SACRAMENTO — "It is a safe, naturally occurring element that prevents tooth decay and builds healthy teeth."
--California Dental Assn.
"It impairs the immune system and alters DNA."
--Safe Water Coalition
Ah, fluoride. There's nothing quite like it to kindle a hot debate.
Admirers view it as a magic bullet, a miracle cavity-fighter that can be slipped into the drinking water supply for the good of one and all.
Critics, on the other hand, insist it is a lethal poison, a menace that may reduce tooth decay, but causes cancer and other maladies as well.
Today, the partisans will draw their swords again for a clash beneath the Capitol dome, where a bill that would mandate the fluoridation of water in California cities with more than 25,000 residents faces its first committee test.
Assemblywoman Jackie Speier--a mother who was advised to give her son drops of fluoride when in Sacramento because the water lacks it--is the bill's author. Speier (D-Burlingame) believes fluoridation is "the most effective preventive health care measure available today."
Aside from the dental benefits, she says, the cost savings of fluoridation are mouth-watering: "By preventing just one cavity in each school-aged child, California taxpayers would save more than $385 million" in annual dental care costs.
Fluoride was first added to public drinking water supplies 50 years ago. But today, only 17% of Californians get fluoride from the faucet, compared with 62% nationwide. Los Angeles, San Jose, Sacramento and San Diego are among the cities that do not fluoridate.
Fluoridation means adjusting the amount of fluoride already present in water to an "optimal" level. The technique has been repeatedly endorsed by the medical and dental establishments, and recent studies credit it with reducing tooth decay by about 25%.
But the spread of fluoridation has been slowed by an aggressive group of foes, who have perpetuated a lingering public anxiety about its safety.
In the early days, the John Birch Society claimed it was part of a diabolical Communist plot to poison America. Other opponents portrayed it as a government conspiracy that would, in the words of one activist, "weaken people's minds and create a race of moronic, atheistic slaves."
More recently, opposition has centered on health-related matters. Dismissing years of scientific research declaring fluoridation safe, critics say some studies have shown that it is a carcinogen and linked it with an increase in hip fractures and osteoporosis.
"The truth is that fluoride is a highly toxic poison with documented side effects," said David Kennedy, a San Diego dentist who has written a book on preventive dentistry. "Just because the government says it's safe doesn't mean it's so. Remember, they said that about lead too."
Kennedy argues that fluoridation leads to "uncontrolled, random doses" of fluoride--meaning that bottle-fed babies and those who drink lots of water could get more than the "optimal" intended dose.
Fluoridation supporters like to call Kennedy and those who share his views extremists who twist scientific findings to unnerve the populace. They note that as recently as 1991, the U.S. Public Health Service reviewed research on fluoridation and found no credible evidence of health risks.
"I liken these fluoridation opponents to the flat Earth society," said Howard Pollick, a professor of dentistry at UC San Francisco. "Ever since science proved the Earth is round, there has persisted a group of people who insist it really is flat."
Los Angeles dentist Eugene R. Casagrande accused fluoridation foes of denying low-income residents the benefits of the cavity fighter. He noted that the people of Beverly Hills have fluoridated water, but that those in South-Central Los Angeles do not.
"Walk into a dentist's office in a disadvantaged area, and see what kind of pain and suffering these kids go through," said Casagrande, a founder of Los Angeles Citizens for Better Dental Health. "You'll be convinced."
Fluoridation's roots date to the early 1930s, when an epidemiologist noted low decay rates among people whose water had high levels of naturally occurring fluoride. In 1945 in Grand Rapids, Mich., the first experiment to test the power of fluoridation began.
From the beginning, fluoridation held great appeal as a public health initiative, in part because it requires no commitment from consumers. As the U.S. surgeon general wrote in 1992: "Whether one is rich or poor, a child at play or in school, a busy adult or a retired person . . . benefits are gained simply by drinking fluoridated water."
Speier's bill, which comes before the Assembly Environmental Safety and Toxic Materials Committee today, is the first attempt to achieve statewide fluoridation since 1975. Her effort--part of a national campaign that aims for 75% of Americans to be drinking fluoridated water by the year 2000--is endorsed by 31 medical and scientific organizations.