Are more teeth decaying since fluoridation in Juneau ended? Dentists seem to think so.

dentist teeth cleaning

(Creative Commons photo by Allan Foster)

Earlier this year the Anchorage Assembly nixed a ballot initiative to cease fluoridating its water supply.

Despite setbacks, activists there vow to keep the effort alive.

Juneau grappled with the question over fluoridation a decade ago and people’s views remain the same today as they were 10 years ago.

“We’re now in the United States at over 70 years of community water fluoridation with levels of fluoride in the water,” said Brad Whistler, Alaska’s top dental officer. “The only health effect that’s seen is reduced dental decay.”

Critics don’t see it that way.

“I’m not against applying fluoride topically as needed,” said Emily Kane, a Juneau-based naturopathic physician and fluoridation critic. “But I didn’t think it was good judgment to medicate the entire population.”

It all began when Juneau’s Public Works Department quietly ceased fluoridation in 2003. After this came to light, dentists urged the city to put fluoride back in the water.

Faced with a deeply divided public, the Assembly appointed a six-member fluoride commission that spent two years studying the question.

“The long and short is the panel was divided 3-to-3,” recalled Bruce Botelho, Juneau’s mayor at the time.

Faced with that impasse, the Juneau Assembly voted to keep fluoride out of the water.

Botelho said that documented cases of fluorosis in other parts of the country — in which excessive fluoride levels can lead to pitted tooth enamel — swayed a number of Assembly members.

“I think even those studies that have been supported by the American Dental Association would acknowledge that there is an issue of fluorosis,” he said. “That for some, small portion of the population there is such a thing as too much fluoride.”

The American Dental Association bankrolled a ballot initiative to overturn the Assembly’s decision.

The Juneau Empire reported what it described as a “stunning amount of campaign spending” by the national group which bought TV and radio spots.

Botelho said the dental association’s pro-fluoride push was heavy-handed and tone-deaf.

“The message, the overall message, was trust us we’re the professionals,” Botelho said. “It didn’t play well.”

That’s an understatement.

Despite dentist groups greatly outspending critics of the pro-fluoride initiative, more than 60 percent of voters rejected fluoridation.

“They spent like $150,000 and we spent $7,000,” recalled David Ottoson, owner of a downtown health food store and vocal member of the grassroots anti-fluoride group at the time. “But just from the conversations I was hearing and the letters I was seeing in the paper, I still thought the money wasn’t going to win in this case and it didn’t.”

Dentist groups say fluoridation is a critical tool to fighting tooth decay. So this begs the question: More than 10 years have passed since fluoride was pulled from the water.

Has tooth decay worsened? Juneau’s dentists seem to think so.

“My own observation in the younger population … yeah, there was an uptick, no question about that,” said David Logan, a former Juneau-based dentist and current head of the Alaska Dental Society in Anchorage.

“You pretty much have to set the clock at the day the the fluoride came out of the water. And then you advance forward until you start seeing teeth erupt,” he said. “The six-year molars no question, saw an uptick in cavities. I’m really worried about the uptick we’ll see on the 12-year, though.”

Ten years ago Kristen Schultz headed the Juneau Dental Society. She’s convinced that tooth decay is rising among her patients 15 and younger.

“But that’s just a gut feeling,” she said. “I kind of wanted to go back and look at my practice and see if that’s just what I want to believe or if there’s actually some sort of trend that is there.”

She ran some numbers based on available records from the past 10 years. The amount of cavities she’s drilled out has risen over time.

But her sample is small and she admits, unscientific.

More complete data doesn’t exist, said Whistler, the state’s dental official. He’s inclined to agree with fellow dentists.

“But as far as having hard data to measure that there’s been a change, we didn’t even have base line data on these communities to even know what it was prior to going off fluoridation let alone having the ability to go in each year and assess if there were changes in dental decay,” Whistler said.

Skeptics aren’t likely to be won over.

“Anecdotal evidence? Well, it’s anecdotal,” Ottoson said. “And I think we suggested at the time might not be a bad idea to look at the results and see.”

The issue in Juneau seems decided — at least for now. That’s because dentists aren’t eager to reopen old wounds.

“It was pretty gut wrenching,” Schultz said. “It wasn’t a fun debate to go through so I don’t know that any of us are gung-ho to fight that battle again and possibly end up with the same results.”

Since Juneau dropped fluoride, the cities of Fairbanks and Palmer have followed suit. And activists in Anchorage continue to push for Alaska’s largest city to cease water fluoridation.

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