Utah Dentists Gear Up for Statewide Fluoride Ban

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    SALT LAKE CITY — Ahead of Utah’s unprecedented ban on fluoride in public drinking water, dentists treating children and low-income residents are preparing for a rise in tooth decay among the community’s most at-risk groups.

    The law, signed by Republican Gov. Spencer Cox, defies recommendations from numerous dentists and health experts who caution that removing fluoride will negatively impact tooth development, particularly for young individuals who lack consistent dental care.

    Florida is set to follow Utah’s lead with a similar ban, as Republican Gov. Ron DeSantis plans to sign analogous legislation. Meanwhile, lawmakers in Ohio and South Carolina are also contemplating similar bills.

    Proponents of these bans agree that fluoride might offer some benefits but argue against government imposition without informed consent from the public. DeSantis commented, “It really shouldn’t be forced on people.”

    U.S. Health Secretary Robert F. Kennedy Jr. praised Utah for its pioneering stance and expressed intent to have the Centers for Disease Control and Prevention cease recommending water fluoridation across the country.

    The Impact in Utah
    A considerable portion of Utah’s water systems already lacked fluoride. The state was 44th in the nation concerning fluoridated water recipients, with data showing around 40% receiving fluoridated water in 2022. State officials said the new legislation will affect approximately 1.6 million residents in Salt Lake City and other northern regions of Utah, eliminating their fluoride supply.

    Salt Lake City dentists reported that few patients knew of the ban, and many were unaware the city had added fluoride to their water for nearly two decades.

    Noe Figueroa, who receives dental care at Salt Lake Donated Dental Services — a clinic offering low-cost or free treatments — remarked, “I did not know about a ban. Well, that’s not good. I don’t think that’s good at all.”

    The clinic anticipates substantial growth in waitlists for children’s dental treatments and a surge in the need for volunteer dentists. According to Sasha Harvey, executive director of the clinic, effects on children’s oral health may be evident within a year.

    “Fluoridated water is the great equalizer,” Harvey stated. “It benefits everyone, regardless of age, gender, ethnicity, education, or income — it helps everyone.”

    Revisiting a Public Health Triumph
    Fluoridation involves enhancing naturally occurring fluoride levels in water to 0.7 milligrams per liter, the benchmark set by the CDC for preventing cavities. This is often achieved by administering fluoride into water supplies, balancing its levels with dosing pumps.

    Currently, about two-thirds of Americans consume fluoridated water, a hallmark of public health achievements. Fluoride strengthens teeth and curtails cavities by replenishing minerals lost through daily activity, which is crucial for children as their teeth form and grow.

    For certain low-income families, fluoridated public water could be their sole preventive dental care method.

    Some Utah law supporters cite studies linking excessive fluoride exposure to health issues and lower IQs in children. However, the National Institutes of Health asserts that obtaining a toxic fluoride dose through standard water or toothpaste levels is “virtually impossible.”

    Elaine Oaks, a trustee for the Bountiful water district, emphasized individual choice over governmental decision in fluoride use, arguing parents should make those judgments for their families.

    Before the bill’s enactment, Cox argued that health outcomes remain consistent with or without fluoride in the community. Yet, Utah dentists assert otherwise.

    “Any dentist can look in someone’s mouth in Utah and tell exactly where they grew up. Did you grow up in a fluoridated area or a non-fluoridated area? We can tell by the level of decay,” stated Dr. James Bekker, a pediatric dentist at the University of Utah.

    Challenges in Accessing Fluoride Supplements
    The recent law places oral health responsibility on individuals, as residents will have to proactively manage their dental care. At Sasha Harvey’s clinic, many patients resort to seeking care only when severe pain occurs, often with financial constraints preventing them from purchasing fluoride supplements for home use.

    Figueroa, a patient, stated that other expenses take precedence over dental care.

    Dr. Bekker warned that fluoride toothpaste isn’t enough for children’s oral health because it lacks penetration to the tooth’s core. Drinking fluoridated water, on the other hand, infuses fluoride into saliva for continual tooth protection throughout the day.

    He advised parents in Utah to incorporate fluoride supplements in their children’s water but acknowledged the challenge for families not engaged in regular medical consultations.

    Currently, fluoride tablets require prescriptions from healthcare professionals. While efforts are underway in Utah to market these supplements over the counter, this transition may take considerable time.