Frequently Asked Questions and
Dispelling the Myths
 

1. Do I receive my drinking water from the Skagit County Public Utility District (PUD) Judy Reservoir?
2. What other communities in Washington have fluoridated water?
3. What is fluoride?
4. Is fluoride safe?
5. Does fluoridation benefit anyone other than children?
6. Is there a cost savings associated with water fluoridation?
7. How serious is dental decay in Washington?
8. Why are there warning labels on toothpaste?
9. These days, we get fluoride from so many sources.  When we have it in our water, will it be safe?
10. Just about everyone brushes with fluoride toothpaste and gets fluoride dental treatments, so why do we need fluoride in our water?
11. What are some of the specific studies that support community water fluoridation?
12. Does fluoridation damage the environment?
13. Do some people have allergies to fluoride?
14. Shouldn't we have the right to choose what we consume?
15. Is the EPA against fluoridation?
16. Have European countries banned fluoridation?
17. Is fluoride a byproduct from the fertilizer industry?
18. What about reports that fluoridation causes cancer/genetic damage/neurological impairment/hip fractures/kidney lesions/etc.?
19. What were the findings from the recent National Research Council report on fluoride?
20. Is there an association between fluoridation and osteosarcoma?
21. Does fluoridated water impair cows' milk production?
22. Does fluoridated water interfere with the oil refinery process?
23. Does community water fluoridation hurt salmon?
24. Do Nobel Laureates oppose fluoridation?
25. Didn't a former president of the AMA oppose water fluoridation?
26. Does fluoridation weaken bones?
27. Isn't the fluoride in our water an industrial toxic waste product and not approved by the FDA (Food and Drug Administration)?
28. Is it true that 32% of American children now have some form of dental fluorosis?

Do I receive my drinking water from the Skagit County Public Utility District (PUD) Judy Reservoir?

To find out if you receive drinking water from Skagit County PUD’s Judy Reservoir, contact the PUD directly at:

Skagit Public Utility District No. 1
1415 Freeway Drive
PO Box 1436
Mount Vernon, WA 98273-1436
Phone:  360.424.7104
Fax:  360.424.8764
E-mail:  pud@skagitpud.org

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What other communities in Washington have fluoridated water?

Accounting for all water systems (both public and private), Washington is about 50% fluoridated.  Some communities that receive the proven health benefits of fluoridated water include:

  Oak Harbor - since 1956
  Poulsbo - since 1959
  Anacortes - since 1963
  Vancouver - since 1963
  Seattle - since 1970
  Everett - since 1992
  Bainbridge - since 1994
  Yakima - since 2002
  Port Angeles - since May 2006

For additional information about fluoridated communities in Washington, visit FluorideWorks.

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What is fluoride?

Fluoride is a naturally occurring compound that can help prevent dental decay.  Fluoride occurs naturally in water at varying concentrations.

The general term fluoride describes a compound of which the element fluorine is one part. Naturally occurring fluorine is the 13th most abundant element in the earth's crust. (U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000, p158)

Fluorine combines with other elements, such as calcium or sodium, to form compounds that are usually found in soil and water in low concentrations (less than 1 part per million). (Morbidity and Mortality Weekly Report 10/22/99; 48(41);p934 933-940, published by Centers for Disease Control and Prevention)

Naturally occurring fluoride levels in water can be higher or lower than levels optimal for prevention of oral disease. Fluoridation of community water supplies does not involve introducing a foreign element to the water, but rather it involves carefully adjusting the existing fluoride levels for maximum oral health benefit.

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Is fluoride safe?

Yes, fluoride is safe. Americans started fluoridating almost 60 years ago, and its safety and effectiveness has been proven time and time again. Virtually every medical and dental association and public health organization considers fluoridation to be an exceptionally safe and effective tool for improving community oral health.  The Centers for Disease Control water fluoridation one of the top public health achievements of the last 100 years.

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Does fluoridation benefit anyone other than children?

Absolutely. While fluoride is most beneficial to children, everybody who drinks fluoridated water benefits from it. Fluoride is key for good oral health throughout a lifetime. Decay rates in areas with fluoridated water can be up to 40% less than decay rates in unfluoridated areas.

Drinking water with adequate fluoride is particularly important for seniors because it helps them keep their teeth and reduces their need for expensive restorative care. Seniors are at a high risk for many forms of oral disease because many suffer from receding gums or take medications which interfere with the body's ability to bring minerals to the teeth. Fluoridated water is proven to substantially reduce decay under both conditions.

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Is there a cost savings associated with water fluoridation?

The cost to fluoridate water for the lifetime of one person is less than the cost to treat one cavity.

Fluoridation costs next to nothing. A community can fluoridate its water for about 50 cents per person per year. For this small investment, you get stronger teeth and substantially lower dental bills.

Every dollar invested in fluoridation saves $38 in dental care (CDC).  Water fluoridation means real savings for families, businesses and taxpayers.

A non-profit foundation will pay for the costs of fluoridation equipment.  We all could enjoy a lifetime of health benefits for less than the cost of a soda each year.

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How serious is dental decay in Washington?

According to the Surgeon General, dental decay is a "silent epidemic."  Oral disease can be intensely painful and impair overall health.

Dental decay impacts almost 60 percent of elementary school children, making it a leading cause of missed school, and affecting children's ability to learn and succeed.  Dental decay is the most common chronic childhood disease, five times more common than asthma.

Nearly one-third of seniors have untreated dental cavities.  Oral disease also is linked to other health problems including diabetes and heart disease.

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Why are there warning labels on toothpaste?

Toothpaste contains highly concentrated amounts of fluoride because it is intended to be used on the surface of your teeth. Fluoridated water, on the other hand, contains an extremely small amount of fluoride. At this concentration, everyone's oral health is improved, and you can drink as much water as you like without fear of getting too much.

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These days, we get fluoride from so many sources. When we have it in our water, will it be safe??

Modern standards for water fluoridation have been adjusted to account for other sources of fluoride. Tooth decay is a serious problem here, in part because people do not get enough fluoride.

Fluoridated water contains only trace amounts of fluoride, and is completely healthy to consume at any quantity. When a case of fluorosis (or over exposure) occurs, it is typically due to the swallowing of too much toothpaste, dental treatments, or fluoride pills. Fluorosis is a treatable cosmetic problem, and experts do not consider it a health problem.

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Just about everyone brushes with fluoride toothpaste and gets fluoride dental treatments, so why do we need fluoride in our water?

For optimal oral health, your teeth need to receive fluoride in two very important ways: directly on the surface of the tooth, and through your system to strengthen teeth from the inside. Fluoride toothpaste and dental treatments are great for bringing high concentrations of fluoride directly to teeth. But these methods are not very effective at providing fluoride systemically.

Drinking water with adequate fluoride works both on the tooth surface and systemically by providing you with a very small yet regular amount that helps build and maintain strong teeth.

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What are some of the specific studies that support fluoridation ?

Community water fluoridation has been studied for more than 60 years. There are thousands of studies on the subject.  To read more about specific studies, visit the CDC web site.

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Does fluoridation damage the environment?

No. In fact, fluoride is one of the earth's most common elements, and is naturally found in varying concentrations in all water. Recent studies have shown that fish and wildlife are in no way harmed by fluoridation.

Under Washington's State Environmental Protection Act (SEPA) a study was conducted in Tacoma-Pierce County to investigate the environmental consequences of adding optimal levels of fluoride to drinking water.  The SEPA study concluded that there are "no probably significant adverse environmental impacts."

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Do some people have allergies to fluoride?

Decades of research have found no adverse health effects associated with fluoridation, not even allergic reactions. The American Academy of Allergy thoroughly investigated alleged cases of fluoride allergy and concluded, "There is no evidence of allergy or intolerance to fluorides as used in the fluoridation of community water supplies."

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Shouldn't we have the right to choose what we consume?

Fluoridation benefits everyone, just like seatbelts, or adding vitamin D to milk or iodine to salt.

Our high rate of oral disease is bad for everyone. The simple fact is our water doesn't naturally contain enough fluoride to keep our mouths healthy. If we had been fluoridating, many painful and expensive cases of oral disease across the community, from children to seniors, rich to poor, would have been prevented.

When people can't pay for dental care, the community as a whole must pay.

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Is the EPA against fluoridation?

No. The Environmental Protection Agency is in no way opposed to fluoridation. The EPA issued guidelines for environmentally safe concentrations of fluoride, and fluoridated water is far below that level.

Opponents claim that the EPA union does not support fluoride, but it should be noted that virtually all medical, dental and health organizations support fluoridation as completely healthy and the most effective way to reduce oral disease.  These EPA unions address standard labor - management issues, such as sick leave, promotions, workers compensation, etc.  They have no role with regard to U.S. EPA scientific policy.  The EPA regulates additives in drinking water (including fluoride) and oversees requirements to ensure their safety.

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Why have European countries banned fluoridation?

No European country has banned water fluoridation.

Fluoridation is recognized throughout the world as a safe and effective way to improve everyone's oral health.

The truth is most European countries simply find it impractical to fluoridate because of their numerous water sources and complex water systems. As an alternative to water fluoridation, most of Europe fluoridates salt.

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Is fluoride a byproduct from the fertilizer industry?

The fluoride used in drinking water is pure. Every batch of fluoride is rigorously tested to ensure that it meets or exceeds national and international safety standards. And, as to any suggestion that drinking fluoridated water is toxic, the exact opposite is true. Communities with fluoridated water are simply healthier than communities without fluoridation. Their rates of oral disease are dramatically lower, and when oral health improves, so does overall health.

Fluoridation has proven itself so safe and beneficial that its opponents have to rely on scare tactics and distorted truths. In this case, their claim is based on the fact that in nature, fluoride is often found mixed with other very useful minerals. And one of those other minerals is used as a component of fertilizer.

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What about reports that fluoridation causes cancer/genetic damage/neurological impairment/hip fractures/kidney lesions/etc.?

The reports are false. The arguments against fluoridation are almost always based on outdated documents or on studies that deviate from accepted scientific practices.

Nearly 60 years of continuous and thorough scientific study of the effects of fluoridation has demonstrated that, in the short term and over a lifetime, consuming fluoridated water greatly improves oral health with no adverse effects to overall health.

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What were the findings from the recent National Research Council report on fluoride?

The National Research Council report does not address community water fluoridation as practiced in Washington state and in communities throughout the United States.  The NRC report did not recommend any changes in procedures currently used by communities to protect residents from preventable tooth decay.

The report recommended that the maximum allowable level for fluoride in drinking water be re-evaluated, but this would only pertain to areas that have naturally-occurring levels of fluoride that are at least four times greater than optimal levels.  This affects approximately 200,000 individuals, none in Washington state.

The levels used by communities to prevent dental decay (0.7 to 1.2 parts per million) have remained constant for the past 40 years and are strongly endorsed by medical, dental and health organizations throughout the United States.

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Is there an association between fluoridation and the rare bone cancer osteosarcoma?

At this time, the weight of the scientific evidence, as assessed by independent committees of experts, comprehensive systematic reviews, and review of the findings of individual studies does not support an association between water fluoridated at levels optimal for oral health and the risk for cancer, including osteosarcoma.

A recent study at Harvard, which started in 1992 and remains ongoing, has looked at two sets of cases of patients with bone cancer: some from 1989 to 1992, which the article discusses in significant detail, and others from 1993 to 2000, which the article mentions only in passing.

Importantly, however, that passing reference to the second set of cases acknowledges that they do not appear to replicate the findings suggested by the first set of cases.  They do not suggest an overall association between fluoride and osteosarcoma.

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Does fluoridated water impair cows' milk production?

No, optimally fluoridated water does not impair cows' milk production.  In the well respected dairy publication, Hoard's Dairyman, Professor James G. Linn & Mary Raeth-Knight identified that fluoride in water was safe for dairy cattle up to 2 parts per million.  In Skagit County, optimally fluoridated water would be half that amount: only 1 part per million.  Therefore, optimally fluoridated water is fine for dairy cattle.

In addition, the Skagit County Dairy Federation has written a letter of support.

Does fluoridated water interfere with the oil refinery process?

Community water fluoridation has no effect on the oil refinery process.  Research indicates that even when fluoride is used at 100 ppm (100 times that which is used in community water fluoridation) it had no effect on the refinery process. (Gary M. Rand (editor), Fundamentals of Aquatic Toxicology: Effects, Environmental Fate , and Risk Assessment, 2nd Edition (1995)Chapter 33)

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Does community water fluoridation hurt salmon?

The extremely low levels of fluoride used in community water fluoridation are not harmful to salmon.  Salmon spend a significant portion of their lives in the ocean.  The earth's oceans contain an average of 1.2 to 1.5 parts per million (ppm) of fluoride.  Optimally fluoridated water contains between 0.7 - 1.2 parts per million of fluoride.

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Do Nobel Laureates oppose fluoridation?

Out of literally hundreds of Nobel Laureates, opponents of fluoridation can only find a few from 40-70 years ago to support their argument.  The one exception is a man who became a Nobel Laureate in 2000, but his objection is based on a personal preference rather than medical fact.

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Didn't a former president of the AMA oppose water fluoridation?

The only AMA president to oppose fluoridation was Charles Gordon Heyd.  He was the president of the AMA from 1936 to 1937.

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Does fluoridation weaken bones?

There is no credible scientific evidence to support the claim that fluoridated water weakens bones.  In fact, researchers are currently studying fluoride's role in strengthening bones.

The American Osteopathic Association supports fluoridation.

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Isn't the fluoride in our water an industrial toxic waste product and not approved by the FDA (Food and Drug Administration)?

Both assertions are intentionally misleading.  Fluoride is a byproduct, not a toxic waste product.  Byproducts are simply materials produced as a result of producing something else – they are by no means necessarily bad or harmful, and, as with fluoride, may themselves be valuable resources.  For example, glycerol, which is used in toothpaste, soaps, and foods, is a byproduct of biodiesel production.  Just like fluoride, which is a byproduct from fertilizer production, byproducts can be harmful if used improperly, but are beneficial when used properly. 

The Environmental Protection Agency (EPA) has exclusive regulatory authority over drinking water served by public water supplies, including any additives in such water.  The FDA does not regulate water systems, so the fluoridation opponents’ reference to the FDA is deliberately misleading.

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Is it true that 32% of American children now have some form of dental fluorosis?

This statistic is misleading.  The CDC found that in 1999-2002 about one-third of children and adolescents 6-19 years of age had fluorosis, about 90 percent of it in mild or very mild forms.  Fluorosis is a mottling of enamel that in the vast majority of cases is a mild discoloration of the tooth surface. Importantly, the majority of fluorosis is caused by things other than fluoridated water, such as the inappropriate ingestion of toothpaste.

It should be noted that most of the children in the study are at an age where they were susceptible to developing fluorosis after widespread use of fluoridated products began, but before public health approaches were introduced to limit such exposures.