USA - Law requires water systems to add fluoride — if state provides funding

Law requires water systems to add fluoride — if state provides funding
By Mike Hasten • mhasten@gannett.com • December 14, 2008 2:00 am
Larger water supply systems throughout Louisiana have until March 1 to assemble plans that could result in all of their customers receiving fluoridated water to improve dental health.
But the mostly municipal systems don't have to purchase the equipment and start fluoridating water until the state supplies the money.
Bossier City is among several Louisiana water systems that already add fluoride to water, and most systems have naturally occurring fluoride. Systems in Shreveport and the surrounding area, Springhill, Natchitoches, Lake Charles, Vidalia, New Orleans, Houma and Leesville also add fluoride to drinking water.
State law (Act 761 of 2008) says water suppliers that have at least 5,000 service connections must submit to the Department of Health and Hospitals by March 1 plans and cost estimates for installing the necessary equipment. The Legislature this year re-enacted and strengthened a law that suggested fluoridation by 2000.
"Most of the civilized world is fluoridated," said Dr. John Taylor, a Crowley dentist and one of the leaders of the fluoridation movement who got his city to start adding fluoride in May. "Here's a chance for Louisiana to join the rest of the civilized world."
But not everyone agrees. A number of Louisiana residents express concerns about fluoridating water, especially in excessive amounts.
James W. Reeves, a retired civil engineering professor in Lafayette, says he and many others are opposed to "forced medication" and "putting toxic waste in my water."
Reeves says he doesn't "claim to be an expert and I'm not" but he has researched the dangers of fluoridation and found more risks than benefits. Too much fluoride results in fluorosis, which ranges from white spots on teeth to brittle bones and teeth, in extremely highly fluoridated water.
He said he is concerned about "swallowing a little bit of poison for the rest of our lives" and what happens when it builds up.
A Centers for Disease Control says that about 70 percent of the people in the United States drink fluoridated water daily and "since community water fluoridation began in 1945, it has been demonstrated to be a safe and cost-effective way to prevent tooth decay."
Fluoride is a naturally occurring element in water, and "we're just adjusting it to its optimal level," Taylor said. "Now we just have to get the money."
Tom Ed McHugh, director of the Louisiana Municipal Association, says the money catch may be the deciding element in the fluoride debate. With an impending $1.3 billion shortfall next year, "the state having extra money for fluoridation is not likely."
Adding fluoride has stirred controversy in some areas of the state. But Health and Hospitals officials and the American Dental Association say it is important because it inhibits bacteria that cause tooth decay and strengthens enamel damaged by bacteria.
Don Broussard, water operations officer for Lafayette Utilities System, said opponents of adding fluoride have organized in Lafayette but he is proceeding with meeting the March 1 deadline for submitting plans.
Besides the state funding loophole, the law has provisions that allow municipalities to opt out of fluoridation.
Broussard points to a section of the new law that allows a referendum of system customers if 15 percent of the elected voters in a service area sign a petition and the governing body — in Lafayette's case, the nine members of the city-parish government — agrees to such a vote. Opting out of fluoridation would require a vote of more than 50 percent of the water system customers.
"That may be what some of the opponents are pushing for," Broussard said.
The law also says the governing body of a parish would be responsible for calling for a vote if the water system also provides service to registered voters in unincorporated areas of one or more parishes or if the water system was created or franchised by the parish or parishes.
Also, systems that have naturally occurring fluoride at significant levels could be exempted.
Jim Barnett, superintendent of public works for Bossier City, said his city's water system has been fluoridated for about 20 years. "We've never had a problem.
"You would have to overfeed consistently for quite a while before anything would show up," he said. The system is "closely watched and monitored regularly" and monthly reports are sent to Health and Hospitals.
Local dentists take samples and complain if the level drops just a bit, Barnett said. "They want to maintain doses in city water," he said, chuckling about dentists being concerned about a low level. "It seems like it would be bad for business" to maintain a level that fights cavities.
The ADA says the optimal level is 0.7 to 1.2 milligrams per liter of water.
A 1997 Tulane University study found almost 50 percent of the community water systems in Louisiana had fluoridated water and 116 communities have naturally occurring fluoride at or above 0.7 milligrams.
In Lafayette Parish, 71 mobile home and subdivision systems tested were shown to have naturally occurring levels of 0.2 to 0.4 milligrams of fluoride. The municipal system was not included in the survey.
In Ouachita Parish, 57 systems were tested with levels ranging from a low of 0.1 milligram in the Monroe city system to 1.4 in the Mathis Waterworks System. Several subdivision systems were at 0.7.
In Rapides Parish, 28 systems were tested. Alexandria, Camp Beauregard and England Industrial Airpark registered 1.1 milligrams per liter. Two villages marked the extremes, Woodworth the highest with 2.2 and Forest Hill the lowest with no fluoride detected.
In Caddo, 44 systems, including the Shreveport municipal system, were tested. The city, Barksdale Air Force Base, Haughton and several smaller surrounding systems all fluoridate their water. Other systems in the parish have low levels — about 0.2 milligrams per liter — of fluoride.
Studies prove water fluoridation is effective in reducing tooth decay by 20 percent to 40 percent, even with widespread availability of fluoridated toothpaste, Health and Hospitals documents say. And fluoride has been cited as the primary factor in saving about $40 billion in oral health care costs in the United States in the past 40 years.