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Wisconsin faces wave of anti-fluoridation efforts

ADA, Wisconsin Dental Association collaborating with other organizations to turn the tide

March 06, 2020

By David Burger

 Infographic of 3 communities in Wisconsin that terminated or are considering termination of fluoridation programs

 
The ADA and the Wisconsin Dental Association are partnering up with other fluoridated water proponents to address February anti-fluoridation movements in three Wisconsin municipalities: Lake Delton, Berlin and Hayward.

The state association is part of a fluoride response team that monitors situations like those in the three communities by sharing information and working together to develop a response when a municipality considers ending — or has already decided to end — community water fluoridation, said Brenna Sadler, WDA director of membership and communications.

“The response is customized based on the particular situation and rationale behind it (cost, junk science, etc.) and can include written letters and submissions of factual Centers for Disease Control and Prevention and ADA information supporting community water fluoridation, securing local dentists and oral health professionals to speak at council meetings and public hearings, media outreach and more,” Ms. Sadler said.

According to the Wisconsin Department of Health Services’ public water supply fluoridation census, about 90 percent of the population in Wisconsin on public water supplies receives the benefits of optimal levels of fluoride. The optimal level for fluoridated systems in Wisconsin is 0.7 parts per million of fluoride, as recommended by the federal government.

 Photo of Russell Dunkel
Dr. Dunkel
Part of the problem in encountering opposition to water fluoridation is that the state does not have an early notification law, said Dr. Russell Dunkel, state dental director.

An early notification law, which can be enacted through legislative action, is in place in Tennessee, Alabama, Texas, New York and Missouri. The laws generally require water systems to provide advance notice to the public and state health officials of proposed changes to fluoridation programs, thereby giving the public greater opportunity to express concerns regarding the elimination of fluoridation.

“We need to get some momentum in getting a law passed,” Dr. Dunkel said. “We find out so late in the game. It would make a big difference.”

For example, in Texas, legislation was passed and went into effect in 2019 that prohibits water systems from permanently terminating the amount of fluoride in the water unless written notice is provided at least 60 days before reduction or termination to the customers of the system and state authorities.

Dr. Leon Stanislav, chair of the ADA National Fluoridation Advisory Committee, was instrumental in getting his home state of Tennessee to pass the law and lamented Wisconsin’s lack of a similar measure.

“If Wisconsin had a statute that required a public water system to notify the state health department and the consumers that an action was being taken to start or remove water fluoridation by a vote of local lawmakers, then all parties could be at the table from the onset,” said Dr. Stanislav, who is closely watching the recent anti-fluoride wave in Wisconsin. “Hayward could have saved some time simply by having stakeholders at the first meeting. Perhaps Berlin would have been more properly positioned to debate the issues. Perhaps it would have made no difference in Lake Delton, but it should always be a transparent process. The only equitable way to do that is with reasonable notification.”

The lack of notification was an issue for Dr. David Clemens, a Lake Delton dentist and past WDA president. He said he didn’t realize his village in south central Wisconsin was even considering the termination of its fluoridated water program until he read in the paper that village officials voted to discontinue it.

After Lake Delton discontinued its fluoridated water program Feb. 10, Dr. Clemens addressed the council at its Feb. 24 meeting. Despite that and letters of support that included one from Dr. Kathleen T. O’Loughlin, ADA executive director, the village board adjourned without discussion, keeping termination in place.

Also on Feb. 10, the Hayward City Council voted to discontinue fluoridation of the water in the northern Wisconsin city.

 image of fluoridation icon
“This has been something they have been considering since at least 2018 when they had a similar vote but decided to continue until this most recent vote,” said Ciara Lotzer, water supply engineer with the Wisconsin Department of Natural Resources. “They are currently just using their remaining supply and will stop feeding in the next month or so when it runs out.”

Jennifer Martinson, secretary of the American Fluoridation Society, criticized Hayward’s officials for their decision.

“The claim was money,” Ms. Martinson said, but “it became absolutely clear the reason had little to do with money and everything to do with opposition. We have decades of research supporting community water fluoridation. It's shocking and scary to know that people serving our public health — water operators, city council members — are so uneducated, uninformed and easily swayed with false information.”

Berlin is a city in northeastern Wisconsin that is considering ending community water fluoridation. A vote on the matter was scheduled for Feb. 26, but a decision was tabled until April.

The CDC and ADA have sent letters to Berlin officials recommending community water fluoridation. Dr. O’Loughlin wrote, “Through decades of research and nearly 75 years of practical experience, fluoridation of public water supplies has been responsible for dramatically improving the public’s oral health. The ADA is truly gratified when, in the interest of the public’s health and welfare, communities provide optimally fluoridated water to their residents.”

The ADA, Wisconsin Dental Association and American Fluoridation Society are not the only advocates working to respond to communities in the Badger State considering or terminating community water fluoridation.

“The Wisconsin Dental Association is part of a very active and robust Fluoride Response Team, which also includes the Wisconsin Department of Health Services’ Oral Health Program, the Children’s Health Alliance of Wisconsin & Wisconsin Seal-A-Smile, the Wisconsin Oral Health Coalition, Oral Health Workforce Educators and the Wisconsin Dental Hygienists’ Association," Ms. Sadler said. "The team works closely with the state Department of Natural Resources, the Wisconsin Rural Water Association, the Wisconsin Water Association and local health departments, as well as national partners like the Children’s Dental Health Project, the American Academy of Pediatrics, the ADA and others. “

Dr. Johnny Johnson, president of the American Fluoridation Society, said he hopes that the interprofessional team results in overturning communities’ votes to discontinue fluoridation.

“We never give up,” Dr. Johnson said. “And the best time to approach a cessation is immediately following its cessation. We’ve had cessations overturned in as little as one day with our support.”

Village and city officials in Lake Delton and Hayward did not respond to requests for comment. The mayor of Berlin referred ADA News to the city's Water & Sewer Commission president, who did not respond to an interview request.

For additional community water fluoridation information, contact Tooka Zokaie, manager of ADA fluoridation and preventive health activities, at zokaiet@ada.org.

For ADA fluoride resources, go to ADA.org/fluoride.