October 26, 2000

On the Ballot: Personal Choice or Public Health

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This election year, Cornell students will not only vote in a new U.S. President but will also have a chance to decide upon an important local issue, one that had been a focal point of controversy decades ago and that has resurfaced in recent years.

The debate surrounding water fluoridation in the City of Ithaca will be decided by public referendum on the Election Ballot as proposals number two and three. Currently, the Ithaca municipal water supply is not fluoridated. Proponents of the proposition, however, including area dentists and public health officials, are seeking to change this on Nov. 7.

Supporters of water fluoridation are seeking to raise the level of fluoride in water from 0.2 parts per million (ppm) to a more therapeutic level of 0.7 to 1.2 ppm, said Dr. John C. Comisi, a dentist in the Ithaca area and proponent of fluoridation.

62 percent of the United States population drinks fluoridated water, according to Comisi. Fluoride is the 17th most common element in the Earth’s crust and found in many foods and beverages. Scientific studies have implicated fluoride as an agent which significantly reduces incidences of cavities and tooth decay.

The Controversy and its History

Supporters of water fluoridation are seeking to raise the fluoride concentration to a therapeutic level. This will effectively reduce the need for fluoride supplements and, as a public health measure, will increase the quality of life of an Ithaca resident, according to Comisi.

Public health officials have increasingly stressed fluoridation as an inexpensive measure to prevent tooth decay.

“Most of the Cornell community comes from outside areas with fluoridated water and after a few years in Ithaca, develop cavities, teeth problems, and require a root canal,” he said. “They may never have had a cavity in their life until they came to Ithaca.”

However, opponents of fluoridation cite numerous problems with the process and its implications on a person’s health. “When fluoride is induced in the body, it is a potent enzyme that affects most of the biological processes in the body,” said Prof. Lennart Krook, emeritus, College of Veterinary Medicine.

In November 1965, Ithacans voted in favor of the city charter amendment prohibiting Common Council from fluoridating the water. As interest in this controversial topic has grown over the subsequent three decades, the Common Council voted unanimously this past April to call for a referendum in November on whether the City Charter should be amended to allow the city to add fluoride to the water supply.

Earlier this month, the Tompkins County Dental Society unanimously voted to endorse the fluoridation of the city’s water supply while less than a week later, the Tompkins County Board of Health voted 4-2 against a motion to endorse fluoridation.

Is fluoridation safe?

Water fluoridation is endorsed by the American Dental Association, the American Medical Association, the World Heath Organization, and the Surgeon General, according to Comisi.

“Therapeutic fluoridation of drinking water is safe, effective and inexpensive,” he said. “The daily exposure of the mouth to fluoride products helps to constantly battle the ever-developing acid attack of bacteria … and makes teeth more acid-resistant.”

A therapeutic level of fluoridation is the amount of fluoride by which one can reduce the amount of dental decay without causing side effects, according to Comisi. He cited the recent British Medical Journal report that fluoride has no evidence of harm and may have the beneficial effect of reducing hip fracture.

However, opponents of fluoridation claim that it is a pollutant whose “potential risks are debatable,” said Brian Eden, Public Service Assistant at Cornell Law library and a member of the Citizens Environmental Coalition. In addition, overexposure to fluoride causes dental fluorosis and makes the bones more brittle, he added.

Better nutrition, better access to dental care, and fluoridated dental products are recent factors that have decreased tooth decay since the 1950s and thereby decreased the rationale for fluoridation, according to Eden.

Which communities are currently fluoridated?

Today, 43 of the largest 50 cities in the U.S. are supplied with fluoridated water, including New York City, Chicago and Boston. However, fluoridation is banned in almost all European countries except Ireland and England, according to Krook.

The issue will be on the election ballot on Nov. 7th in Ithaca, in addition to other U.S. counties such as San Antonio, Las Vegas and Spokane, Wash.

Dental Debates

Comisi recommends that all people drinking water without a fluoridated system invest in a topical fluoride rinse. “I currently provide fluoride supplements in drop-form and tablet-form to kids ranging from the ages of one to 16 years, depending on the need and development of their teeth.” This will reduce tooth decay until fluoride is added to the water supply, he said.

However, according to Krook, fluoridation does not have the effect of reducing tooth decay. In a 1987 study by the federal government of 39,000 school children living in fluoridated, non-fluoridated and partly-fluoridated communities, there was no difference in decayed, missing and filled teeth between the groups, he said.

However, Comisi cautioned that most of the studies that have been conducted to denounce fluoridation have “dealt with faulty science and faulty methodology and been interpreted inappropriately.”

Residents would have to drink approximately 5,000 gallons of water a day to get a toxic level of fluoride and create an acute toxicity in their bodies, he added.

Freedom of Choice?

Opponents of fluoridation cite the addition of a chemical to the city’s water supply as a breach of personal freedom. To add a toxic drug into the water supply and expose the entire population to it is “mass medication,” according to Krook.

As a counter-debate to the notion of mass-medication, Comisi claimed that “this is not medication but is a mineral … it is a travesty that we don’t have a fluoridated system here [in Ithaca.]”

Additional Information

Students are encouraged by both proponents and opponents of the fluoridation debate to investigate both sides of the issue and decide for themselves before Nov. 7 whether they want fluoride to be added to the city of Ithaca’s drinking water.

Archived article by Rachel Pessah