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Portland City Council Schedules September 12 Vote on Fluoridating the Water

August 24, 2012 -- Comedian George Carlin once joked that everybody complains about their local tap water, and nobody brags about it. Not so in Portland. “Portlanders pride themselves on having some of the best drinking water in the world,” said Kim Kaminski, executive director of Oregonians for Safe Drinking Water, a Portland-based nonprofit that opposes adding fluoride to municipal water supplies throughout the state.
August 23, 2012

August 24, 2012 -- Comedian George Carlin once joked that everybody complains about their local tap water, and nobody brags about it. Not so in Portland. “Portlanders pride themselves on having some of the best drinking water in the world,” said Kim Kaminski, executive director of Oregonians for Safe Drinking Water, a Portland-based nonprofit that opposes adding fluoride to municipal water supplies throughout the state.

Now Portland's City Council is about to vote on the issue, and three of five city commissioners have stated publicly that they intend to support adding fluoride to the water supply on September 12 after hearing public comment September 6.

For now, it looks like a lock, but anti-fluoride activists have already started circulating petitions – the online petition site Change.org actually has several petitions asking Portland's City Council not to add fluoride to drinking water – and intend to create a ballot referendum if the council takes such action. Thus far, the largest petition has gained more than 2,500 signatures.

Fluoride has long been a contentious issue in Oregon, which has some of the highest rates of dental decay in the nation, particularly among school-age children. In 2005 and 2007, legislators defeated bills that would have mandated adding fluoride to water supplies in all cities with populations of more than 10,000.

Now the fluoride fight is happening at the municipal level. Earlier this year, the citizens of Philomath voted to add fluoride back to their drinking water after the city council voted had it removed last year. Last summer, Portland City Commissioner and Water Bureau director Randy Leonard – asked why Portland has not fluoridated its water historically and whether he would consider an initiative – told The Lund Report he favored fluoridation.

“Coincidentally, I’ve been looking into the issue and am weighing whether or not to bring a proposal forward for city council consideration that would allow us to fluoridate our water,” he said in an e-mailed statement to The Lund Report. “It seems unfair to me that our poorest communities in Portland that cannot afford regular dental care has children that suffer from increased cavities due to the lack of fluoridation in our drinking water.”

The recent push to fluoridate is the result of campaigning by a coalition of healthcare and community groups called Everyone Deserves Healthy Teeth. A list of partners and funders can be found here.

“All of the funders are members of the coalitions on that list. We're solely funded by community foundations and health organizations,” said coalition spokesperson Kylie Menagh-Johnson. She
declined to share specifics about how the coalition campaign is funded, but confirmed she’s a paid contractor with Upstream Public Health, which received a $50,000 grant from the Oregon Community Foundation to campaign for children's dental health.

“Upstream Public Health as well as every paid coalition member has paid staff doing this as part of their job,” Menagh-Johnson said. (See update below for a more detailed breakdown of the structure of the coalition. According to Menagh-Johnson, some coalition members may be performing coalition work as part of paid positions, many are community volunteers.)

“I want to underscore that this has been a behind the scenes, hush-hush campaign to put toxic wastes into our drinking water,” Kaminski said. Her group, and others petitioning against the use of fluoride in drinking water, said if communities are really concerned about poor children's dental health, there are ways to improve it without fluoridating drinking water.

Oregon Community Foundation Communications Director Joan Vallejo said the foundation has supported children's dental health for several years. In 2011 it gave grants to Friends of Creston
Children's Dental Clinic (for general operational support), the Dental Foundation of Oregon (for the Tooth Taxi oral health program) and Umpqua Community Health Center (for a school-based children's health program).

In 2010, Northwest Health Foundation made a $35,000 grant to Upstream Public Health to advocate for community water fluoridation, and has also made grants to clinics to provide dental sealants and dental care for low-income children and families. (The foundation also provides grant funding to The Lund Report, but neither dictates coverage nor reviews stories for publication.)

School children in Multnomah County receive fluoride rinses and tablets through a school-based dental health program – but still experience twice the amount of dental decay as children in Washington.

Dental pain is also a major cause of emergency room referrals. According to Jim Newman, associate director for media relations at Oregon Health & Science University, its emergency room saw 678 patients last year who came to the hospital with dental pain or dental health issues. Eleven people were admitted to the hospital, and the majority were either uninsured or on the Oregon Health Plan.

If anti-fluoridation activists – some of whom say the drug isn't safe or even effective taken systemically – are skeptical that fluoridation will improve children's oral health, they’re also concerned about the environmental effects.

Some environmental groups oppose public water fluoridation, partly because community water supplies are usually supplemented with fluorosilic acid, a byproduct of fertilizer manufacture, instead of sodium fluoride, which is typically used in pharmaceutical fluoride and is more expensive.

An earlier version of this story said that the Sierra Club opposes drinking water fluoridation, which is not correct. The organization opposed previous bills mandating fluoridation of drinking water in Oregon, but does not categorically opposed fluoridation of drinking water in Oregon. The group's position on the issue can be found here.

The initial story also stated that most major environmental organizations have opposed fluoridation, but most of the top 10 members of the Oregon Conservation League (which includes the Oregon Environmental Council, the Oregon League of Conservation Voters and the Bicycle Transportation Alliance) do not take a position on the issue. One, the Pew Charitable Trust, supports community water fluoridation. Of the two other organizations named in the initial story, Willamette Riverkeepers has recently commented in opposition to fluoridation, and Columbia Riverkeepers released anti-fluoridation statements in 2007 but has not recently commented on the issue, and the group's website does not mention its position on fluoride.

According to Menagh-Johnson, the Environmental Protection Agency's standards for evaluating fluoride additives are actually more stringent than pharmaceutical standards.

The Environmental Working Group, which advocates for reduced amounts of fluoride in public drinking water and for more research on its possible carcinogenic effects, has ranked Portland's tap
water 59th in a survey of 100 major cities in terms of the quality of its tap water, because of the concentration of halacetic acids (chemicals used to disinfect water) in the city's water.

Both sides maintain that fluoridation is a social justice issue, and critical to public health. Whether or not voters decide to support fluoridation, Kaminski believes they should be the ones making the call.

“If you are putting a product into our drinking water for the purpose of medication, people deserve the right of informed consent,” she said.

TO LEARN MORE:

Change.org petition

Everyone Deserves Healthy Teeth

Oregon Community Foundation Page on Dental Health

Northwest Health Foundation Dental Health grants

Image for this story by sj_sanders (CC-BY-NC SA 2.0) via Flickr.

 

UPDATE, 8/27/12: Following the publication of this story last week, Kylie Menagh-Johnson contacted The Lund Report requesting the information given about the structure of the Everyone Deserves Healthy Teeth Coalition, and her role within it, be clarified. She submitted the following statement:

"I was a founding board member of Upstream in 2002 and have volunteered and partnered with them for years on a variety of issues, particularly around school nutrition and tobacco prevention, which both affect oral health. I’ve worked in public health for more than a decade and I’ve always supported water fluoridation.    "I've been volunteering on the coalition and was recently asked to serve in a very modestly paid, short-term role. I continue to volunteer and donate most of the time I'm working on this. Many people on the coalition are donating time for free, over and above their normal work duties and hours. Many coalition members and supporters are just community volunteers, or are unpaid board members of coalition organizations. Partnership and coalition-building is a 'best practice' used in the public health and non-profit sectors. Partnering on community coalitions and representing your organization on a coalition are a standard part of the job description in the public health and non-profit sector."   The story has also been edited to more accurately reflect the position of the Sierra Club and other major environmental organizations on community water fluoridation. The Lund Report regrets the errors.

Comments

Submitted by Nys Cof on Fri, 08/24/2012 - 04:50 Permalink

There is no evidence that any Portlander is fluoride-deficient but ample evidence that many, especially the poor, are dentist deficient. The problem is that most dentists won't treat Medicaid patients and that dentists have priced themselves out of affordability for people both with or without insurance Tooth decay crises are also occurring in all fluoridated cities and states see: http://www.FluorideNews.Blogspot.com Emergency rooms in all fluoridated cities are flooded with people in dental anguish because they could not afford traditional dental care. This often costs the tax payer ten times the amount a simple filling would have cost. US children have died from the consequences of untreated tooth decay. Deamonte Driver was turned down by 2 dozen dentists before he died after two weeks in an emergency room and $250,000 of medical care. The solution is to allow dental therapists to work in the US as they have been in other developed countries and for decades and successfully. It takes just a few years to educate them. They could work in areas and mouths where dentists refuse to go. Unfortunately, for us, Organized Dentistry lobbies long and hard against this. The American Dental Association is the richest and most powerful health lobbying group. And they choose to hold onto their lucrative monopoly - even if Americans will die as a result So they prefer to give us fluoridation as an illusion that they care about the poor people they won't actually treat. Don't let them fool you, fluoridation is their ticket to political viability. The problem is they have fooled too-trusting organizations to lobby too-trusting legislators - none of whom have actually read the science - to force fluoride into us which in the long run benefits dentists and not the poor people they believe they are helping It would be interesting to tract back to where the germ of this idea originate from.
Submitted by Peggy Thatcher on Sat, 08/25/2012 - 15:10 Permalink

The evidence for "fluoride deficiency" is the high incidence of cavities in Portland. Fluoridation is a *preventative* that can keep people from needing more dentists in the first place. If you are confused about the fluoridation issue, I recommend you talk to your dentist about the issue, unless you are convinced by "nyscof" that all dentists are evil incarnate.
Submitted by Trisha Yates on Fri, 08/24/2012 - 14:37 Permalink

Community water fluoridation works. It is cheap compared to other alternatives and reaches everyone regardless of income or race. It is the first line of defense against cavities. The reast - treatment comes after you already become sick. Prevention is worth a pound of cure. Because of how important the mouth is to our health and dental pain is very bad for ones health, it is no wonder doctors, nurses, dentists, health activists, and race equality activists all support fluoridation of Portland. The science supports it. This is about making positive change - local people who really do want to make a difference in the health of their community.
Submitted by Trisha Yates on Fri, 08/24/2012 - 14:48 Permalink

Community water fluoridation is the first line of defense to protect the health of teeth. It is the basic building block for good oral health because it is the is proven to work for everyone. It makes good sense, especially considering the problems that poor teeth can cause in everyone's lives. The above poster mentioned some - visits to the emergency rooms, in some rare cases even death. Some people with bad teeth have a hard time finding a job, lose time due to dental pain, or can't study. Then add that impact up accross the population. Children with rampant decay who see dentist's may have to go under anthesisia. Healing cavities can be a tramatic process - for children, parents, and dentists. One more reason to prevent cavities before treatment is needed. An once of prevention is worth a pound of cure. Yes, there are additional solutions to oral health problems. It is a disease that needs many approaches to solve. The msot proven and cost effective being community water fluoridation - that is why doctors, nurses, professionals, and health and race equity advocates are fighting working to bring the benefit to Portland. Good science makes good neighbors.
Submitted by Kurt Ferre on Fri, 08/24/2012 - 16:38 Permalink

I am a retired general dentist, and have lived in Portland for over 32 years. I was trained in fluoridated Chicago, Ill. and practiced an additional 4 years while my wife completed her medical school training. During my 4 years of practice, part of my practice I was taking care of the poorest of the poor. Guess what? Even in fluoridated Chicago, poor people got more cavities than middle and upper middle class people. It wasn't until I relocated to Portland in early May, 1980, that I had my "you're not in Kansas anymore" epiphany on the public health value of fluoridation. My first day of practice I saw a 20 year old female with a full upper denture (never saw that in Chicago at that age). Most of the adults born and raised in Portland had fillings or cavities on every surface of their teeth, I saw more early childhood cavities (greater than 7 cavities in one child's mouth), and I saw a far greater amount of root surface cavities in adults. Since 1999 I have been advocating for improved oral health for all Oregonians and I believe, as every public health official I've met, that fluoridation is the FOUNDATION of a sound public dental health policy. If you want to learn about the real science and true facts on fluoridation: www.ilikemyteeth.org www.everyonedeserveshealthyteeth.org By the way, the Nyscof or New York State Coalition to Oppose Fluoridation is a Long Island housewife named, Carol Kopf. She often posts as "Sally Stride". I suspect until recently she thought Portland was Portland, Maine, not Portland, Oregon. She spends her life blogging against fluoridation.
Submitted by Billy Budd on Fri, 08/31/2012 - 13:27 Permalink

Mikes .. For certain disease prevention is preferable to simply providing disease treatment. What Portland would do differently if they embrace this concept for cavities, is optimize the drinking water fluoride concentration.
Submitted by Benjamin Teasel on Fri, 08/31/2012 - 15:13 Permalink

I wonder what Portlanders are eating when they're children. Soda and candy bars? Is it possible that those with lower incomes eat more sugar or high-fructuse containing processed foods? What's so wrong with the school-based topical fluoride treatments, which children are already getting? Are they not happening frequently enough? It seems like this would be a more targeted solution for 'fluoride deficiency' in Portland's children. I'll just say that it took me over twenty years of visiting dentists to come to an understanding of how and why we should brush and floss our teeth. Though the most influential discovery was probably that my bite needed to be corrected. I was able to do this as soon as I discovered it, without spending any money or needing a dentist's help. This is one profession where it's 'like pulling teeth' to get useful infomration out of the practitioners, and as a result I'm highly skeptical that they know what they are talking about. Especially about fluoride, or fluorosilic acid, as it's more commonly used.
Submitted by Billy Budd on Fri, 08/31/2012 - 18:38 Permalink

The costs and effectiveness of a wide variety of public health interventions, including educating people about diet and oral hygiene have studied. A very recent example of that was the Colorado study which found community water fluoridation returns about 150% on the program's investment in saved dental bills. None of the other options had such a large economic return. Prev Chronic Dis. 2012 Mar;9: A simulation model for designing effective interventions in early childhood caries. Hirsch GB, et al Generally, people who have all these "alternative ideas" and completely naive about public health science. Interested citizens can conveniently read in their own words what the many expert academic societies, professional organizations and health care advocates say. see: http://www.ilikemyteeth.org/fluoridation/respected-organizations/