"It's incredibly obvious isn't it?" asks a crazed General Ripper in Dr. Strangelove, convinced that water fluoridation is a Communist plot to control America. "Foreign substances introduced into our precious bodily fluids, without the knowledge of the individual. Certainly without any choice. That's the way a hard-core Commie works."
Although not without its real life conspiracy-theorist supporters, municipal water fluoridation is hardly a pinko plot to take over America. The American Dental Association (ADA) has supported fluoridation, calling it "the single most effective public health measure to prevent tooth decay." But as Charleston Water System awaits a new fluoride tank that won't arrive until early this summer, new understandings of the potential health effects of fluoride are drawing critical attention.
The tank that holds Charleston's fluoride was scheduled to be replaced this year, but problems with the old tank required the system to shut down the existing one in late November, leaving Charleston's water fluoride free and leading the water system to alert local dentists.
Charleston dentist John Rink says it shouldn't be a cause for concern. Fluoride has been added to municipal water systems across the U.S. for half a century, due to its perceived beneficial effects in building strength and preventing decay in the developing, permanent teeth of children. In the absence of fluoridated tap water, Rink has advised his patients to utilize a fluoride mouthwash in the morning and at night, but to avoid swallowing it.
Many dentists have been taught that the ingestion of fluoridated water is essential for children to build strong, permanent teeth. However, recent reports from the Center for Disease Control, the U.S. government's largest advocate of water fluoridation, say its primary benefit is for young people and adults whose teeth have grown in, and that water fluoridation is more effective for its topical use — swishing around in the gums throughout the day — rather than through ingestion.
Ninety-five percent of our state's municipal water is fluoridated, and the S.C. Department of Health and Environmental Control's website states that fluoride at recommended levels is "entirely safe." Optimal concentration of fluoride is established at 0.7 to 1.2 milligrams per liter, and Charleston maintains a level of 0.8 milligrams per liter.
While our drinking water is safe, accumulated fluoride can hurt certain at-risk groups — particularly infants who could be left with irreparably stained teeth and kidney patients who can't process it like other people. The high concentrations in most toothpastes warrant warning labels about the dangers of swallowing it, particularly for children, and companies market child brands with reduced or eliminated fluoride.
But babies are at particular risk for cosmetically damaging their emerging teeth. In areas of the U.S. where fluoride levels in water reach 4 milligrams per liter — much more than Charleston's level — 10 percent of small children exhibit severe enamel fluorosis. Caused by overexposure to fluoride while teeth are forming, the condition causes irreparable brown streaks and spots on teeth.
The ADA, while still supportive of fluoridated water, issued a report in 2006 stating that mothers who use infant formula should use fluoride-free drinking water when mixing it. Because most home water filters don't remove fluoride, that would require purchasing fluoride-free bottled water. The Food and Drug Administration followed up with the announcement that fluoridated water marketed to infants could not claim to reduce cavity risk.
At his North Charleston clinic, dentist Ray Hayes, an opponent of fluoridation, only utilizes fluoride as a topical treatment in cases of exceedingly rampant decay. His home has a series of reverse osmosis and activated charcoal filters to remove fluoride and other toxins from his family's water.
"When you take a bottle of infant formula mixed with fluoridated water and put it in a baby that weighs eight pounds, think of the concentration per pound versus a 180 pound man who drinks the same bottle of water," says Hayes. "What they're doing is mass medicating society with regard to equivalent dosage for each person drinking it."
Fluoride can also have a negative impact on people with kidney problems. In the average person, about 50 percent of the fluoride ingested is processed by their kidneys and exits the body in urine. The other half is absorbed in the bones and the teeth. Those with damaged kidneys are unable to process the excess, thus increasing potential health risks.
Earlier this year, the National Kidney Foundation removed their name from the ADA's list of fluoridation supporters, and stated that, "Individuals with chronic kidney disease should be notified of the potential risk of fluoride exposure."
Anti-fluoridation activist Daniel Stockin believes it's a strategic move by the Kidney Foundation, made ahead of a storm of lawsuits he believes will make fluoride the "next asbestos."
"The reason people have such a hard time believing this is that it's kind of terrifying for the public health community to contemplate that the system they've participated in all these years could have missed something so fundamental," says Stockin, who works full-time for the Lillie Center, an organization opposed to fluoridation. "I call it fluoride-gate. This is going to blow sky high."
Whether we choose to drink tap or bottled water, foods that are made using municipal water provide an additional dose of fluoride — an additive that may counteract the sugar in our beer, soft drinks, and cereal to prevent cavities. It's an example of how few consumers pause to think about what else might be in their food, beyond the list of ingredients.
If your kidneys are healthy and you're not an infant, there's no reason to avoid Charleston's tap water. Especially for the next six, tank-free months.