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The Tooth Is Out There

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Strange Love: 'Do you realize that fluoridation is the most monstrously conceived and dangerous Communist plot we have ever had to face?'

Fluoride opponents are setting up Santa Cruz to be a test case against the new state fluoridation law

By John Yewell

IN STANLEY KUBRICK'S 1963 cult classic, Dr. Strangelove, Gen. Jack D. Ripper summed up the communist "conspiracy" behind fluoridation, ranting about "precious bodily fluids" even as nuclear annihilation approached. Today, the perpetrators of the fluoride conspiracy have changed. Now the bad guys are corporate America, the Pentagon and a supposedly corrupt medical establishment. But the arguments sound the same, played out in a new, wired world.

Through Measure N in next week's special election--the sole item on the ballot--Santa Cruzans will have an opportunity to vote to prohibit the artificial introduction of fluoride into their precious bodily fluids. The confusing part to casual observers is that we already have a City Council-passed ordinance on the books that prohibits fluoridation. In addition, the vote may prove for legal reasons to be meaningless. So why is this election being held at all?

Proponents say Measure N would provide a stronger ban on fluoride than the current law because it wouldn't be subject to the whims of shifting council majorities; it could only be changed by another ballot measure. That is also the case with the current ordinance, which doesn't permit fluoridation without a vote of the people. So what's really at stake?

The drafters of Measure N had bigger things in mind: it was designed to position Santa Cruz in the forefront of a legal challenge to a state law that mandates fluoridation in certain water districts. Assembly Bill 733, passed in 1995, requires the fluoridation of water systems with 10,000 or more hookups; the Santa Cruz system has some 22,500. According to officials in the state Department of Health Services, with or without Measure N, the city would be subject to state law.

Jeff Green has other ideas. Green is the statewide director of Citizens for Safe Drinking Water, which was formed in response to AB 733, and helped write Measure N. Green says Santa Cruz could become the "ideal test case" of the law. Green told Metro Santa Cruz in a recent interview that Measure N was written to serve as a vehicle to oppose AB 733 in court. "The language of Measure N was crafted with a legal challenge in mind," Green says. Far from trying to settle a controversy with Measure N, fluoridation opponents are itching for a fight.

The language of the ordinance that would be created by the ballot measure alleges links between fluoride and "increased risk of hip fractures, cancer, neurological impairment, dental fluorosis and other harmful effects."

"When we go to court under Measure N," Green continues, "we want to bring up all the issues in the language, describing links to adverse effects, so the state would have to address those issues. Our argument would have more merit."

Local Measure N proponent Theodora Kerry agrees with the importance of Measure N in the statewide debate. "Is it an ideal test case? I would say yes."

By the Numbers

AFTER FAILING TO get an initiative on the ballot in 1997 that would have banned fluoride in drinking water statewide, Citizens for Safe Drinking Water concentrated its efforts at the local level. Santa Cruz is well positioned to serve as a legal guinea pig--if the state chooses to make it one.

Santa Cruz is No. 12 on a list of 167 California cities slated for fluoridation as soon as private money becomes available to pay the capital start-up costs (AB 733 provided no state funding). According to Green, Santa Cruz is one of only three cities on the list which currently has a local ordinance prohibiting fluoridation; San Diego at No. 18 and Sunnyvale at No. 75 are the other two.

Last month the state received its first private grant--$10 million from the California Endowment--to jump-start the program. That amount is enough to fluoridate the first 29 cities on the list, excluding Los Angeles, which is No. 17 and would require $6 million alone.

Dr. David Nelson, a fluoridation consultant for the state Department of Health Services, points out that the state has the authority to jump around on the list, and he would not say when Santa Cruz would be chosen. It will not necessarily be the 12th city fluoridated--it could even be the first.

State water authorities could choose to put off challenging Santa Cruz's local ordinance, or decide to use it as a test case. Either way, Nelson says, Measure N is pretty much a waste of time--and money.

"They can pass all the ballot measures they want," Nelson says. "In the final accounting they will have to comply with the law."

City attorney John Barisone contends that the city has both its own charter and state law on its side. By excluding smaller water systems in AB 733, Barisone says, the state demonstrated that the law is not a matter of "statewide concern"--a crucial legal hurdle for any state law to clear in order to supersede local ordinance. There is also language in the state public utility code (article 5, section 12814) which appears to require local water districts to hold a referendum before implementing fluoridation. But he agrees with Green:

"It is likely to end up in court," Barisone says.

City water director Bill Kocher notes that the Public Utility Code may not apply to Santa Cruz, although it probably would to other county non-municipal water districts such as San Lorenzo Valley and Soquel Creek.

"The city of Santa Cruz is not controlled by the PUC," Kocher says. "The code only applies to water districts under the PUC."

Department of Health Services legal counsel Trudy Mohr was not aware of that provision of the Public Utility Code, but she believes nevertheless that Santa Cruz will have no choice but to comply with state law. Mohr has prepared a legal brief laying out the state's case for local compliance with AB 733. "The state fluoridation mandate is crystal clear," Mohr says.

Isn't That Special

MEASURE N ASKS: Should the city's water supply be prohibited from being used "to deliver products or substances intended to affect the physical or mental function of persons consuming such water?" The omission of the word "fluoride" from the ballot language has prompted charges of misrepresentation by Measure N opponents, who claim the language is designed to keep voter turnout low to aid a small cadre of anti-fluoride activists.

"The stealth wording of the measure betrays a fundamental mistrust of government," says Jay Balzer, executive director of Dientes Community Dental Clinic and a staunch Measure N opponent.

Theodora Kerry says Measure N supporters simply wanted to provide as broad a prohibition as possible against the addition of foreign substances to drinking water.

"As far as not mentioning fluoride, it's a moot point," says Kerry. "It doesn't strike me as disingenuous."

To add to the confusion over what people are actually voting on, a "Yes" vote on Measure N is a vote against fluoride, while a "No" vote keeps the status quo.

The question in some minds is not how to vote, but who gets to vote.

Only Santa Cruz city residents can vote on Measure N, but the Santa Cruz water system extends well beyond the city limits and covers another 30,000 people in Live Oak, Capitola, Davenport and elsewhere who don't get to vote.

First District Supervisor Jan Beautz, who represents Live Oak, says she's had 10 or 12 constituents complain about the process.

"It impacts them too," Beautz says. "It's frustrating to not be able to participate." Beautz says she is personally opposed to fluoridation. Santa Cruz's two representatives in Sacramento, Assemblymember Fred Keeley and Sen. Bruce McPherson, both support fluoridation.

Another factor in the election will be turnout. County elections manager Gail Pellerin predicts around 30 percent of Santa Cruz's 37,000 registered voters will go to the polls Tuesday. If so, a majority of only 5,600 votes would determine the measure's fate, even though over 85,000 people in the water district are affected. Low turnout tends to favor the most motivated voters, which in this case is likely to be anti-fluoride, pro-Measure N voters.

The cost of the election could run as high $130,000, according to Pellerin, but officials had little leeway in choosing the date. Once Measure N supporters turned in their 5,314 signatures last October, the electoral wheels were set in motion.


AND WHAT OF THE pros and cons of fluoride? With all the charges and countercharges about scientific methodology, "mass medication" and "toxic waste," it usually comes down for most people to a question of whom to believe.

Just about every major medical organization in the world supports fluoridation of public water supplies, including the American Medical Association and the World Health Organization. The Environmental Protection Agency says fluoride is safe and effective and that there is no "scientific documentation of adverse medical effects at levels of fluoride below 8 [milligrams] per liter per day." Even so, the EPA set the maximum concentration level at 4mg/L/day. Typically, public water supplies receive fluoride supplements of 1 part per million, a level calculated to take daily dietary fluoride intake from food and beverages into account.

The proponents of fluoride make a simple assertion: that it is beneficial. Fluoride opponents respond with a daunting list, with everything from AIDS to the Holocaust at one time or another being attributed to fluoride use.

The lengthy list of supposed fluoride-related ailments includes cancer, genetic damage, neurological impairment, bone pathology, lowered IQ in children, crippling skeletal fluorosis, rare liver cancers, kidney failure, decreased fertility, Alzheimer's disease, Down's syndrome, accelerated aging, chronic fatigue syndrome and sleep disorders.

Opponents also claim that, given variables in individual diets, most people already get as much fluoride as they need, or more, through daily food and beverage consumption. They often cite a chart from a 1991 study by the U.S. Department of Health and Human Services called "Review of Fluoride Benefits and Risks" to support their contentions. But they omit caveats pointing out that the figures are "rounded to reflect the widest range from listed fluoride sources." The studies themselves show that a typical day's fluoride intake is well under the EPA recommended limits, even in fluoridated areas.

The anti-fluoride side also says that you don't need it in the first place because it's not effective. A study done in 1986-87 by the National Institute of Dental Research is used by both sides to support diametrically opposed conclusions about fluoride effectiveness.

According to Dr. Stanley Heifetz, a professor at the University of Southern California Medical School who has studied the report, the study demonstrates at least 20 percent reductions in tooth decay in fluoridated communities. Fluoride opponents who interpreted the results failed to take into account the residence history of the test subjects, says Heifetz--meaning they could not determine how much fluoride the test subjects had been exposed to in their lifetimes. This invalidated their conclusion, he says, which was that there were no differences in decay rates between fluoridated and nonfluoridated communities.

The Credibility Game

IT'S HARD TO KNOW how to evaluate all these charges. But when it comes to how much fluoride is good for you, one thing seems clear: anti-fluoride literature and activists seem to want to have it not just both ways but three ways: people are already getting enough fluoride, it isn't effective anyway and it's poisonous and you shouldn't be ingesting any at all. Opponents can't seem to decide if we're getting enough fluoride, too much fluoride--or whether we should avoid it altogether.

Local activists fall into the same trap. One minute they will argue that we are already consuming a therapeutic dose of fluoride, and the next they'll say it's bad for you at any dose. Why not lobby then to remove it from all foods if it's so dangerous? One local activist swore that the cost of operating a fluoride system for Santa Cruz would run $280,000 a year, and she gave us her source in the water department. But when we checked with the source it turned out the activist had confused start-up costs with capital costs--which are not borne by taxpayers at all.

The real cost is closer to $40,000 a year in the Santa Cruz water system, or about 50¢ a year per person, according to Terry Tompkins, deputy director of operations for the Santa Cruz water system. The cost of the election alone, by Tompkins' estimate, would fund three years of fluoridation.

The same anti-fluoride activist said that France doesn't accept California wines because of their fluoride content--a demonstrable absurdity.

In other unsigned pamphlets, fluoride opponents call it a "politically protected poison" whose use has been foisted on a gullible public by the chemical industry with the help of "faked dental studies and lots of PR." Likening fluoride to lead, arsenic and even Sarin nerve gas, other anti-fluoride literature contends that fluoride is an industrial waste byproduct that carries with it toxic impurities that also get dumped in the water. Besides that, they claim, it doesn't work.

There's even a Y2K angle: Fluoride opponents say equipment could malfunction on that date and dump too much fluoride into the water supply. People might be "mysteriously dropping dead." By the time authorities figure it out, reads one pamphlet, "a significant portion of the city could literally be wiped out."

This tendency toward paranoid hyperbole and contradiction undermines whatever truth awaits discovery in the anti-fluoride case. The suggestion that fluoride was used in Nazi death camps has a particularly nefarious ring to it. The same local activist mentioned above tried to deny that her organization was connected to that gruesome assertion: "That's not our literature," she said. But there it was, printed right on the flier: Citizens for Safe Drinking Water.


DESPITE THE ONGOING game of scientific badminton, the question of choice may be the most nettlesome of all. There are other ways to get more fluoride into your diet, such as through prescription supplements and by adding it to salt, as is widely practiced in Europe. Why not just leave it to choice?

Fluoride proponents counter that "compliance"--that is, regular usage--is typically very low with these methods and that the people who suffer the most are the poor who have less time, money or motivation to do the extra work to add fluoride to their diets.

Dr. Michael W. Easley, an associate professor of medicine at SUNY Buffalo and a well-known fluoride proponent (he helped draft AB 733), says the water system is the logical way to do it. He says that fluoridating the water supply yields a 1-to-80 cost-to-benefit ratio, taking into account reduced costs to government and individual health care costs. The reason is that fluoridation is cheap.

More than 60 percent of Americans drink fluoridated tap water, but in California the figure is only 17 percent. California's failure to keep up with the rest of the country baffles Easley.

"The whole concept of a public water system was to prevent disease," Easley says. "We mandate immunization for public schools. How this ever became a voter issue I don't know."

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From the February 24-March 3, 1999 issue of Metro Santa Cruz.

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