Reprinted from the Health District's quarterly publication mailed to district residents (Fall 2003)

At its April 22 meeting, the Health District Board of Directors voted to strongly support continued fluoridation of the city of Fort Collins’ water supply due to its significant positive impact on the health of the community.

The Board reached its decision after reviewing findings from the Fluoride Technical Study Group (FTSG) and a pro and con analysis of the issue prepared by Health District staff. The FTSG’s complete report, as well as an executive summary of its findings, is available at www.fcgov.com/utilities/fluoride-report.php. The Health District’s pro and con analysis is available at www.healthdistrict.org/policy/bills/fluorideanalysis.pdf

Summary of FTSG findings

• Drinking fluoridated water prevents caries (cavities) in all age groups, over and above that from toothpaste and other sources of fluoride. If Fort Collins suspended water fluoridation, rates of decay in our community would likely increase.

• The only proven negative health effect attributable to water fluoridation is dental fluorosis, a change in the appearance of the tooth enamel that occurs when an infant or young child swallows excessive amounts of fluoride during enamel development. Drinking fluoridated water is associated with an increase in the mildest forms of this condition, which does not impact either cosmetic appearance or dental function. The main sources of fluoride intake in children are water and other beverages, food and fluoride-containing dental products such as toothpaste. The FTSG concluded that the current total daily intake for children older than six months in Fort Collins is unlikely to exceed the limit set by the federal government to prevent moderate and severe forms of dental fluorosis. However, some infants fed powdered formula reconstituted with public drinking water may exceed this limit. The best way to avoid more severe forms of dental fluorosis is to use nonfluoridated water when mixing formula for infants, to avoid prescribing fluoride supplements (drops) to children who drink fluoridated water and to supervise tooth brushing in young children (to prevent swallowing of toothpaste).

• The available evidence shows that optimally fluoridated water has no effect on rates of cancer, bone fractures, bone disorders, problems with thyroid or immune function or any other serious adverse health effects. The FTSG noted that the possibility of a small increase or decrease in cancer or bone fracture risk can not be completely ruled out.

• Water fluoridation is cost-saving. The total annual cost of fluoridating the water in Fort Collins is 71 cents per person. Based on conservative assumptions regarding the effectiveness of fluoridation in our region, the FTSG estimated that the annual per capita savings in averted dental costs is $4.11, for a net savings of $3.40 per person each year. The costs of treating mild forms of dental fluorosis in those who find it objectionable were not included, but would be expected to be small in comparison with the dollars saved by preventing decay.

• There is no credible evidence that the product Fort Collins Utilities uses to fluoridate our water — hydrofluorosilicic acid (HFS) — is unsafe. Once added to water, it rapidly and completely separates into hydrogen ion, silicates and fluoride ion before it leaves the water plant. Each of these substances, which are widely found in nature, has been exhaustively studied and has been shown to be safe at the levels found in our water. There are very small amounts of contaminants such as arsenic and lead in the concentrated HFS. Fundamentally, we know that adding HFS to the water must increase the concentration of these substances some very small amount, but their levels in the finished water are so low that they cannot be detected in the laboratory, and are well below the maximum levels that are thought to be protective of public health and legally allowed by the federal Safe Drinking Water Act.