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Oral Health Without Fluoride

news2A look at the future of dental health in the wake of the Watsonville fluoridation debate

Ten years of debate over whether or not to add fluoride to Watsonville’s public water supply came to an end on Wednesday, Feb. 1 when the California Dental Association Foundation (CDAF) withdrew its promise to fund the fluoridation project.

“The CDA Foundation notified the City of Watsonville that its planned fluoridation facilities were too costly to be accomplished within the required time frame,” Alicia Malaby, director of communications for CDA, writes in an email to GT. She goes on to say that the foundation would have had the funding necessary if the bids came in at $1.6 million, the estimated cost determined by the original design firm. “Unfortunately, construction bids were significantly higher and additional funding could not be secured within the time frame of the contract,” she adds.

As Watsonville moves into a fluoride-free future, opponents and proponents of fluoride find some common ground in looking to the possibilities for Watsonville’s oral health. While remains of the argument over the effectiveness, safety and necessity of fluoridating the public water supply are still present between Watsonville residents, all agree that the next step toward dental health is to focus on the city’s alternatives to fluoride.

Laura Marcus is executive director for Dientes Community Dental Care, one of two low-income dental clinics in Santa Cruz County. Marcus has been active on the pro-fluoridation side of the debate for years and considers it to be the most viable, cost-effective way to promote dental health. However, she has invited some of the most vocal fluoridation opponents in the region to sit down with Dientes and discuss what’s next for dental care in Watsonville. These opponents include members of the group Citizens for Safe Drinking Water (CSDW), which is vocally anti-fluoridation, and John Martinelli of local apple juice and cider company S. Martinelli & Co.

 “Whatever side you stand on, the bottom line is we have a really serious problem in this community and we don’t have a good solution,” Marcus says. “So, fluoridation isn’t going to be a solution we see anywhere in the near future. What are we going to do to help the community so that we don’t see the disease and the infection and the kids missing school, etc., etc.? We’re smart people around the table. I think we can come up with some good solutions.”

The question at hand, she says, is “How, as a community, can we support preventative efforts since the cheap, effective option is not going go through right now?”

David Kennedy, former president of International Academy of Oral Medicine and Toxicology, a nationally and internationally recognized lecturer on toxicology and restorative dentistry as well as a practicing dentist for 20 years, now works with the anti-fluoridation group CSDW. He sees the fluoridation project falling through as a good thing.

“Fluoridation has no beneficial impact on tooth decay so it is a total waste of money,” he says, “Many areas with long-term fluoridation suffer with chronic high tooth decay and early childhood caries crisis. It is a fake oral health program that causes mottled teeth that stain rapidly.”

While Kennedy and CSDW do not agree with Marcus that fluoridation is the “cheap, effective option” to prevent tooth decay, they can agree on some things. Jeff Green, national director for CSDW, also says education and prevention are the most important steps Watsonville can take at this time.

Green has owned and operated his own consulting firm since 1972, where he has provided services to more than 400 dentists and other health professionals and has been vocal in fluoridation debates in Santa Cruz County “from the beginning.”

“We don’t believe the [CDAF] would put up any money to provide dental care,” he says. “That’s one thing they could do if they had those millions of dollars, they could certainly hire dentists if they wanted to, but more importantly we think they could incorporate public policy. My question to the city council would be, why haven’t they instituted any other public policies to prevent the increase in tooth decay?”

According to Kennedy, the most effective ways to prevent tooth decay are “... daily oral hygiene with a Bass brush, and to remove sugar and food from the hallways of schools.”

The issue that emerges in educating and providing dental tools to the public is primarily monetary for clinics like Dientes.

“How do we serve the needs of tens of thousands of children when our public health system has cut every education prevention program?” asks Marcus. “Whether it’s oral health, behavioral health, for everything preventative, the money is gone. We’re treating disease instead of addressing education beforehand so we prevent disease.”

Though the budget is tight, Marcus says throughout the fluoridation debate, Dientes was working on other ways to increase prevention of and education about dental issues for the community.

For example, Dientes partnered with Second Harvest Food Bank to distribute 10,000 hygiene packets that included toothbrushes, toothpaste, floss and basic oral health informational sheets in Spanish and English once a quarter at Second Harvest’s various locations.  

Looking to the future, Dientes and the county’s other low-income dental clinic, Salud Para La Gente, are working together to improve their oral health programs and determine ways in which the two organizations can provide more care to more people.

“Sixty-thousand people in the community need a source of dental care, and Salud and Dientes together see about 20,000 of them,” says Marcus. “So there’s a huge need that’s still unmet. We’ve been talking about somehow collaborating in the school-based health clinics, and community programs going out to neighborhoods, working with people in their own homes that can help teach health programs.”  

Marcus says another idea Dientes has for the future is to seek help with oral health education from primary health care providers in the community.

“I don’t care about what you think about fluoridation,” she says. “What I do care about is what you think about oral health and making sure that the public realizes how important it is that everyone, including poor people and poor kids, have access to the dentist.”

Photo: Keana Parker

Comments (7)Add Comment
...
written by Charlie Red Stick, February 17, 2012
I see too many children with silver teeth! Especially in Watsonville among the Mexican community. Fluoridation of the water supply will not fix the fact that the parents/grandparents of children with the silver (formally rotting) teeth were put to bed with bottles and sippy cups!
...
written by Steve Hartman, February 15, 2012
Didn't think I still had the link but dug through an old email. Here is the link for that moutwash I mentioned in another comment. Best to all.
http://dvice.com/archives/2012/02/smart-bomb-mout.php
...
written by Steve Hartman, February 15, 2012
Some are sad and some are not. Both sides battled fiercely. Personally speaking, having followed this long ordeal - but not living in affected area, I think Watsonville has saved a ton of money. I also think that by the time the flouride ever got put into the water, there would also be new thinking on how to flouridate teeth.
There is a new mouthwash, already approved elsewhere, and soon to be looked at (if not already) by the FDA that will protect teeth with only occasional use instead of daily use. So, keep an eye out... err tooth out for it!
...
written by Maureen Jones, February 15, 2012
Keepers of the Well.org is an informative website that focuses on the unapproved products used to fluoridate public drinking water and presents documented and highlighted published information rather than opinion and anecdotal stories. I've never thought of it as "an organization".

With the exception of hearing Congresswoman Jackie Speier make the monumental error of calling the National Institute of Dental Research "an anti-fluoridation organization" on a radio program in 1996, I think she has just been out-errored! It's slightly more amazing to hear The Denver Post newspaper and dental journals such as Journal of Public Health Dentistry, Public Health Reports,
Pediatric Nursing, Pediatric Dentistry, the California Department of Health Services and the Centers for Disease Control, referred to as "anti-fluoride".

...
written by Laura Marcus, February 15, 2012
I would like to make clear that Maureen Jones is a member of "Keepers of the Well" which is the organization opposing fluoridated public water sources so it is not surprising that the articles she quotes are anti-fluoride.

I think it would be beneficial for the public to know that there exists a large volume of studies by public health bodies that continue to support fluoridated water. For example, check out:

Achievements in Public Health 1900-1999 Fluoridation of Drinking Water to Prevent Dental Caries
from the Center for Disease Control at http://www.cdc.gov/healthywate...aries.html

and
The World Oral Health Report 2003 at www.WHO.org

Regardless of the fluoridation argument, the need for dental care continues to outpace Dientes ability to provide it. I hope you will consider visiting our website to learn more about our program and the patients we serve.
www.dientes.org
You can also click "Donate Now" to help us improve access to oral healthcare and prevention programs for our low income community members.

Thank you!



...
written by maureen jones, February 15, 2012
Ask UCSF for part of their $24.4 million so you can buy the tooth brushes........

Baby Bottle Tooth Decay aka Early Childhood Caries:

After decades of promoting water fluoridation for the sake of disadvantaged children, the University of California San Francisco School of Dentistry announced on December 18, 2008 they had received a record $24.4 million from the National Institutes of Health to fight early childhood caries, also known as “baby bottle tooth decay” or “nursing caries”.

Published literature has long noted fluoridation’s failure:

1) Auge, K. Denver Post Medical Writer. Doctors donate services to restore little girl's smile. The Denver Post, April 13, 2004. (Note: Denver, CO has been fluoridated since 1954.)
“Sippy cups are the worst invention in history. The problem is parents' propensity to let toddlers bed down with the cups, filled with juice or milk. The result is a sort of sleep-over party for mouth bacteria,” said pediatric dentist Dr. Barbara Hymer as she applied $5,000 worth of silver caps onto a 6-year-old with decayed upper teeth. Dr. Brad Smith, a Denver pediatric dentist estimates that his practice treats up to 300 cases a year of what dentists call Early Childhood Caries. Last year, Children's Hospital did 2,100 dental surgeries, many of which stemmed from the condition, Smith said, and it is especially pervasive among children in poor families.

2) Shiboski CH et al. The Association of Early Childhood Caries and Race/Ethnicity Among California Preschool Children. J Pub Health Dent; Vol 63, No 1, Winter 2003.
Among 2,520 children, the largest proportion with a history of falling asleep sipping milk/sweet substance was among Latinos/Hispanics (72% among Head Start and 65% among non-HS) and HS Asians (56%). Regarding the 30% and 33% resultant decay rates respectively; Our analysis did not appear to be affected by whether or not children lived in an area with fluoridated water.

5) Barnes GP et al. Ethnicity, Location, Age, and Fluoridation Factors in Baby Bottle Tooth Decay and Caries Prevalence of Head Start Children. Public Health Reports; 107: 167-73, 1992.
By either of the two criterion i.e., two of the four maxillary incisors or three of the four maxillary incisors, the rate for 5-year-olds was significantly higher than for 3-year-olds. Children attending centers showed no significant differences based on fluoride status for the total sample or other variables.

6) Kelly M et al. The Prevalence of Baby Bottle Tooth Decay Among Two Native American Populations. J Pub Health Dent; 47:94-97, 1987.
The prevalence of BBTD in the 18 communities of Head Start children ranged from 17 to 85 percent with a mean of 53%. The surveyed communities had a mixture of fluoridated and non fluoridated drinking water sources. Regardless of water fluoridation, the prevalence of BBTD remained high at all of the sites surveyed.

9) Bruerd B et al. Preventing Baby Bottle Tooth Decay: Eight-Year Results. Public Health Reports: 111; 63-65, 1996.
In 1986, a program to prevent BBTD was implemented in 12 Head Start centers in 10 states. In three years BBTD decreased from 57% to 43%. Funding was discontinued in 1990.

10) Von Burg MM et al. Baby Bottle Tooth Decay: A Concern for All Mothers. Pediatric Nursing; 21:515-519, 1995.
“Data from Head Start surveys show the prevalence of baby bottle tooth decay is about three times the national average among poor urban children, even in communities with a fluoridated water supply.”

13) Thakib AA et al. Primary incisor decay before age 4 as a risk factor for future dental caries. Pediatric Dentistry; 19:37-41, 1997.
In summary, initial primary incisor caries is a risk factor for developing future carious, extracted, and restored teeth.

PIT AND FISSURE TOOTH DECAY

“Fluoride primarily protects the smooth surfaces of teeth, and sealants protect the pits and fissures (grooves), mainly on the chewing surfaces of the back teeth. Although pit and fissure tooth surfaces only comprise about 15% of all permanent tooth surfaces, they were the site of 83% of tooth decay in U.S. children in 1986-87.”
Selected Findings and Recommendations from the 1993/94 California Oral Health Needs Assessment.

“Because the surface-specific analysis was used, we learned that almost 90 percent of the remaining decay is found in the pits and fissures (chewing surfaces) of children's teeth; those surfaces that are not as affected by the protective benefit of fluoride.”
Letter, August 8, 2000, from Jeffrey P. Koplan, M.D., M.P.H., CDC Atlanta GA.


...
written by NYSCOF, February 15, 2012
Rotten diets make rotten teeth regardless of how much fluoride or brushing goes on. Wealthier Americans can afford to have their teeth fixed to cover their poor dietary choices.

It's simple, dentists must be mandated to treat more low-income people or stop lobbying against viable groups willing to do so.

No child is fluoride-deficient. Too many are dentist-deficient. Fluoridation is a smokescreen for what really needs to be done.

Dentists received welfare for the rich in the form of tuition and dental school government grants and more. They receive even more hand-outs from corporations that benefit from tooth decay. It's time that dentists be forced to give back.

Isn't it interesting that the CDA didn't choose to use the millions earmarked for fluoridation to actually treat poor children's teeth. I think that speaks volumes. Organized dentistry will do all it can to keep dentists income as high as they can and retain their lucrative monopoly regardless of who is suffering in dental pain.

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