Tama changes directions on water fluoridation
Fluoride water treatment appears to be returning to the City of Tama.
During the regular meeting of the Tama City Council on Oct. 4 a measure was passed by a 3-2 vote that reversed an action taken in April which discontinued fluoride treatment in the city water system.
On April 5 the council heard a recommendation from City Water Superintendent Kent Campbell to discontinue fluoride treatment of the city water system.
A vote was taken and the measure passed 3-1 with council members Larry Thomas, Anne Michael and Matthew Beatty voting to discontinue and Emily Babinat voting not to discontinue. Council member Aaron Haughey was not present during the April meeting.
Two months later a group of dental health professionals from the Iowa Department of Public Health, Tama County Public Health, as well as Dr. Steven Levy, a research professor at the University of Iowa College of Dentistry, attended a Tama council meeting to encourage the council to reconsider their decision to discontinue fluoride treatments.
Tama’s water system, which without fluoride treatment, is under the 0.7 milligrams per liter of fluoride per liter recommended by the Center for Disease Control.
Comparatively, the City of Toledo’s water system meets the 0.7 milligrams per liter recommended fluoride threshold without the need for treatment as the city’s water is obtained from the Jordan aquifer which contains fluoride that is naturally occurring.
According to the Iowa Department of Public Health, community water fluoridation provides benefits including a cost-effective and efficient method of reducing tooth decay and reduction in cavities by at least 25 percent.
For every $1 spent on community water fluoridation, $38 in dental treatment costs are saved.
During the June meeting, Levy presented research he conducted at the U of I over 25 years that studied the effects of varying amounts of fluoride in the body. Hundreds of individuals were studied from birth to age 25 and the conclusion that emerged was there were no adverse health effects on developing bone structures in individuals who had fluoride in their body.
Over the summer the Tama County Board of Health issued a position statement regarding community water fluoridation.
The statement opens with, “The Tama County Board of Health is strongly committed to the fluoridation of community water systems. Community water fluoridation has been extensively studied for over 75 years and has been proven to be safe and effective.”
The statement goes on to list the benefits of community water fluoridation and encourages communities in Tama County to use water fluoridation at the recommended levels.
The Tama Council took no action following the discussion held in June, but on the request of council member Babinat, brought it back on the agenda in October.
“We need to vote on it because people are asking me to please put fluoride back in the water because we have young children and we live in a low income area and there are parents that might have to choose between food and toothpaste sometimes,” said Babinat.
Dentists address council
Two additional dental professionals with ties to the Tama community were in attendance at Monday’s meeting including Dr. Robert Bowers from the University of Iowa and Dr. Rebecca Gabriel with the Meskwaki Health Clinic.
Prior to becoming an assistant professor at the University of Iowa College of Dentistry, Bowers worked from 2016 to 2020 as the Dental Director at the Meskwaki Health Clinic, a position Gabriel now holds.
Bowers joined with his colleagues in encouraging the city to restart their community water fluoridation efforts.
“On the surface, the anti-fluoridation argument is certainly a compelling story with (suggestions of) negative effects like brittleness of bones, effects on piping and other things like that. The problem is, if you really look at the deep, unbiased science, there’s no quality backing on these negative theories.”
Bowers said both he and Gabriel have seen the state of oral health in the area, even with fluoride present in the water systems.
“The amount of kids and adults that have chronic oral health disease is devastating”
Bowers’ concern is that removing the protection that fluoride provides from the Tama system would be detrimental to an area already underserved by dental practices and heavily impacted by dental health issues.
“In Tama County there’s a high number of individuals, especially kids, on Medicaid supplemental plans. And offices aren’t taking Medicaid patients for various reasons. More or less they’re paying 40 cents on the dollar and right or wrong, dentists aren’t taking it. So that means people have to go to public health clinics.”
Bowers described times while working in Tama County where his office would need to refer multiple kids to the University of Iowa where they ended up having to wait six months to get treatment for chronic abscesses across their teeth.
“I can’t predict the future, but if you do pull fluoride from the water, the number of cavity incidents is going to go up, there’s no question about it,” Bowers said. “I wish everyone would brush their teeth twice a day, floss and wouldn’t eat a bunch of candy and sugar. But that’s not going to change. So what can we do to add basic public health support to limit some of the disease?”
“I’m all for debate, I’m a skeptic myself. But the science is so definitive on water fluoridation that I think you would be making a big mistake for the community if (fluoride) was pulled.”
With recent closures of two dental offices in Tama-Toledo, there are now only two dental clinics left to serve the public in a county of 17,000. Dr. Nicholas Kubik serves patients in Tama and the Pipho and Gingrich Family Dentistry office is open in the northeast corner of the county in Dysart. The Meskwaki Dental Clinic is open on the Meskwaki Settlement, however services there are only available to Meskwaki tribal members.
City water superintendent Kent Campbell again spoke against water fluoridation saying that he felt the use of hydrofluorosilicic acid to add fluoride into water systems would lead to negative effects like pitting in the bones and lung cancer.
According to a 2018 Fluoridation Facts publication put out by the American Dental Association, studies have shown there to be no adverse effects associated with water fluoridation regardless of which fluoride additive was used. References supporting this information come from eight peer-reviewed reports that were published in the U.S., the U.K. and Australia.
Campbell claimed his information was derived through reading he has done, though he provided no sources or citations during the discussion Monday.
Campbell previously lobbied the council to remove fluoride from city water in 2014, an effort that ultimately stalled for lack of action.
According to Tama News-Herald reporting around that time, city records show fluoride treatment equipment first being installed and utilized in Tama in 1986.
During the discussion Monday, city attorney Dan Rathjen challenged Bowers and Gabriel about where their information and citations were coming from, to which Gabriel responded that the presentation given at the June meeting was a 90-slide PowerPoint listing all of the studies that backed the community water fluoridation information as well as more than a dozen national associations and organizations that reviewed the literature in the studies and deemed them to be of good quality.
Before the discussion progressed further, Babinat motioned for the council to add fluoridation back to the city water system.
Michael then seconded the motion and it passed 3-2 with Beatty voting in favor and Thomas and Haughey voting against.
According to City Clerk Alyssa Devig, the city will need to complete work before community water fluoridation is able to resume in the City of Tama. When the department discontinued use of fluoride treatment this spring, they got rid of a scale that is used in the treatment process.
Also, the facility that houses the water treatment system will need an upgrade to its ventilation system to bring the building up to code.
There is no set timetable established for completion of the work.
It is not clear if the work will be complete ahead of the November city election in which two of the council members that voted in favor of community water fluoridation (Babinat and Beatty) are being challenged in their reelection bids.
This summer the Iowa State Legislature passed a law that requires cities that provide public water to notify consumers at least 90 days prior to taking any action to permanently discontinue fluoridation of their water supply.
Should the composition of the council change in 2022 and another vote be taken to reverse course and again remove fluoride treatment, the city would be required to notify water customers of their intention to discontinue the practice.
The city was not forced to notify the public earlier this year as the new law was not yet in effect.