By Luigi DeFrancesco
It seems to me that the question of using fluoride to prevent decay is still going on. After reading Mr. Art Hoffman’s letter to the editor (“Fluoride helps our kids preserve smiles,” Sept. 14) I feel that the public has the right to know about fluoride, first, and secondly, I want to know if they want educational institutions such as PENNCREST School District to act as a social service agency.
The availability of the Internet at home is just like having a huge library where one can search any topic one wishes. Anyone with access to Internet can get a ton of information about “fluoride” and if you don’t have a computer at home you can use one at your local library courtesy of the property owners of Crawford County.
The federal Centers for Disease Control and Prevention (CDC) website about fluoride is cdc.gov/fluoridation/faqs/index.htm. The CDC does not address fluoride in tablet form but as an additive to water supplies.
The following are some excerpts from the CDC: “The EPA’s (federal Environmental Protection Agency’s) enforceable standard for the highest level of fluoride that is allowed in public water supplies is 4.0 milligrams per liter and is set to protect against risks from exposure to too much fluoride. The Department of Health and Human Services’ (HHS) proposed recommended optimal level of 0.7 milligrams per liter is set to promote public health benefits of fluoride for preventing tooth decay while minimizing the chance for dental fluorosis.”
The point that I attempted to make at the Sept. 9 PENNCREST School Board meeting was that water company suppliers should not exceed the recommended dosage in their drinking water and the reason is that according to the CDC, “Children age 8 and younger exposed to excessive amounts of fluoride have an increased chance of developing pits in the tooth enamel. Excessive consumption of fluoride over a lifetime may increase the likelihood of bone fractures and may result in effects on bone leading to pain and tenderness, a condition called skeletal fluorosis.”
It is clear to me that the CDC recommends the addition of fluoride in the water system to prevent tooth decay but at the same time one may conclude that it is important to know how much fluoride is ingested naturally before an additive is introduced. How much fluoride do the tablets contain? Has the school district’s dentist evaluated the dosage? Is the same dosage adequate for all the kids?
The following are recommendations that the CDC gives to health professionals: “Fluoride supplements can be prescribed for children at high risk of tooth decay whose primary drinking water has a low fluoride concentration. For children under 8, weigh the risk for decay without fluoride supplements, the decay prevention offered by supplements and the potential for dental fluorosis.
“Counsel parents and caregivers on the use of fluoride toothpaste by young children, especially those younger than 2 years. Fluoride toothpaste is a cost-effective way to reduce the prevalence of tooth decay. However, because they do not have a well-developed swallowing reflex and may like the taste of the toothpaste, young children often swallow a large portion of the toothpaste put on their brush.”
There are opposing views on the health benefits of fluoride and the Fluoride Action Network (fluoridealert.org) has lots of information. That website states that according to Dr. Arvid Carlsson, the 2000 Nobel Laureate in Medicine and Physiology and one of the scientists who helped keep fluoridation out of Sweden: “Water fluoridation goes against leading principles of pharmacotherapy, which is progressing from a stereotyped medication to a much more individualized therapy as regards both dosage and selection of drugs. The addition of drugs to the drinking water means exactly the opposite of an individualized therapy.”
This is exactly my point when it comes to medication. One size does not fit all. For example, if the Cambridge Springs and the Saegertown water systems introduce fluoride into their water, should the students in these areas take fluoride tablets? What about fluoride they intake from other sources?
The Pennsylvania American Academy of Pediatrics (PAAAP) has a PowerPoint presentation for medical providers called “The Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Program” which can be found at paaap.org. The presentation emphasis is on oral hygiene and they claim that a major culprit of dental caries is the process when bacteria on teeth consume sugar to produce acid that dissolves tooth mineral. It seems logical to me that the best way to prevent tooth decay is to eliminate sugar from a child’s diet.
They do recommend fluoride varnish but they do not mention fluoride in water or tablets. In conclusion: Is fluoride “too much of a good thing” as stated by the National Research Council (Summer 2006 Vol. 6 No. 2) where they actually recommend that the EPA lower its maximum contaminant level in order to prevent enamel fluorosis? In our modern times parents have access to information through the electronic media. They should take advantage of it and then they should make their own decision on what is good for their own children.
Be aware of the knock at your door with the following: “I am from the government and I am here to help you.” When the fluoride program was first instituted in PENNCREST my wife and I decided that we did not need the federal program to help us. We followed the recommendation of the PAAAP and today all of my four children have beautiful smiles nonetheless.
The residents of the school districts in Crawford County must decide if they want their schools to be social service agencies or institutions of learning. Dispensing fluoride tablets is a social service, in my opinion, that is not mandated by law the same as the child care program which PENNCREST eliminated.
Should the school district follow its mission statement, which emphasizes education, or dispense fluoride tablets today hoping that someday someone will not determine that grandma’s hip shattered because of excessive fluoride in her bones?
DeFrancesco, who is president of the PENNCREST School Board, can be reached at firstname.lastname@example.org.