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7/16/2017 12:48:00 PM
In some areas, fluoride debate rages
Alexandria Water Department Superintendent Mark Caldwell shows the fluoride system, when he turned off in 2008, with three pumps for each of the city's wells. Staff photo by John P. Cleary
+ click to enlarge
Alexandria Water Department Superintendent Mark Caldwell shows the fluoride system, when he turned off in 2008, with three pumps for each of the city's wells. Staff photo by John P. Cleary
+ click to enlarge
Supplementing fluoride
Though it may be more convenient and cost-efficient to receive fluoride through water systems, that doesn’t mean families living in communities that don’t fluoridate can’t receive the fluoride they need in other ways.

The Centers for Disease Control and Prevention recommends people who live in areas where fluoride in water is below or above recommended levels consult with their pediatrician or dentist. They can prescribe a mouth rinse, gel or foam, tablets, lozenge, liquids or varnish.

Those same prescriptions can be made for residents in communities where water is not fluoridated.

In fact, Alexandria dentist and City Council member Dr. David Steele said he routinely has tested the water and prescribed fluoride for children living in the more rural areas not attached to the city’s water system.



Rebecca R. Bibbs, Herald Bulletin

ALEXANDRIA – After nearly a year of political wrangling, Alexandria City Council member Dr. David Steele took a bold step and introduced in March a resolution to force his colleagues’ hand and get the city’s fluoride system turned back on.

But the Alexandria-based dentist’s gamble failed.

In spite of testimony from another dentist and an official from the Indiana State Board of Health, Alexandria’s city leaders made national news on April 3 when four of the seven City Council members voted against turning on the fluoride.

Alexandria, Orestes and Ingalls are the only municipalities in Madison County that don’t fluoridate their water.

“I got calls from people in dentistry who said, ‘This just doesn’t happen,’” Steele said.

Alexandria Water Department Superintendent Mark Caldwell turned off the fluoride in 2008 after years of studying what he believes are its negative effects. He has argued the city’s water naturally contains sufficient fluoride, that children rarely drink water out of the faucet anymore and that some users remove it.

“I went through the proper channels,” he said, adding he had received permission from then-Mayor Jack Woods. He also notified the Indiana Department of Environmental Management.

“I don’t think it was the right decision, I know it was,” he added. “I don’t care what every other town does. I don’t work for any other towns.”

Among Steele’s arguments is that Mayor R. Max Branch introduced fluoride to the city’s water system after the city council passed a resolution in 1968. The problem is that resolution is nowhere to be found, and Caldwell insists it never existed.

Council President Jeff Bryan, who voted against turning on the fluoride, and Patty Kuhn, who voted in favor of it, each said they voted according to the will of residents with whom they consulted in the months leading up to the vote.

“I talked to a lot of my constituents in my district and tried to get a feel for how they felt about the issue,” Kuhn said. “They were pretty divided. There were as many people who were for it as against it. Then I listened to the pros and the cons presented by the experts in the meetings. I just didn’t see where there was the great harm. I felt fluoride would do more good than harm.”

The controversy

“Fluoridating community drinking water is safe, economical and by far the single most effective way of preventing tooth decay, one of the nation's most widespread diseases and the number one reason for tooth loss among all ages,” the Indiana State Department of Health website said.

The health department is one of dozens of agencies and organizations nationally, including the American Dental Association, the American Medical Association and the American Academy of Pediatrics, that endorse the use of fluoridated community water for the prevention of tooth decay.

Though the Centers for Disease Control and Prevention named water fluoridation one of the top 10 public health achievements of the 20th century, laymen have blamed fluoride for a variety of ills, including higher rates of cancer and chronic kidney disease and negative effects on human intelligence.

Indeed, there are documented health hazards associated with fluoride. For instance, nearly every tube of toothpaste containing fluoride is printed with a warning that reads something like: “Warnings: Keep out of reach of children under 6 years of age. If you accidentally swallow more than used for brushing, get medical help or contact a Poison Control Center immediately.”

As a result, the IU Health’s Indiana Poison Center fields about 600 calls annually, about 1 percent of the total calls received, said Dr. James B. Mowry, the center’s director.

However, though he said swallowing fluoride has the potential to be toxic, he added that it would require much more than what is contained in the average tube of toothpaste or normal daily water consumption.

“Most fluoride consumption does not cause major toxicity,” he said. “To tell the truth, if a 2-year-old were to ingest a whole tube of toothpaste at a time, we would not consider that to be toxic.”

At odds

A native of Bluffton, Steele grew up in Alexandria and returned in 1971 to what he considers his hometown after studying at the I.U. School of Dentistry in Indianapolis.

While there, Steele, 76, learned about what he considered the miracle of fluoride. Up to that point, he’d developed some cavities, but he started to use a fluoridated toothpaste.

“In 46 years, I have not had a new cavity. And that’s because of what I learned about fluoride,” he said.

In fact, the father of four said he never would have endangered his own now-adult children by giving them fluoride if he didn’t believe in it.

Over the years in his dental practice, none of the parents of Steele’s youthful patients has refused topical fluoride given when their teeth are cleaned or supplements when he found their water wells didn’t contain high enough levels. However, the topical treatment is temporary and best supplemented with regular consumption of fluoridated water, he said.

“I can almost tell when someone is in a non-fluoridated area, and I can see what happened,” he said. “It gives me the most odd feeling when there is something that is so effective and has been presented so well but rejected.”

Caldwell isn’t exactly anti-fluoride. The Kentucky native and his family use fluoridated toothpaste.

But in the certification classes to become a licensed water plant operator he took in the 1990s, Caldwell had to learn about two common additives, chlorine and fluoride. Neither, he said, are required to be added under Indiana law.

Caldwell, 49, who has worked 26 years for the Alexandria Water Department, pulled out a thick, three-ring binder started 16 months ago, containing pages of research he has printed from the internet. The binder also contains the results of his own fluoride studies of Alexandria’s water.

State Department of Health fluoride specialist Jim Powers testified before the council that he’d tested Alexandria’s water for natural fluoride. But, he admitted, he’d tested only two sites.

Caldwell said since mid-January to the first week of March, he had tested 34 city water and private well sites. They tested between 0.4 milligrams per liter and 1.2 mg/L. The recommended therapeutic level is about 0.6 mg/L.

At about $15,000 a year, fluoridating the water also might not be cost-effective, Caldwell said. Of the 1.3 million gallons of water pumped through the city daily, one-third is used by Poet Biorefining, which must remove the fluoride, he said.

In Ingalls

Who is consuming the water also is part of what determined whether the Town of Ingalls would fluoridate.

Ingalls Water Department Superintendent Randy McVay said water there, which has natural fluoride levels of about 0.4 mg/L, was fluoridated until 2001. That’s when the water plant at the Pendleton Correctional Facility was replaced, and a fluoride system never was engineered into the plans, he said.

“It doesn’t do any good to send fluoridated water to the prisoners because once they are over the age of 16, their teeth aren’t in the development stage anymore,” he said.

There have been times that fluoride has been a hot-button issue in Ingalls, McVay said, but not in recent years.

“Our customers have not expressed an interest in fluoridating everybody’s water,” he said.

Related Stories:
• A short history of the discovery and use of fluoride
• IU dental school pioneered use of fluoride

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