RICHMOND, Vt. (AP) — Residents of a small Vermont community were stunned by the news last month that an official at their water board quietly lowered fluoride levels nearly four years ago, raising concerns for their children’s dental health and transparent government — and Highlighting the persistent misinformation about water fluoridation.
Katie Mather, who lives in Richmond, a town of about 4,100 in northwest Vermont, told a water commission meeting this week that her dentist recently found her two children’s first tooth decay. She acknowledged that they eat a lot of sugar, but noted that her dentist recommended against supplemental fluoride because the city’s water should do the trick.
Her dentist “operated and made professional recommendations based on government standards that we all assumed were met, which were not the case,” Mather said. “It’s the fact that we didn’t have the opportunity to give our informed consent that bothers 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 it still does not go down well with some people, and many countries do not fluoridate water for a variety of reasons, including feasibility.
Critics argue that the health effects of fluoride are not fully understood and that adding it to municipal water can become an undesirable drug; Some communities have ended the practice in recent years. In 2015, the US government lowered its recommended amount in drinking water after some children got too much of it, resulting in white spots on their teeth.
While such stains are primarily a cosmetic concern, the American Dental Association notes on its website that fluoride — along with life-giving substances like salt, iron, and oxygen — can be toxic in large doses.
But at recommended levels, fluoride in water reduces tooth decay, or cavities, by about 25%, according to the US Centers for Disease Control and Prevention, which reported in 2018 that 73% of the US population had adequate fluoride from water systems to protect teeth. So it came as a shock to some people in Richmond to hear that their water was not up to standard.
Richmond Superintendent of Water and Sewer Kendall Chamberlin told the Water and Sewer Commission in September that he had reduced fluoride levels due to concerns about changes in procurement and recommended levels.
He said he’s worried about quality control of the fluoride used in US hydration systems because it’s sourced in China — a claim that echoes unsubstantiated reports of Chinese fluoride circulating online in recent years.
And, he said, he doesn’t think the state’s recommended fluoride level is warranted at the moment.
“My duty is to use reasonable care and judgment to protect the public health, safety and environment of my customers,” he said, adding, “Playing it safe isn’t a bad position.”
Chamberlin did not respond to an e-mail from the Associated Press seeking comment.
Two of the three fluoride additives that U.S. water systems can use actually come from China because they don’t have domestic manufacturers, but all are subject to strict standards, testing and certification to ensure safety, CDC spokeswoman Tracy Boehmer said in an E- Mail. Vermont Department of Health spokespersons agreed that all additives must meet these national standards.
Chamberlin’s decision stunned local residents and doctors.
“It is unreasonable for an individual to unilaterally decide that this public health benefit may not be warranted. I find it outrageous,” said Dr. Allen Knowles retired at the September 19 meeting. He said he has an 8-month-old granddaughter who he thought was getting adequate fluoridated water.
“Fluoride is again one of the most successful and important public health interventions ever undertaken in this country,” said Knowles. “The reduction in dental disease is undeniable. They do not establish certainty based on the opinion of one person or a study or this or that.”
Most water naturally contains some fluoride, but usually not enough to prevent tooth decay.
The mineral was first added to public water in 1945 in Grand Rapids, Michigan. Now it’s commonplace, although it’s more common in some states than others. Oregon, New Jersey, and Hawaii have the lowest percentages of residents with fluoridated water, according to the United Health Foundation.
Fluoride is also added to toothpaste and other topical products, and is found in some foods.
In sparsely populated and largely rural Vermont, 29 of the 465 public water systems fluoridate voluntarily, and just over half of residents served by a public system receive fluoridated water, according to the Vermont Department of Health and Human Services. The state’s standard level is based on federal recommendations.
Cities that fluoridate must keep levels within state 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 fall back,” Robin Miller, the office’s director for Oral Health, wrote in an email to the AP.
Miller said she didn’t realize that the city’s fluoride levels had been consistently low for so long until March of this year. After a field visit by the state in April, scores didn’t improve, so in June Miller contacted the Richmond city manager, who asked her to attend the September meeting, she said.
At the second meeting on Monday, where Katie Mather raised concerns about her children’s teeth, Chamberlin – who lives out of town and appeared online – read out a statement of apologies.
“Words cannot express how sorry I am for causing this controversy,” he said. “Believe me when I say I’ve only ever 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 that the monthly report is reviewed by the city manager and forwarded to the state.
“It’s not just a guy who does what he wants. He takes those reports to his boss, who signs them off,” said Erik Bailey, now village manager in Johnson.
Town manager Josh Arneson said Chamberlin or other employees always told him the values were acceptable. He said he first heard about the consistently low readings from the state in June.
The commission voted to fully fluoridate the water again. It’s not clear if anyone could face professional consequences; Personnel issues were discussed in a non-public meeting.