The Oak Bluffs water district has been fluoridating the public water supply since April of 1992, and is the only town on the Island to fluoridate its water supply. But the board of health is considering ending the practice as soon as this summer.
Last month the board voted to set a public hearing to discuss the matter. The hearing will be held on June 10 at 10 a.m. at the town library.
“The general consensus is if you want fluoride, you should be able to get it but you shouldn’t have to have it,” said Patricia Bergeron, chairman of the board.
The discussion about eliminating fluoride was initiated last month by Dr. John Campbell, a chiropractor who is a member of the board. Dr. Campbell said he has received numerous calls from people concerned about the fluoridation of the water supply. Reached this week, he said the board is still gathering information and weighing the pros and cons of fluoridation.
But from what he’s read so far, he believes fluoride is best used topically, he said.
“I will just say that fluoride is most effective by coating and not by ingesting,” Dr. Campbell said.
Island dentists take a different view, calling fluoridation of water a public health success story, proven to prevent tooth decay.
The town voted to fluoridate the water in 1987, although the actual practice began in 1991 with a $32,000 state public health prevention block grant.
Oak Bluffs has 4,225 service connections, making it the largest public water supplier on the Island.
If the board votes to remove the additive, it will join Tisbury and Edgartown, towns that have never fluoridated their public water. Up-Island, water is delivered in private wells and is generally not fluoridated.
Of the 351 municipalities in the commonwealth, 140 fluoridate at least part of their public water supply, roughly 40 per cent.
In Oak Bluffs, sodium fluoride is fed into the water system at each of the four major pumping stations. Fluoride is present at about .8 parts per million, an amount determined by the state Department of Public Health. The water district says fluoridating requires regular sampling and testing of the water supply. The actual powder costs the district about $2,500 per year but there are other significant costs associated with labor, said Kevin Johnson, water district superintendent. He could not estimate the actual cost. But he said he personally feels fluoride should be eliminated.
“If we were to eliminate fluoride, we could take the money that is appointed to fluoride and use it for other things, use it for a better purpose than fluoridation,” Mr. Johnson said. “My feeling has been that not only were we concerned with costs associated with putting fluoride in the water, but we were also concerned with the fact that fluoride can be harmful."
Ms. Bergeron emphasized the board has not made a final decision. “If the public persuades us not to do it, we will definitely consider that,” she said.
“I am going to do some investigation to see what is best for the town,” said board member William White.
Island dentists contacted by the Gazette strongly condoned fluoridation through the water supply, saying it makes it available to those who cannot afford dental care.
“It’s very helpful,” said Dr. Nina Giambro, an Island orthodontist who has authored several articles on fluoride. “It reduces the amount of caries [cavities] in children tremendously.”
She said children do not often brush thoroughly, and fluoride passes through the teeth more easily when it's in liquid form. “Water goes between the teeth easier than just paste, and kids don’t brush that long, so having water flow helps more,” she said. She said the risks associated with fluoride are present only with high dosage, far above the level present in the public water supply.
Dr. Bruce E. Golden, a pediatric dentist in Vineyard Haven, said he regrets not doing more to get the other towns to fluoridate the water.
He said community fluoridation lowers the incidence of cavities in the community by 20 per cent, without even having to go to the dentist.
“It is a very safe and wonderful thing to do and from a public health standpoint, there is not public health measure more effective in the United States than community water fluoridation,” he said. “Oak Bluffs should definitely not take it out.”
He said there are many children from low-income families on Martha’s Vineyard who need fluoride on a daily basis. “They need it because they can’t afford to go to the dentist,” he said.
Fluoride remineralizes the enamel on teeth, making it less soluble to the acids that are produced by the bacteria which digest the leftover food in the mouth.
It also limits bacterial plaque, Dr. Golden said. Still, people who live in Oak Bluffs and drink tap water should not have other sources of fluoride besides toothpaste, he said. Toothpaste is not swallowed.
He said fluoride costs about 75 cents per person in the community per year but much more is saved in dental care costs.
Dr. Garrett Orazem, who has practiced dentistry on the Island for 33 years, concurred with the sentiment that ending fluoridation would be a setback for Island children, especially those whose families cannot afford dental care. “One of the ways to keep them from growing up with an excess of dental health problems is to have fluoride in the public water supply,” he said, adding: “It will simply mean more business for the dentists, more missing teeth, more dentures, and missing front teeth again on the Vineyard."
Dr. Orazem also said water fluoridation has been rigorously researched for safety, and the claims that it presents health risks are unfounded.
“People have been blaming fluoride for unexplainable maladies since they first discovered that it’s useful,” he said.
Tisbury Water Works superintendent Paul Wohler said his department only alters the water by raising its pH level, which prevents the buildup of lead and copper.
Edgartown selectmen considered water fluoridation in the 1960s, but ultimately voted in favor of encouraging fluoride intake in pill form. The Gazette ran a series of stories and editorials backing community fluoridation, sparking impassioned debate on the newspaper’s editorial pages.
“We never wanted to take it on,” said Shane Ben David, chief operator of the Edgartown water system, this week. “It’s just an extra thing that you have to do paperwork for the state, and we didn’t see a need for it.”