There’s an oncoming storm sweeping across the political landscape, and tonight it will make landfall in Anchorage, Alaska.
It’s an issue that bridges traditional divides of left and right, leaving most of us stuck in the middle scratching our heads going “Whuuuh?” This issue, which will define a generation, is a populist movement against our greatest and most unknown and unseen enemy. It’s a secret war against the villainous threat, of…
*queue dramatic music*
But what is fluoridation? Where does it come from? What the heck does it actually do? Why does it garner such strong opposition from the hippies to the doomsday preppers?
Fluoride in Alaska
Fluoride, as it is used in water treatment, is a substance derived from fluorite, which is a naturally occurring mineral. According to the Alaska Resource Data File of the U.S. Geological Survey, in Alaska there are 109 known deposits of fluorite. Eight have been actively mined sites at some point, 58 have been observed in prospected claim sites, and 43 have been observed occurring. A large clustering of fluorite occurs in Southeast Alaska, particularly around Petersburg. There have also been several sites located in the Talkeetna Mountains and in the Philip Smith Mountains, which are part of the Brooks Mountain Range.
Fluorite is common in Alaska because it is associated with granite and limestone formations in areas of high geothermal activity. It’s so common in the Juneau and Fairbanks watersheds that those cities don’t artificially fluoridate the water; it leeches from the rocks and soil into the streams that make up the city water supply. Sitka has a mixture of natural and additive amounts. Anchorage is the only large populated area that artificially fluoridates its water. Now the municipality is opening up discussion on whether it should continue that operation. Being the good scientist that I try to be, I decided to consult the data about the potential benefits and drawbacks of fluoridated water.
Pros and Cons
One thing that I find interesting about science is that it can be (and is) used by opposing sides of an argument to support respective claims. There is no shortage of science demonstrating that low concentrations of fluoride in water are good for teeth, particularly in children. However, the counter studies are usually poorly constructed and incredibly selective in their review of literature.
Unfortunately a lot of the studies supporting fluoride use are over 50 years old and don’t control for other variables like diet, other sources of fluoride, or socio-economic status. Only one study that I found showed that the number of decayed, missing, or filled (DMF) teeth that occur in children is more common in low socio-economic status (SES) families. The older studies also consider simple sodium fluoride as the additive of choice, while most water supplies currently use silicofluorides for water fluoridation. There doesn’t appear to be as much conclusive work on what the potential health impacts might be between the two additives.
One of the most referred to papers on the dangers of silicofluoride looks at the effects it has on absorption of lead in the blood. The study by Masters and Coplan received several rebuttals that focused on a lack of transparency in methods and analysis. The paper failed to prove a biochemical relationship between silicofluoride and lead, and simply looked at correlation with no respect to causation or even rate of exposure to lead.
Other studies that try to correlate fluoride to cancer have also been thoroughly debunked for similar reasons. Additionally, conspiracy theorists like to point to a Meta study (or a study of studies) that links fluoride to loss of IQ. The biggest problem with using IQ as an outcome is that it is inherently subjective and culturally rooted; no one can agree on what IQ is, let alone how to measure it. Another major issue with this study is that it was conducted in China, where fluoride concentrations can already be incredibly high in very specific watersheds. These concentrations are not comparable to the 1 part per million standard in the U.S. Similarly, toxicity studies on lab rats involve dosages 20 to 80 times that of what we are generally exposed to.
While I believe that science supports the benefits of fluoride more than it does the potential harm, I think the ultimate question on its use is one rooted in ethics. Does the government have the right to mass medicate the populace for the good of the poor children? Can such a highly technical process be carried out safely and effectively? What are the safeguards, the checks and balances, which oversee such a process? What is our emergency response plan should something go wrong? How often are we within tolerances? Are people properly educated on ALL the sources of fluoride that they are exposed to on a daily basis? These are all legitimate policy concerns that should be hashed out transparently and with public participation.
There are serious health concerns related to exposure to super high concentrations of fluoride, and water isn’t our only source. Tea naturally contains fluoride. It’s also a common ingredient in most brands of toothpaste. One of the most dangerous sources of overexposure comes from powdered baby formula. These powdered formulas already include high amounts of fluoride, important for initial development of bones, and reconstituting them with fluoridated water can expose babies to higher than recommended doses.
Whether or not these concerns will enter the discussion remains to be seen. Much of the debate that is coming to Anchorage stems from an accident at Hooper Bay. That particular case left 300 people sick in the surrounding rural communities. The underlying problem with having this conversation is that it often gets hijacked by conspiracy theorists that tend to oversimplify and over exaggerate.
Conspiracy theory sites like Infowars tend to be self aggrandizing, relying heavily on their own prior works to support their claims or links to similar sites that do the same. When they do reference outside, peer reviewed, scholarly works, they cherry pick studies and even sentences that support their assertions while ignoring the broader context of the study and the research literature. Such practices are misleading and not conducive to discovering the whole truth.
Hopefully the oncoming storm of the great fluoride debate will avoid these pitfalls. Citizens have a right to understand and know what is being pumped into their water and their bodies, and the Municipality has a responsibility to facilitate that discussion in a fair and truthful manner.