Fluoride: Portland City Council poised to back water treatment

Cities have wrestled with the notion of fluoridating water supplies to improve dental health for more than half a century. In the early days, naysayers warned that fluoride was conceived as a secret Communist weapon to pacify unruly populations. Advocates have pleaded that parents are losing the war on cavities and need community backup.

The latest battleground is Portland, Ore., the largest U.S. city that doesn’t put fluoride in its municipal water supply. That appears about to change: A majority of the City Council has signaled a willingness to vote next week in favor of an ordinance to inject low levels of fluoride into drinking water, heading off a promised ballot initiative seeking to prevent it.

The debate in free-thinking Portland has been a contest between the overwhelming weight of mainstream medical organizations -- which have weighed in on fluoridation as a safe and effective way of promoting dental health -- and concerns of some critics about possible links to lower IQ and bone cancer at high doses, as well as citizens’ right to choose what is in their water.

On Wednesday, more than 250 people packed the City Council chambers and three overflow rooms in a four-hour hearing so intense that Mayor Sam Adams twice threatened to evacuate unruly spectators.

Outside, protesters carried signs warning of “Zombie Nation,” and “Fluoride Is a Trick, It Will Make You Sick.”

“This process today is a sham. This is being railroaded through. We are the largest unfluoridated city in the country, so we are squarely in the cross hairs, and they are ramming this down our throats without any democratic process whatsoever,” Kimberly Kaminski, director of Oregonians for Safe Drinking Water, said in an interview before the hearing.

A representative of the West Slope Water District, one of several wholesalers that buys water from Portland to serve surrounding communities, complained that the city is moving forward without allowing citizens outside the city to have a voice.

“As a customer of Portland for over 90 years, we are appalled that no action has been taken to consult or advise us in any way on this issue,” the district said in a letter read to the council.

Since the 1940s, cities across the U.S. have been gradually moving toward fluoridating water — a step that the national Centers for Disease Control and Prevention and most major medical organizations say is largely risk-free and reduces tooth decay.

Several towns have moved to reverse that decision in recent years, especially since a widely cited study of naturally occurring fluoride in China that was, at levels higher than those used for public fluoridation in the U.S., linked to slightly lower IQs in children and a rare form of bone cancer known as osteosarcoma.

But the trend has been toward expanding fluoridation, and Portland remains an outlier. According to the CDC, nearly three-fourths of all Americans, about 204 million people, are on fluoride-treated community water systems. The number has grown by 42 million since 2000.

Supporters on Portland’s progressive-minded City Council have framed the issue as a step toward public health and social justice.

According to testimony at Thursday’s hearing, four in 10 Latino children and seven in 10 African-American children in Oregon — where less than a quarter of state residents have access to fluoridated water — have untreated dental decay.

“Frequently we see a child, their hair is healthy, their skin is healthy, their eyes are healthy, they walk with a normal gait. Otherwise they’re fine. And then they open their mouth, and we see this: what we call rampant decay throughout the mouth … and abscesses,” said Michael L. Plunkett, a public health dentist who works with low-income families.

“Seven percent of the children [younger than] 5 in our program got their dental care in a hospital operating room under general anesthesia because their dental problem was too severe to treat otherwise,” he said.

The coalition backing the fluoride plan, Everyone Deserves Healthy Teeth, includes more than 75 organizations, educational institutions and labor unions. The Oregon Medical Assn. and the Oregon Dental Assn. are among them.

Kylie Menagh-Johnson, who heads the coalition, acknowledged in an interview that Oregon voters have rejected water fluoridation three times. But she said the last ballot measure, in 1980, was decided with a very low voter turnout and characterized by a “misinformation campaign” by the anti-fluoride lobby.

“People were confused about what the science said about how fluoridation reduces tooth decay and doesn’t have any harmful health effects,” she said. “Now people have come together and said enough is enough, we’re going to take on this dental health crisis and fluoridation is the answer.”

Kaminski said that if the council votes to approve the fluoridation ordinance on Wednesday, as expected, another ballot measure can be expected. Critics at Thursday’s hearing said public water fluoridation endangers people with medical problems such as thyroid disease who might be harmed by high fluoride exposure.

Many speakers said they don’t believe widespread assurances that links between fluoride in water and IQ deficiencies have not been established at levels as low as those in fluoride-treated water in the U.S.

“They’ve never tested for it in the United States,” said Rick North, one of dozens of people who asked the council not to adopt the ordinance. “How many, I wonder, would trade the intelligence of their kids to prevent a cavity?”

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