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Letter: Problems With Municipal Fluoridation

To the Editor:

The use of systemic fluoride is recommended for children between the ages of 6 months and approximately 12 years of age to reduce the prevalence of dental decay. It does provide this benefit. Systemic fluoride can be provided in two ways: as a chemical carried in a municipal water supply or in tablet or liquid form as an adjunct to an oral multi-vitamin or a stand-alone tablet. The proper daily dosage in fluoride liquid or a pill provides the most predictable benefit to the target population.

Fluoride in a water supply is less effective because consistent intake at the same time every day and at the proper dosage is seldom if ever achieved. Children do not drink (town) water at the same time each day, nor even the same amount during various seasons of the year. There is no way to ensure that an appropriate and consistent “dosage” of fluoride from a municipal water system is consumed at regular intervals. Fluoride is not recommended for infants under the age of 6 months. The dosage then varies from a child between 6 months and approximately 2 years of age, and again changes after age 2. After age 12, there is no dental benefit derived from ingesting fluoride.

Fluoridating an entire town’s water supply and monitoring fluoride levels is an expensive delivery system for a relatively small number of beneficiaries. The topical application from fluoride rinses and toothpaste has a different chemistry of action and is of benefit to a wider age population. Fluoride in a municipal water supply is chemically combined in one of three compounds: silocofluorides, flurosilic acid, or sodium fluorsilicate. When silocofluoride is used, two toxic neurological effects were reported, according to research (see Coplan, Patch, Masters & Bachman, September 2007). One effect increased blood levels of lead by dissolving the lead solder used in old piping and plumbing.

The most reliable and effective way to benefit from fluoride’s decay-preventing property is to obtain a prescription from an appropriate health-care provider and comply with the directions. This will ensure that the expected benefit is provided to the appropriate age group. If a family is on well water and wants to give their child fluoride tablets, it is recommended that a water sample be sent to the state of Vermont to determine baseline fluoride levels, if any. The appropriate dosage can then be calculated. Fluoridating a town’s water supply to reduce dental decay is a shot-gun approach and not based on current knowledge about administering medications effectively to those who will benefit.

James Gold, D.D.S.

Norwich