Daily Hampshire Gazette

Fluoridation in South Hadley

By COLLEEN STONE, Staff Writer

Monday, September 18, 2000 -- (SOUTH HADLEY) - Fred Kowal thought it would be easy to fluoridate South Hadley's water.

Fluoridated water has been credited with reducing cavities and is endorsed by the American Dental Association.

Kowal, South Hadley's health director, said he and Board of Health members pushed for fluoridation as a cheap and effective public health measure. "A lot of people don't get proper dental care, and there's a lack of insurance," he said.

But one year after the Board of Health ordered South Hadley's public drinking water fluoridated, the initiative sits stalled amid politics over who has the right to decide what goes into drinking water, public opposition to fluoride and disagreement over the credibility of information used by both sides.

Meantime, the South Hadley Board of Health is weighing voluntary options, like distributing fluoride tablets and rinses.

For proponents of fluoridation, the South Hadley impasse is a victory for medical quackery. Introduced in the U.S. in the Cold War 1950s, fluoridation has been linked to communist plots and lower intelligence by those who don't want it in their drinking water.

Opponents, some of whom do ascribe to those beliefs, see it differently. They see it as an individual decision over what is introduced into their water, good or bad.

"The essence of the Granby decision was choice," Granby Health Agent J.M. Sorrell said of the Board of Health's opposition to the fluoridation proposal. Granby's public drinking water is supplied by South Hadley.

Crisis, cure, conflict

A report released by the Massachusetts Special Commission on Oral Health last February said a lack of insurance and regular dental care has resulted in "an oral health crisis" in the state. The commission recommended that $1.5 million be granted to the 178 Massachusetts cities and towns that are without fluoridated water.

One-hundred-and-twenty-two cities and towns in the state receive fluoridated water.

Though the funding hasn't been approved, many health officials maintain the commission's findings support their push for fluoridation.

As state law allows, the South Hadley Board of Health ordered the town's water supply fluoridated in August 1999. The $40,000 initial cost would be paid by the state. The program would then cost the town $9,600 a year.

The order hit its first snag when the board realized that the Ludlow and Granby boards of health would have to agree to the order because a combined 588 households in the towns are served by South Hadley's two water districts.

While the town waited for a decision from Granby and Ludlow, some South Hadley residents took steps to ensure it wouldn't happen. Judith Dietel took the lead.

Dietel, who works at the University of Massachusetts, had friends in California who are active in the anti-fluoridation movement. She didn't take their interest very seriously "and then, all of a sudden, it was in my backyard."

Dietel primarily used the Internet, where the query on a search engine on the "dangers of fluoride" can produce more than 200,000 Web pages devoted to the issue.

Dietel attended a meeting sponsored by the health board on the fluoridation issue last year and presented the board and residents with studies she obtained on the Internet. According to the studies, fluoride lowers IQ, increases bone fragility, and adversely affects neurofunction. Dietel also sent the information to the Granby and Ludlow boards of health.

Her sources include Dr. Phyllis Mullenix, formerly of Harvard University, and EPA members who have come out against fluoride, claiming the government uses water fluoridation as an excuse to dispose of toxic waste.

Dietel said she believes the South Hadley Board of Health members were well-intentioned, but that public water supplies should not be a vehicle for anything but drinking water.

"It should not be used to medicate us, good or bad," Dietel said.

Dietel is upset that people like Francis Nelen, a South Hadley Board of Health member and dentist, refused to read her information. Nelen says the information has no medical credibility.

"They have been discredited by sources such as Harvard Medical School, the State of California, and the Massachusetts Board of Health. Just about any credible source has discredited these information sources ... Anything she can possibly show me, I've already seen before," Nelen said.

Nelen said people conducting research on fluoridation usually don't completely understand the information, and often rely on sources filled with misinformation.

"The Internet is an avenue where anyone can get a Web site and post information," Nelen said.

More opposition

In Granby and Ludlow, the fluoridation proposal didn't fare any better. Both towns took their time conducting research and mulling whether they should order fluoridation or leave the decision up to their residents.

Sorrell, Granby's public health agent, and members of the Granby Board of Health conducted months of research before they decided against fluoridation.

"I went to Harvard Public Health Library, Tufts Public Health Library, and looked at dental and public health journals," Sorrell said.

The conclusion: the benefits of fluoride did not outweigh the risks.

Granby Board of Health member Richard Bombardier cited risks such as dental fluorosis (staining of the teeth) and toxicity to infants consuming baby formula made with fluoridated water. More than the possible risks, the issue of letting residents decide on the issue swayed Granby's vote to block fluoridation.

Ludlow soon followed suit, and voted down the initiative, 2-1.

Sorrell said Granby didn't rely on Internet sources for fear of being discredited.

"We looked at the Internet in the beginning and realized there's a lot of inflammatory material on either end of the spectrum. We wanted to take a more scientific approach," Sorrell said.

"We wanted to try to get as well-rounded an amount of information as possible ... South Hadley didn't give us balanced information. They said to read the ADA report. That prompted our research," Sorrell said.

Dietel is also suspicious of sources South Hadley cites to support water fluoridation - especially government sources, such as the U.S. Surgeon General, who released a report in June deeming fluoride in water a safe and effective measure to promote oral health.

"Do you know how much we don't know about because it hurts the big pharmaceutical companies? The fact that the surgeon general hasn't said much about it doesn't surprise me because I don't think our government focuses on important issues," Dietel said.

The fluoride initiative faces a tough road as long as it still needs the approval of all three boards of health.

As it stands, the issue is tabled until the three boards can agree to fluoridate. Granby has said it will reconsider its decision if a public vote by residents shows a majority supports fluoridation. The next time a vote on the issue could be held is during water district elections in March and April.

But no one is quite sure if such a vote would be binding if the boards don't first back the initiative, and there is still the question of whether the initiative would survive a vote, given the public backlash.

"It's politically impossible," said South Hadley board member Francis Nelen. 

© 2000 Daily Hampshire Gazette