WASHINGTON – When Princess Anne adds fluoride to its water next spring, the Somerset County town will join the vast majority of public systems that have added the cavity-fighting chemical.
But decades after the government recommended fluoridation, a handful of systems in the state still have their doubts about its health benefits, and some opponents have gone to court to get fluoride out of their drinking water.
Maryland public water is “relatively good,” with 90 to 91 percent fluoridated, said Dr. Harry Goodman, director of oral health at the state Department of Health and Mental Hygiene. Nationally, about 62 percent of public water systems are fluoridated.
Those numbers do not include well water. Fluoride can occur naturally in water, and there are some aquifers in Charles and St. Mary’s counties that contain low levels of fluoride.
But Calvert County remains “without a drop of fluoridated water,” Goodman said, and only one of Cecil County’s three public water systems — the one that is supplied from a Delaware source — is fluoridated. St. Mary’s and some Eastern Shore counties have less than 50 percent of people on public water receiving fluoride.
Calvert County does not plan to fluoridate because officials there do not think it is safe or necessary. About 90 percent of the county’s population uses well water and Jimmy Herriman, the county’s director of environmental health, sees no need to fluoridate the public water system.
“It’s very thin line between the correct amount of fluoridation and too much,” Herriman said. “It’s a concern. You’re walking on a fence on that one.”
Fluoride can be dangerous in high levels, said Herriman, noting that dentists give fluoride treatments to children and that toothpaste now has fluoride added to fight cavities.
With improvements in dental care, and with more people carrying insurance, Herriman said Calvert County would rather stay away from fluoridating the public water supply.
Elsewhere in the state, where water supplies have been fluoridated, opponents vowed to continue the fight. After Cumberland and Frostburg this year added fluoride to their water supplies, the Pure Water Committee of Western Maryland Inc. went to court to reverse the action.
“We’ve kept it out of the water for 50 years,” said Mary Miltenberger, treasurer of the committee.
The committee filed a federal lawsuit against Cumberland, Frostburg and the Evitts Creek Water Co., which operates Cumberland’s water system. The case, to be heard in Baltimore in March, charges the defendants with practicing medicine without a license, because community members never signed medical consent forms for the addition of the fluoride.
“If you are not a doctor, you cannot prescribe a drug,” which is what Miltenberger and her group claim officials are doing by adding fluoride to people’s drinking water.
The Pure Water Committee is also pushing for a referendum on fluoridation in Frostburg and Cumberland.
Right now, fluoride levels in water systems statewide follow Centers for Disease Control and Prevention guidelines of one part per million. Too much fluoride can lead to a cosmetic dental condition called fluorosis, which causes tooth discoloration.
But groups like the Pure Water Committee cite research that suggests that fluoride can lead to far more dangerous conditions than brown teeth.
“It’s very toxic, it’s carcinogenic, it’s not pharmaceutical, it’s toxic runoff — that’s why we have so many health problems in our country and no one wants to admit it,” Miltenberger said.
But the medical and dental communities have endorsed fluoridated water supplies for decades — an endorsement that was reinforced by the CDC recently with a new report. An independent task force that did the report found that tooth decay typically decreased by 30 percent to 50 percent after starting or continuing community water fluoridation.
Dr. Paul Weiss, chairman of the provisional section on Pediatric Dentistry for the American Academy of Pediatrics, said the dental community “absolutely” recommends fluoride in drinking water for cavity prevention. Supporters downplay reports of possible health hazards from fluoridation.
More-populated areas of the state has been drinking fluoridated water for decades, following the CDC’S findings in the 1950s that fluoride in drinking water could prevent tooth decay.
For the good it does to prevent cavities, Goodman said fluoridation is a bargain. He said the price could be as low as 50 cents per person for a year. He said the biggest outlay of money the state has had to come up with was “around $50,000.”
There was no dispute over fluoride in Princess Anne, said Robert Street Jr., manager for Somerset County’s sanitary district. He said fluoridation was a matter of funding and planning: The town received a grant from the state that allowed it to go forward with the project.
Princess Anne’s water system serves an estimated 1,600 residents and the University of Maryland Eastern Shore, said Street.
The project comes at a time when Princess Anne, “desperately needs all the help it can get” to deal with tooth decay. “They have very high tooth decay rates,” said Goodman.
But even supporters concede that just adding fluoride to the water will not create perfect dental hygiene.
“You just can’t insure that everybody is brushing their teeth,” Goodman said.