AYESHA RASCOE, HOST:
Skepticism about putting fluoride in drinking water has been around for a long time. Some of it is based on evidence and some on conspiracy theories. One of the most prominent critics is Robert F. Kennedy Jr., the new secretary of Health and Human Services. He says he'll advise removing fluoride from the nation's water supply. Some cities in the U.S. have already removed fluoride like Juneau, Alaska. Member station KTOO's Clarise Larson has this report on how almost two decades without fluoridated water has affected Juneau's dental health.
CLARISE LARSON, BYLINE: Dr. Yvonne Tijerina-Burleson uses a tiny toothbrush to paint topical fluoride on a patient's teeth at the SouthEast Alaska Regional Health Consortium Dental Clinic in Juneau.
YVONNE TIJERINA-BURLESON: Dry, dry, dry and paint, paint, paint. Simple with some amazing benefits.
LARSON: Those benefits include strengthening teeth and reducing cavities. The Centers for Disease Control and Prevention says fluoride can reduce cavities by around 25%. Since Juneau voted to get fluoride out of their water nearly two decades ago, this is one of the main ways people here get it now.
DANE LENAKER: Fluoride - if you're not getting it in the water system and it's not getting incorporated into your teeth that way, this is another way that it basically gets painted onto your teeth.
LARSON: That's Dr. Dane Lenaker, who directs dental services at the clinic. He says he thinks the easiest, most effective way of getting fluoride is through water, though some people can also get it through topical fluoride, toothpaste or pills. That's how David Ham gets it. He advocated to remove fluoride from Juneau's water because he worries that there could be health consequences that doctors don't know about yet.
DAVID HAM: I used a fluoride toothpaste, and then I could spit out the toothpaste and not swallow it and ingest a questionable substance into my body.
LARSON: Data does not show fluoride in drinking water to be harmful at the levels recommended in the U.S. drinking water supply. But some research has shown that at much higher levels, there's an association with decreased IQ in children. Although 60% of the U.S. population has access to fluoridated tap water, there's a movement among some cities to roll it back. What some data collected in Juneau shows, however, is that when people have to seek out fluoride individually, cavities do go up.
JENNIFER MEYER: What we know happens is over time, you start to see kids with more and more decay and some with some really advanced decay.
LARSON: Jennifer Meyer is a public health researcher at the University of Alaska Anchorage, who conducted a study in 2018 showing that kids in Juneau have needed more dental work since they stopped getting fluoride in the water. Her study focused specifically on the teeth of children under 6 in Juneau. She used a set of Medicaid dental claims to get data for about 2,000 kids. The data came from two different years - one where there was fluoride in the water and one a few years later when there wasn't. She found that when the water had fluoride in it, kids had an average of 1 1/2 cavity-related procedures per year. But once it was gone, that went up to about 2 1/2 procedures a year.
MEYER: Places that are going to cease fluoridation, just hold onto your pocketbook because it's going to get expensive.
LARSON: She says it costs more to fix cavities than to prevent them with fluoridated water, which can be expensive for individuals and for state and federal programs like Medicaid. Dr. Lenaker, the dental clinic's director, says that dental issues can also affect people's lives in other ways, especially kids.
LENAKER: There's quite a bit of literature that has shown tooth pain can contribute in a very negative way to kids functioning in school, learning, eating, sleeping.
LARSON: The Juneau city government confirms there are no plans to propose adding fluoride back to the water. For NPR News, I'm Clarise Larson in Juneau. Transcript provided by NPR, Copyright NPR.
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