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AGD IMPACT:
An official publication off the Academy of General Dentistry

February 1987

The Science and Politics of Fluoride

By Zev Ramba
Washington Bureau Editor

Dental and medical groups have been battling anti-fluoridationists since the first dose of fluoride was metered into the water of Grand Rapids, Michigan in 1945. For decades, it seemed that dentistry was winning those battles - that science was prevailing over the rhetoric of the antifluoridationists.

Today the battle lines are not so clearly drawn. The anti-fluoridation movement has found supporters on the left as well as the right, particularly among groups dedicated to safeguarding the environment. And as the base of support broadens, community fluoridation appears to be losing ground. About 60 percent of the 2,000 referendums on fluoridation held in the U.S. Since 1950 have been voted down. A 1985 poll by ADA found that 36 percent of the 255 fluoridation programs surveyed had been cancelled, and 14 percent had been delayed or cut back.

As the "antis" have become more effective, organized dentistry and other supporters of fluoride have become less effective. The reason may be, in part, our unwillingness to release any information that could cast fluoride in a negative light. That unwillingness probably comes from the anti's penchant for distorting and misusing scientific information. But organized dentistry's reduced effectiveness comes mainly from losing its objectivity - the ability to consider varying viewpoints together with scientific data to reach a sensible conclusion.

The current dispute at the Environmental Protection Agency over raising the maximum safe level of fluoride in public water supplies is a case in point. The EPA was pressured by supporters of fluoride, however well-meaning, and by states that would have to remove excess fluoride, to raise the standard to a level that now borders on unsafe, according to EPA's own scientific review.

EPA's actions were not driven by science, but by political pressure from supporters of fluoride. In its zeal to fight the anti-fluoridationists, dentistry appears to be overlooking data that shows that some communities will face harmful effects from high levels of fluoride. The American Dental Association supported South Carolina's bid to remove fluoride from the list of drinking water contaminants regulated by EPA. When they took that tack, they mirrored the anti's argument against fluoridation because the ignored the issue of dosage. At optimal levels, fluoride reduces decay and produces no harmful effects; at the higher levels that deregulation would have permitted, it is a toxin.

The supporters of fluoride, from the U.S. Surgeon General on down, need to return to objectivity in fighting the antis. Regulating fluoride along with drinking water contaminants may provide a bit of fuel for anti-fluoridationists , but dentistry's attempts to deregulate it will supply the antis with even more ammunition. Fluoride is too effective a public health measure to be held back by political gamesmanship.