Maine CDC Press Release

March 19, 2007

Maine Health Organizations Proclaim Support for Community Water Fluoridation

Representatives from 20 major Maine health, public health, and dental health organizations reiterated their support for fluoridation of community drinking water at a press conference Monday at the State House.

Dora Anne Mills, MD, MPH, Director of Public Health
Maine Center for Disease Control and Prevention
Tel: (207) 287-3270
John Martins, Director Employee and Public Communications
Department of Health and Human Services
Tel: (207) 287-5012

AUGUSTA - Representatives from 20 major Maine health, public health, and dental health organizations reiterated their support for fluoridation of community drinking water at a press conference Monday at the State House.

“In light of recent concerns arising from misinformation about fluoride disseminated in some Maine communities, we stand here together to assert our long-standing support for what the U.S. CDC declared as one of 10 most successful public health achievements of the 20th Century – community water fluoridation,” announced Dora Anne Mills, MD, MPH, Director of the Maine CDC in the Department of Health and Human Services.

“The single most effective way to prevent tooth decay is fluoridation of public water,” said Don Burgess, MD, FAAP, President of the Maine Chapter of the American Academy of Pediatrics. “Tooth decay is the most common chronic disease among our children. It can interfere with children’s ability to learn and do well in school and can lead to a lifetime of ill health, including tooth loss, pain, infections, and poor nutrition. Dental disease is increasingly linked with other illnesses and chronic conditions such as heart disease.” Burgess said the tragedy is that with about half of Maine children suffering from dental disease, virtually all of this is preventable. “Prevention strategies include fluoride, dental sealants, and regular visits to a dental professional,” he added.

“Fluoride is found naturally in most water supplies, since it is one of the most common elements in the earth’s crust. Community water systems that fluoridate simply adjust the concentration to the optimal level of fluoride we require for dental health,” said Jonathan Shenkin, DDS, MPH, representing the Maine Dental Association. “The first use of adjusting fluoride in water to prevent dental caries was 62 years ago – in 1945. As a result, tooth decay and tooth loss saw dramatic declines in the United States these past decades. Fluoride in drinking water is effective because it supplies a low dose of fluoride to the surface of teeth that reduces tooth decay, along with incorporation into enamel during early tooth development.”

Brian Tarbuck, Assistant General Manager of the Augusta Water District said that Maine’s challenge of assuring adequate fluoride for children is complicated by the number of private wells in the state. “About half of our population gets its drinking water from private wells, not public water supplies,” he said. “Although some private water supplies have sufficient naturally-occurring fluoride, most do not, and supplementation is needed. Public drinking water is the simplest and most cost-effective to assure that our children receive the optimum levels of fluoride for dental health.”

Representative Lisa Miller (D-Somerville), who is also a public health professional, noted that all of Maine’s 16 counties deal with a shortage of dental health providers. “This means we in Maine especially need to rely on community prevention measures such as fluoridation.”

“Recently, a 12-year-old boy, Deamonte Driver, of Maryland, died from a severe brain infection that appeared to have resulted from untreated dental disease,” added Andrew MacLean, JD, Deputy Executive Vice President of the Maine Medical Association. “This is a tragic wake-up call to the nation that dental disease is an important part of our overall health and very preventable with basic public health measures such as fluoridation and dental care.”

“Indeed, if we don’t have good dental health, we’re not healthy and dental health begins with the basic, longstanding, proven public health measure of community water fluoridation,” concluded Dr. Mills.

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De-Bunking Fluoride Myths

Fluoride works to prevent caries in several ways, including: fluoride in plaque and saliva inhibit demineralization of enamel and improves recovery of damaged enamel; and fluoride reduces the activity of bacteria that causes caries.

Some say fluoride is mass medication. Fluoridation of community drinking water is analogous to adding folic acid to some wheat and cereal products to prevent some birth defects, to adding iodide to salt to prevent hypothyroidism (goiter), to adding chlorine to water to disinfect it, and to adding vitamin D to milk for bone health. These are all public health measures. In the case of community drinking water fluoridation, the public health measure is a matter of assuring that this naturally-occurring element is found in concentrations in public drinking water that is optimal for dental health.

Some say that countries in Europe are discontinuing community water fluoridation. A number of European countries (France, Germany, Spain, Switzerland, Hungary, for example) choose to add fluoride to their salt rather than their water. Salt fluoridation can be as effective as water fluoridation. Therefore, these countries are fluoridated – simply by using salt rather than water.

Some have said that the National Research Council report does not support fluoridation of community drinking water. The latest report from the National Research Council, “Fluoride in Drinking Water”, from March 2006 has been grossly misrepresented. This report did not examine or call into question the safety of community water fluoridation. The report was conducted for the U. S EPA and focused on those with high exposure (four times the exposure from community fluoridated water sources) to fluoride from naturally-occurring fluoride (>4 mg/L) found in some occasional areas of the country. Those drinking water systems that adjust the fluoride for dental health purposes maintain concentrations of 0.7 – 1.2 mg/L. The report states: “Because fluoride is well known for its use in the prevention of dental caries, it is important to make the distinction here that EPA's drinking-water guidelines are not recommendations about adding fluoride to drinking water to protect the public from dental caries.” There is nothing in this report to support dangers from the lower intake of fluoride that occurs when an appropriate amount is in the water, entire naturally or after being adjusted for intentionally to assure dental health.

Some have said that the American Dental Association’s recent report does not support giving fluoride to infants. The American Dental Association’s report from November, 2006 has also been misrepresented. This report also did not examine or call into question the safety of community water fluoridation. The report addressed some simple and effective ways to reduce fluoride intake from reconstituted infant formula for those infants whose diet is primarily from formula and whose parents may be concerned about a possible increased risk of fluorosis (cosmetic mottling) before primary teeth have erupted. Once the tooth is formed and in the mouth, fluorosis cannot progress. The first year of life, therefore, is the time when teeth can be most affected. This is why monitoring exposure to fluoride for infants is recommended. The occasional use of fluoridated water will not harm a baby’s developing teeth. The American Dental Association continues to recommend fluoridation of water. (

Some make claims there is a relationship between cancer, especially bone cancer, and fluoridation. However, the American Cancer Society states emphatically, “Scientific studies show no connection between cancer rates in humans and adding fluoride to drinking water.” (, page 32 and

Some have said that topical fluoride is just as effective, so there is no reason to add it to the drinking water. Fluoride works both ways – by ingesting it and by applying it topically. However, ingesting it is important because it not only helps strengthen teeth that are still forming but it also becomes present in saliva, and therefore provides teeth frequent small exposure, rather than relying solely on frequent teeth brushing. (, page 10 and

Some say that fluoride is rat poison. We are not aware of fluoride being used as rat poison. Stating this ignores the fact that poison is usually a matter of dose. Large amounts of most substances – including pure water – can poison people. The amounts of fluoride contained in fluoridated community water are not poisonous, and in fact, is very beneficial.

Some say there is no correlation between low cavity rates and water fluoridation. Caries levels have been shown repeatedly to be lower with fluoridation - both among children when community water is fluoridated and compared with non-fluoridated communities.