No fluoride comes at great cost to dental health

experts-fluoridationBy LAWRENCE WOLINSKY

This article originally appeared in the Dallas Morning News.

Published: 30 April 2014 07:22 PM
Updated: 30 April 2014 07:49 PM.

Dallas residents have received the benefits of community water fluoridation for nearly 50 years. Whether they have dental insurance or not, adults and children who grab a glass from the tap at home or a sip from the water fountain at work or school absorb this mineral’s cavity-fighting protection simply by taking a drink.

If only more public health issues could be addressed so efficiently. It is effective, too: Fluoridation is implemented in 74.6 percent of U.S. public water systems and has reduced tooth decay more than 25 percent.

If members of the group No Fluoride Dallas 2014 get their way, that may change for Dallas’ 1.2 million residents.

Last week when The Dallas Morning News ran a story about several City Council members asking questions about whether water fluoridation should continue, it didn’t take long for the news to reach Texas A&M University Baylor College of Dentistry, a part of the Dallas landscape for nearly 110 years. Alumni and practicing dentists, college faculty and dental researchers alike voiced their concerns for the effect this could have on our city.

As a scientist, dentist and educator, I couldn’t stand idly by while the reputation of one of our most powerful cavity-fighting weapons was sullied. The debate presents the opportunity to reiterate the benefits of this internationally recognized public health measure.

Community water fluoridation is touted by the Centers for Disease Control and Prevention as one of the 10 great public health achievements of the 20th century — for good reason. It strengthens tooth enamel, the single most effective way to prevent tooth decay.

More than 210 million Americans drink from a fluoridated water supply, including about 20 million Texans, according to 2012 numbers from the CDC. If Dallas were to stop this practice, it would become the largest city in the U.S. to have nonfluoridated water, surpassing Portland, Ore., and Tucson, Ariz.

On its No Fluoride Dallas 2014 Facebook page, the group states that fluoride is harmful with no benefits. It’s not the first time concerns have been raised about ingesting fluoride, and it’s important to address them.

Fluoride naturally occurs in water and soil in varying levels. Community water fluoridation is simply an adjustment of those levels. It’s similar to the process of fortifying salt with iodine, milk with vitamin D, and orange juice with calcium.

When fluoride in a water supply becomes too high — more than 4 parts per million — adverse health effects may occur, including pitting of teeth, bone tenderness and a heightened risk of fracture, according to the U.S. Environmental Protection Agency. Dallas’ water supply averages 0.4 parts per million of fluoride, which falls well under the U.S. Public Health Service’s recommended range of 0.7 to 1.2 ppm.

It’s such an important issue that A&M Baylor College of Dentistry has for years provided independent water fluoride analysis testing, a resource to residents whose water sources, such as well water, aren’t monitored for fluoride levels.

The subject of money is a central focus in the arguments of water fluoridation opponents. According to the April 23 article, Dallas could opt not to renew its three-year contract, worth more than $2 million, with water treatment company Pencco in 2015. If this occurred, the savings for the city would be noteworthy. But the cost for individuals would be far greater.

Dental decay is one of the most common childhood diseases — responsible for an estimated 51 million school hours lost among children — and emergency room visits prompted by preventable dental conditions increased 16 percent between 2006 and 2009, according to a 2012 Pew Charitable Trusts report. Put those facts together, and it’s clear that ceasing fluoridation is counterproductive.

To put it in perspective, a lifetime of community water fluoridation for one individual is less expensive than the cost of a single silver filling. The return on investment for the residents of Dallas? Immense.

Dr. Lawrence Wolinsky is dean of Texas A&M University Baylor College of Dentistry. He may be reached at

Read the article in The Dallas Morning News