'I can no longer sit back and allow Communist infiltration, Communist indoctrination, Communist subversion and the international Communist conspiracy to sap and impurify all of our precious bodily fluids.'
-Gen. Jack D. Ripper in 'Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb'
This quote should be familiar to anyone who listens to Saranac Lake's Rock 105 radio station. It is one of a number of canned quotes they use after commercial breaks, before they return to programming, but it is an interesting choice for this area, since none of the water systems in Essex, Hamilton or Franklin counties are fluoridated, according to Bill Amberman with the state Department of Health's Saranac Lake office. Statewide, 27 percent of people using public water systems were drinking unfluoridated water in 2008.
For opponents of fluoridation, a healthy diet and consistent dental hygiene is all you need to keep teeth healthy.
(Enterprise photo — Nathan Brown)
Consumption of too much fluoride can lead to fluorosis, a condition seen above, which stains the teeth.
(Photo courtesy of the Fluoride Action Network)
In some areas, like Saranac Lake, that do not treat drinking water with fluoride, students take fluoride supplements at school. Here, Kristin Germosen’s first-grade class at St. Bernard’s Elementary School in Saranac Lake receives its fluoride.
(Enterprise photo — Nathan Brown)
"Dr. Strangelove" was intended as a parody of right-wingers who feared fluoridation was a communist plot. But the people of the Tri-Lakes area have rejected fluoridation when the topic has come up, according to area water superintendents, viewing it as unnecessary to put it in the water when it is so readily available so many other ways.
"It's been talked about a few times, but we've never really wanted to get involved in it," said Lake Placid water Superintendent Brad Hathaway. "This is something, we've always felt here, is up to the parents. It's easy for the parents to have the pediatrician supply them with the fluoride pills, so we've never really wanted to get into fluoride injection in the water."
"We'd have to have a reason why we wanted to fluoridate the water," said Tupper Lake water Superintendent Bob Fuller. "The children have fluoride drops throughout school. Certainly, dental records for our children are much better than mine or my parents' records. With the better toothpaste, I think we're getting the fluoridation we need. Unless we were made to, or something happened, we would have no reason why we would want to."
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Fluoridated water systems
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"Nobody has ever asked, and most people I've talked to in the village don't want to see it," Hathaway said. "They would rather just give (their children) the fluoride pills, where they're under control of that. They know what they're giving to their kids, and they know how much."
Fluoridation in Saranac Lake
Saranac Lake water Superintendent Bob Martin said the issue came up once about 30 years ago, but village residents rejected the idea.
"It's not a requirement, and they felt they didn't want it in their water system, so it was never added," Martin said. "The subject has never been brought up again, as far as I know."
Paul Ericson, who retired from practicing dentistry in Saranac Lake two years ago after 30 years, was part of this debate.
"It was an issue when I first came here," he said. "I had three or five village board members as patients. I lobbied them, and we talked about it. They actually (voted) to implement fluoridation. That was right before a municipal election. At that municipal election, there was a change in the composition of the board, and the new board voted to rescind that fluoride mandate."
Ericson said, as a dentist, he noticed a "remarkable difference" between the teeth of patients from Saranac Lake and ones from the Plattsburgh area, where fluoride has been used since 1956.
"There are much (fewer) childhood caries in those patients from the Plattsburgh area, and other areas that grew up with fluoridated water," Ericson said.
Ericson also said Frank Ratigan, who was mayor in the 1950s, favored fluoridation, and Saranac Lake's water was fluoridated for a brief period while he was mayor.
The American Dental Association favors fluoridation, as do the Centers for Disease Control, the state Department of Health and the large majority of dentists; however, Ericson said, few people in town supported the proposal.
"A lot of (the opposition) is just a resistance to have anything that nature may not have provided in the lifestyle or in the environment," Ericson said. "It's partly ignorance. It's probably still an excitable issue for lots of people, but unfortunately, because of that the kids in the Tri-Lakes have really started with a couple of strikes against them for their dental health."
Fluoride and children
Fluoride treatments are offered at schools in this area; children at St. Bernard's Elementary School in Saranac Lake receive them every week, as do students at all Saranac Lake elementary schools. The fluoride is provided by the state Dental Bureau, which provides it to all districts that do not have it in their main water source, Saranac Lake school dental hygenist Suzanne Snizek told the Enterprise in February.
Additionally, Snizek said, kindergarteners receive a daily fluoride tablet. Parents have to consent to the fluoridation program, which Snizek said the majority do. Those who don't often say their children get enough fluoride at home.
"(The fluoride) comes in a little clear plastic container" containing an ounce or two of fluid, said Tupper Lake district Superintendent Seth McGowan. "You peel the top off the thing, stick it in your mouth, swish it around and spit it out in the sink."
Snizek said she thinks children should get as much fluoride as they can.
"Dental decay and dental caries are very prevalent still in this area," Snizek said. "There is a lot of need for dental care."
Snizek said a number of factors are to blame, such as poor dental hygiene and "a diet loaded in carbohydrates and sugars."
While these treatments help, as does ingesting fluoride through toothpaste, the DOH says ingesting fluoride through drinking water is better, as this exposes the teeth to small amounts of it throughout the day.
"This frequent exposure to fluoride combats the acids in the mouth that cause decay," DOH spokeswoman Beth Goldberg wrote in an e-mail.
"Systemic fluoride, or in the fluoridated water, is incorporated into the tooth when it is formed," Ericson said. He said it enters "the chemistry of the tooth, and it makes it less likely to decay."
Children absorb more fluoride through their teeth and retain more of the fluoride they take in than adults, and their consumption needs to be monitored to make sure they're not taking in too much. This can be difficult, as products are almost never labeled for fluoride content. The federal Department of Agriculture maintains a list on their Web site of fluoride levels in various foods.
People ingest fluoride from many sources other than drinking water, such as toothpaste, food and beverages processed in areas that fluoridate, and by eating fruits and vegetables sprayed with fluoride-containing pesticides, said Carol Kopf of the Canton-based Fluoride Action Network. It is recommended that people don't swallow toothpaste or mouthwash partly to avoid ingesting too much fluoride.
Arguments against fluoride
"Fluoride is neither a nutrient nor essential to healthy teeth," Kopf said. "People who don't consume Vitamin D get rickets. People who don't consume Vitamin C get scurvy. People who don't consume fluoride get nothing."
Kopf said people who clean their teeth regularly, visit the dentist and eat well should have good teeth without fluoride. She called tooth decay a "diet-related disease," citing early 20th-century research by Weston Price, a dentist who studied a number of indigenous groups and found that these people, who had never brushed their teeth or visited a dentist, didn't experience tooth decay if they had healthy, natural diets that didn't include processed western foods such as canned goods and refined sugars and flours.
"Putting it in the water is a bad way to prescribe fluoride and not be able to regulate the amount each person gets," Kopf said. "It really should be given individually in a doctor's or dentist's office."
Kopf said a 2006 study by the National Research Council showed that even low levels of fluoride in water are harmful to babies, kidney patients and children with thyroid problems, and could contribute to reduced IQs and cancer. She said other studies have shown connections between fluoride and bone damage.
The most common consequence of too much fluoride is fluorosis, a disease where the sufferer's teeth are stained. Fluorosis is how the tooth-decay limiting properties of it were discovered - in the first decade of the 20th century, a Colorado dentist named Frederick McKay noticed many of his patients had brown-stained teeth. These patients also had noticeably less tooth decay than others. The water in the area had naturally high fluoridation.
The solution to tooth problems, Kopf argued, is better dental care. She said 120 million Americans lack dental insurance, and 80 percent of dentists refuse Medicaid. She said "organized dentistry" is pushing for fluoridation because "they don't want to be mandated to actually treat people.
"When the individual dentists speak to you, they're being truthful," she said. "They think fluoridation works. In the 1940s and '50s, they truly believed it was a good thing, but the years have not been kind to fluoridation and the science is not supporting it."
Goldberg said studies in the 1930s and '40s showed fewer cavities in children drinking naturally fluoridated water.
"The first water supply fluoridated in New York was Newburgh in 1945," Goldberg said. "By the 1960s, 13-to-14-year olds had 70 percent less dental decay than the children in neighboring non-fluoridated Kingston."
Many New York water systems adopted fluoridation between the 1950s and '80s. About 70 percent of Americans drink fluoridated water.
The state recommends adding one milligram of fluoride per liter of water, Goldberg said, and monitors to make sure the fluoride level in water systems that fluoridate stays between .8 and 1.2 milligrams per liter.
"It's something that has to be watched very carefully, because fluoride is something that can make you sick," Hathaway said.
This need for constant monitoring could be an obstacle to smaller communities adapting fluoride. William Todd, manager of Plattsburgh's water plant, told the Press Republican in January that the city's water system is checked three times per day for fluoride levels.
"I can understand why some towns with smaller water systems don't use it, because they don't have somebody to watch it constantly," Todd said.
Equipment and chemical startup costs for fluoridation are about $20,000, Goldberg said, and fluoridating a water system serving less than 5,000 people costs, on average $3 per year per resident.
Communities in the North Country abandoning it
Canton village trustees voted to end fluoridation in 2003, after a campaign led by St. Lawrence University staff and students. The campaign was organized by Paul Connett, a now-retired chemistry professor at St. Lawrence University who is a co-founder of the Flouride Action Network. Nearly 130 faculty and staff, and 300 students, signed Connett's petition.
The issue came up again in Plattsburgh earlier this year, with Connett asking the city council to cease fluoridation and local dentists arguing in favor of continuing it.
Rouses Point also used to fluoridate its water but has abandoned the practice, and former village water Supervisor Steve Corcoran was one of 600 doctors and other professionals in related fields who signed a petition opposing fluoridation in 2007.
If a municipality wants to start fluoridating, the local government would have to get the approval of the DOH.
"Any time a water supply is going to add another treatment method, whether it's disinfection, fluoridation or corrosion control, they have to submit plans and get the approval of our department," Amberman said.
A municipality can stop fluoridating without anyone else's approval.
Contact Nathan Brown at 891-2600 ext. 26 or firstname.lastname@example.org.