.cdc.gov/fluoridation/safety/index.htm. Accessed November 21, 2014.
[19] Cost Savings of Community Water Fluoridation. U.S. Centers for Disease Control and Prevention website. http://www.cdc.gov/fluoridation/factsheets/cost.htm. Accessed November 21, 2014.
[20] Kumar JV,Adekugbe O, Melnik TA. Geographic Variation in Medicaid Claims for Dental Procedures in New York State: Role of Fluoridation Under Contemporary Conditions. Public Health Reports. 2010;125(5):647-54. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925000/. Accessed November 21, 2014.
[21] Brunson D, O’Connell JM, Anselmo T, Sullivan PW. Costs and Savings Associated With Community Water Fluoridation Programs in Colorado. Preventing Chronic Disease. 2005;2(Spec No):A06. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459459/. Accessed November 21, 2014.
[22] Washington State Hospital Association. Emergency Room Use. 2010. http://www.wsha.org/files/127/ERreport.pdf. Accessed November 21, 2014.