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| Photo Credit: AP. |
RICHMOND, Vt. (AP) — Residents of a small community in Vermont were blindsided last month by news that one official in their water department quietly lowered fluoride levels nearly four years ago, giving rise to worries about their children’s dental health and transparent government — and highlighting the enduring misinformation around water fluoridation.
Katie
Mather, who lives in Richmond, a town of about 4,100 in northwestern Vermont,
said at a water commission meeting this week that her dentist recently found
her two kids’ first cavities. She acknowledged they eat a lot of sugar, but
noted that her dentist recommended against supplemental fluoride because the
town’s water should be doing the trick.
Her dentist
“was operating and making professional recommendations based on state standards
we all assumed were being met, which they were not,” Mather said. “It’s the
fact that we didn’t have the opportunity to give our informed consent that gets
to me.”
The addition
of fluoride to public drinking water systems has been routine in communities
across the United States since the 1940s and 1950s but still doesn’t sit well
with some people, and many countries don’t fluoridate water for various
reasons, including feasibility.
Critics
argue that the health effects of fluoride aren’t fully known and that its
addition to municipal water can amount to an unwanted medication; some
communities in recent years have ended the practice. In 2015, the U.S.
government lowered its recommended amount in drinking water after some children
got too much of it, causing white splotches on their teeth.
While such
splotches are primarily a cosmetic problem, the American Dental Association
notes on its website that fluoride — along with life-giving substances
including salt, iron and oxygen — can be toxic in large doses.
But in the
recommended amounts, fluoride in water decreases cavities or tooth decay by
about 25%, according to the U.S. Centers for Disease Control and Prevention,
which reported in 2018 that 73% of the U.S. population was served by water
systems with adequate fluoride to protect teeth. So for some people in
Richmond, it was a shock to hear their water wasn’t meeting the standard.
Kendall
Chamberlin, Richmond’s water and wastewater superintendent, told the Water and
Sewer Commission in September that he reduced the fluoride level because of his
concerns about changes to its sourcing and the recommended levels.
He said he
worries about quality control in the fluoride used in U.S. drinking systems
because it comes from China — an assertion that echoes unfounded reports about
Chinese fluoride that have circulated online in recent years.
And, he
said, he doesn’t think the state’s recommended level of fluoride is warranted
right now.
“My duty is to take reasonable care and
judgment for the protection of public health, safety and the environment of my
customers,” he said, adding that “to err on the side of caution is not a bad
position to be in.”
Chamberlin
did not respond to an Associated Press email seeking comment.
Two of the
three fluoride additives U.S. water systems can use do, in fact, come from
China because they have no domestic manufacturers, but all are subject to
stringent standards, testing and certification to ensure safety, CDC
spokesperson Tracy Boehmer said in an email. Spokespeople for the Vermont
Department of Health concurred that all additives must meet those national
standards.
Chamberlin’s
decision flabbergasted residents and doctors.
“For a
single person to unilaterally make the decision that this public health benefit
might not be warranted is inappropriate. I think it’s outrageous,” retired Dr.
Allen Knowles said at the Sept. 19 meeting. He said he has an 8-month-old
granddaughter he thought was getting adequately fluoridated water.
“Fluoride,
again, is one of the most successful and important public health measures that
has ever been undertaken in this country,” Knowles said. “The reduction in
dental disease is just inarguable. You don’t establish safety based on one
person’s opinion or one study or this or that.”
Most water
naturally contains some fluoride, but typically not enough to prevent cavities.
The mineral
was first added to public water in Grand Rapids, Michigan, in 1945. Now it’s
commonplace, although more prevalent in some states than others; Oregon, New
Jersey and Hawaii have the lowest percentage of residents with fluoridated
water, according to the United Health Foundation.
Fluoride is
also added to toothpaste and other topical products and is in some foods.
In sparsely
populated and largely rural Vermont, 29 of the 465 public water systems
voluntarily fluoridate, and just over half of residents served by a public
system get fluoridated water, according to the Vermont Department of Health.
The state’s standard level is based on federal recommendations.
Towns that
fluoridate must maintain levels within the state’s recommendations and submit
monthly reports to the state Health Department.
The state’s
former fluoride program manager, who retired in 2019, had tried working with
Chamberlin and his team in Richmond, “and things would improve for a while, but
drop back down again,” Robin Miller, the director of the Office of Oral Health,
wrote in an email to the AP.
Miller said
she didn’t realize the town’s fluoride number had been consistently low for so
long until March this year. After a site visit by the state in April, the
levels did not improve, so Miller contacted the Richmond town manager in June,
who requested she attend the meeting in September, she said.
At the
second meeting Monday, the one at which Katie Mather raised concerns about her
children’s teeth, Chamberlin — who doesn’t live in town and appeared online —
read a statement of apology.
“Words
cannot express how sorry I am for causing this controversy,” he said. “Believe
me when I say I have always only had good intentions based on a
misunderstanding. I promise I will make sure nothing like this ever happens
again.”
A former
Richmond employee who worked under Chamberlin pointed out the monthly report is
reviewed by the town manager and goes to the state.
“It’s not
just one guy doing what he wants. He’s bringing these reports to his boss, who
signs them,” said Erik Bailey, now the village manager in Johnson.
Town Manager
Josh Arneson said Chamberlin or other staffers always told him levels were
acceptable. He said he first heard from the state in June about the
consistently low levels.
The
commission voted to return the water to full fluoridation. It’s not clear
whether anyone could face professional repercussions; personnel issues were
discussed in a closed session.