Testimony of Ellen Fineberg, Children’s Alliance of NH’s Executive Director, to the NH House Committee on Resources, Recreation & Development

January 10, 2012

Dear Chairman Renzullo and members of the Committee,

My name is Ellen Fineberg and I am the Executive Director for the Children’s Alliance of New Hampshire.  We are an independent research-based advocacy organization that promotes policies and practices that enable all children to lead healthy and productive lives and reach their full potential.

Oral health is an important component of children’s overall health, which is why the Children’s Alliance is opposed to HB 1416.  At a time when thousands of children in the Granite State lack dental insurance, it is disturbing to see a bill that would negatively impact our state’s children by ending water fluoridation —removing a proven, cost-effective form of prevention against decay.

If enacted, HB 1416 would make it impossible for local communities to provide residents with fluoridated water—a practice that the U.S. Centers for Disease Control and Prevention praised as one of “10 great public health achievements of the 20th century.”[1] We urge you to reject HB 1416 for the following three reasons:

1. Fluoridation is proven to fight tooth decay in children. As you may know, fluoride exists naturally in water.  Fluoridation is simply the process of adjusting fluoride to the optimal level to prevent tooth decay.  Fluoride counteracts tooth decay and strengthens teeth by fighting harmful acids and drawing calcium back into the enamel. Drinking water is an ideal vehicle for fluoride because it offers these benefits without requiring families to spend extra money or change their routine.

Studies show that fluoridation reduces tooth decay by about 29 percent.[2] People of all ages and income levels benefit from drinking fluoridated water.  The American Academy of Pediatrics, the American Dental Association, the American Medical Association and many other respected medical or health organizations recognize the health benefits of fluoridation.[3]

2. Fluoridation is critically important for children. Although dental health has improved for many Americans in recent decades, tooth decay remains the most common chronic childhood disease—five times more common than asthma.[4] Untreated tooth decay can undermine a children’s ability to sleep, grow and learn, and its impact can last for many years by hurting their ability to find jobs as adults. Decay and other dental problems can cause a person’s overall health to suffer.

Fluoride toothpaste isn’t enough.  The benefits from water fluoridation build on those from fluoride toothpaste.  The co-author of a 2010 study noted that research has confirmed “the most effective source of fluoride to be water fluoridation.”[5] A 2002 study called fluoridation “the most effective and practical method” for reducing the gap in decay rates between low-income and upper-income Americans.[6]

3. Substantial evidence shows fluoridation is safe. In most cases, proposals to stop fluoridation are driven by unfounded fears that a handful of people raise about safety.  These fears are based on confusion or misinformation.

For example, some anti-fluoride groups misrepresent a 2006 report of the National Research Council (NRC), claiming this report expresses concern about fluoride.  But the NRC voiced concern about areas of the U.S. with natural levels of fluoride in water that are at least double or triple the level used to fluoridate a public water system.  As the NRC stated, “it is important to note that the safety and effectiveness of the practice of water fluoridation was outside the scope of this report and is not evaluated.”[7]

As the Centers for Disease Control and Prevention notes, “For many years, panels of experts from different health and scientific fields have provided strong evidence that water fluoridation is safe and effective.”[8]

It would be virtually impossible for any individual to consume food or water that wasn’t fortified with at least some added ingredients to benefit human health.  Iodide is added to salt to prevent goiter, which affects the thyroid gland.  Chlorine is added to prevent outbreaks of E. coli or other forms of bacteria in drinking water.  Folic acid is added to many breads and cereals to produce healthy red blood cells.

Before you vote on a proposal to turn back the clock on water fluoridation, we ask that you carefully consider the solid evidence that supports continued fluoridation.  Please do not deprive the children and adults in New Hampshire of a practice that has been proven to benefit health.

Respectfully submitted,

Ellen Fineberg

Executive Director

Children’s Alliance of New Hampshire

Sources

[1] “Ten Great Public Health Achievements – United States, 1900-1999,” Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, April 2, 1999, Vol. 48, No. 12, 241-243, accessed on January 25, 2011 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm.

[2] The children who experienced this reduction in the median decay rate were aged 4 to 17.  See: “Summary of Task Force Recommendations and Findings,” The U.S. Task Force on Community Preventive Services, (2002), http://www.thecommunityguide.org/oral/fluoridation.html, accessed November 22, 2011.

[3] “Protecting All Children’s Teeth (PACT),” a training module by the American Academy of Pediatrics, accessed on Jan. 20, 2011 at http://www.aap.org/oralhealth/pact/ch6_intro.cfm; “Fluoride & Fluoridation,” American Dental Association, accessed on Jan. 12, 2011 at http://www.ada.org/fluoride.aspx;

[4] “Preventing Cavities, Gum Disease, Tooth Loss, and Oral Cancers: At A Glance 2010,” from the “Oral Health” page of the U.S. Centers for Disease Control and Prevention (2010), http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm, accessed on October 20, 2010.

[5] “Drinking Tap Water May Help You Avoid Dentist’s Drill, Study Says,” ScienceDaily (April 13, 2010), http://www.sciencedaily.com/releases/2010/04/100413121328.htm.

[6] B.A. Burt, “Fluoridation and Social Equity,” Journal of Public Health Dentistry, (2002), Vol. 62, Issue 4, 195–255, http://onlinelibrary.wiley.com/doi/10.1111/jphd.2002.62.issue-4/issuetoc.

[7] “Fluoride in Drinking Water: A Scientific Review of EPA’s Standards,” Report in Brief, prepared by the National Research Council (March 2006), accessed on April 20, 2011 at http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/fluoride_brief_final.pdf.

[8] “Community Water Fluoridation: Safety,” Centers for Disease Control and Prevention, accessed November 9, 2011 at http://www.cdc.gov/fluoridation/safety.htm.