OPINION: The facts on fluoridation — lessons for a healthier Alaska

Every time Anchorage residents drink tap water, they receive the recommended amount of a mineral called fluoride to protect their teeth from cavities. You might wonder, when decision-makers stop or pause community water fluoridation programs, as they have done in Juneau, Fairbanks, Palmer and recently Girdwood, what happens?

To answer this question, colleagues and I compared how healthy children’s teeth were in two Alaska cities: Juneau and Anchorage. We looked at Medicaid dental claims from two different years: 2003 and 2012. In 2003, both Anchorage and Juneau had water that was fluoridated. In January of 2007, city officials in Juneau voted to end water fluoridation. This vote occurred after the chair of a study commission asserted that the evidence for fluoridation’s effectiveness and safety was “inconclusive” and “further research is needed.” By 2012, Juneau had not fluoridated its tap water for more than 5 years, but Anchorage had continued water fluoridation.

What did we find? The difference was like night and day. In Anchorage, between 2003 and 2012, the average number of cavities treated among 0-18-year-olds enrolled in Medicaid modestly declined (down 6%), while in Juneau it increased 16%. Similarly, the inflation-adjusted cavity-related costs rose by only 5% ($18.47) in Anchorage, while in Juneau costs jumped by 47% ($161.84). As decades of earlier research suggested, Juneau children suffered from more cavities without fluoridated water, and taxpayers paid more for procedures that could have been prevented.

Clearly, Anchorage is doing the right thing by providing residents fluoridated water, but some other Alaska cities have made misguided decisions about fluoridation. Sadly, city leaders in Fairbanks and Palmer ended fluoridation several years after Juneau. Why? Misinformation played a big role. Recently, town officials in Girdwood said they don’t expect the fluoridation system to be repaired until 2024. I have no doubt the email inboxes of local officials and residents are now flooded with misinformation and false claims from anti-fluoridation organizations. Much like the well-financed anti-vaccine apparatus, opponents of fluoridation are very active online, questioning fluoridation’s benefits and attacking its safety.

For example, they wrongly claim that fluoridation at modern levels lowers IQ scores, but this has not been proven. In fact, the prestigious US National Academies of Sciences, Engineering, and Medicine found that the fluoride-IQ “link” was not backed by “clear and convincing” evidence. Canada’s Agency for Drugs Technology and Health criticized the lower IQ claim, calling the evidence “weak” and containing “potential errors and biases.”

In public health, our job is to protect and promote the health of everyone, not just certain groups. Across Alaska, policymakers should not be distracted by false claims about the benefits and safety of fluoridation. City leaders also have a responsibility to reflect on past decisions, especially those that affect the public’s health. It’s time for Juneau, Palmer and Fairbanks to correct the mistakes of the past and reinstate community water fluoridation for healthier teeth in children and adults. Girdwood residents also deserve a fair chance at good oral health and their fluoridation system should be repaired as soon as possible.

Jennifer Meyer is an Assistant Professor of Public Health at the University of Alaska Anchorage.

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