Bruce Bagley, MD, took a tough political question to his town supervisor last month in Latham, NY. His mission wasn't about taxes or zoning. He wanted to know what action was needed to get fluoride added to the public water supply.
Fluoridated water should be part of every community's agenda, Dr. Bagley says. "There's a health benefit to having fluoride in the water. But there's political trouble to the official who suggests it."
Dr. Bagley says he's using the AAFP policy on fluoride to encourage his local community government to look at the issue.
"They say there would need to be a groundswell of support in the community for them to take up this issue," Dr. Bagley says. "I've started looking into support from dentists, other doctors, and insurance companies."
Dr. Bagley, a member of the AAFP Board, chairs AAFP's Commission on Public Health.
One of the goals of Healthy People 2000, a Public Health Service campaign, is for fluoridated water to be available to 75 percent of the people using public water systems. Currently, 62 percent of the population has access to fluoridated water.
"The issue of fluoride seems to come in cycles," says Martin Mahoney, MD, PhD, of Kenmore, NY, resident member of the Commission on Public Health. "It goes back to the late '80s when it became a huge political issue. People were fighting against adding anything to the public water supply."
Dr. Mahoney helped draft the AAFP's position on fluoride, adopted in 1995.
Dr. Mahoney says all family physicians need to know what's in the water, even if it isn't fluoridated.
Although there are health concerns about fluoridated water and its association with cancer, Dr. Mahoney says there's not much hard evidence supporting this relationship.
"A lot of people have a lack of understanding about the true risks and benefits of fluoridated water," Dr. Mahoney says. "The issue is certainly more expansive than only dental health." Other benefits include the stimulation of bone growth.
Dr. Bagley says monitoring the level of fluoride in the water isn't any more complicated than measuring the chlorine level--something that's done in every public water system.
Both Drs. Bagley and Mahoney agree family physicians should be willing to speak out on public health issues such as fluoridated water.
"It can only help a community stay healthy," says Dr. Mahoney.
An AAFP position paper on the fluoridation of public water supplies was published in the May 15 American Family Physician.
AAFP Policy
Fluoridation of public water supplies is a safe, economical, and effective measure to prevent dental caries. Family physicians should know the fluoride content of local drinking water supplies, educate patients to prevent excessive fluoride intake, and be knowledgeable about the health risks and benefits associated with fluoride. Dietary fluoride supplements should be considered for children from ages six months through 16 years when drinking water levels are suboptimal.
FP Report, October 1996
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