Fluoride: It’s in the water — and in the news

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Fluoride is back in the news. Robert F. Kennedy Jr., presumably an operative in President-elect Donald Trump’s coming administration, seeks its removal from water treatment systems. I’m bemused because five decades ago, though I was paid to dump the chemical into public drinking water, I briefly rebelled. Skulls and crossbones emblazoned the sacks of sodium fluoride, and I wore a respirator when I emptied the powder into a mixer at a municipal water treatment plant. As mandated by law, we added fluoride to prevent tooth decay, but that skull bothered me.

Calcium fluoride occurs naturally in many aquifers, and it’s recognized that people imbibing water from such sources have fewer dental caries. So fluoride helps prevent cavities, but what kind of fluoride? Have you read the fine print on your toothpaste tube? Consider this from a common brand: Active ingredient sodium fluoride ... Warning. Keep out of reach of children under 6 yrs. of age. If more than used for brushing is accidentally swallowed, get medical help or contact a Poison Control Center right away.

Sodium fluoride is toxic. It’s linked to cancer, to respiratory disease, to kidney and liver damage, to neurological problems. It’s in toothpaste and municipal drinking water, but the chief use of fluorine-based compounds is industrial. They’re essential for refining bauxite into aluminum, and for producing refrigerants, insecticides, pesticides, fertilizers, lubricants and other products. The substance I added to the mixer was not a natural constituent of groundwater but a by-product of commercial applications.

Circa 1950, the chemical business lobby convinced the American Dental Association (ADA) and the Public Health Service (PHS) that sodium fluoride could serve in place of calcium fluoride. Note that the PHS was directed by a former attorney for Alcoa Aluminum, a big industrial user, and one member of the ADA’s three-person advisory committee had financial interest in fluoride. Was substitution a means to monetize an industrial by-product?

There were skeptics, but with dentists and public health officials on board sodium fluoride advocates prevailed. An isolated pocket of resistance was in Brainerd, Minn.

In 1967, the Minnesota Legislature passed a bill to compel statewide fluoridation. Brainerd objected and held a city referendum in 1972. The vote was 1,863 opposed to the chemical, 199 in favor. Nevertheless, the city lost a court case in 1974, wherein the government maintained that “the state has a substantial interest in fluoridating the public drinking water to prevent tooth decay.” Really?

I was proud to be a licensed water treatment plant operator, aware that clean water rivaled medicine in fostering human health. When water treatment took hold around the turn of the last century, results were dramatic. Mortality rates in the U.S. dropped 40% between 1900 and 1940. Child mortality fell by half. Life expectancy rose from 47 years to 63. Providing safe drinking water for the community was a crucial vocation and a public trust. But what about those baneful sacks of poison? I framed it as a moral problem.

One day the fluoridator broke down, again. The machine was fickle, tiresome to repair. I saw an opportunity. I left it idle and began to doctor the water samples we sent to the Minnesota Department of Health. Our local water had a natural calcium fluoride level of about 0.6 ppm (parts per million), so I’d sift a minute amount of sodium fluoride into a test tube until I had a dosage in the acceptable range around 1.2 ppm. I did this for months. A sympathetic supervisor looked the other way.

However, we were subject to unannounced visits from Health Department inspectors, and one eventually appeared. He noted the fluoridator wasn’t operating. I offered him a sob story about the mixer’s recalcitrant nature. He clucked in sympathy, but expressed expectation that the machine would be repaired.

I continued to produce bogus fluoride samples, but the inspector must’ve been suspicious because he returned sooner than usual and testily ordered me to repair the mixer. I did.

On one hand, so what? A reason conventional water treatment is effective at promoting health is due to the potent disinfectant chlorine. It’s also toxic, but I was readily feeding it into the water, even though it almost killed me. Once, after connecting a fresh cylinder of chlorine to the system, I opened the supply valve and was engulfed by a cloud of pressurized gas. Gagging, I rushed from the room. When I stopped coughing, I donned a self-contained breathing apparatus, re-entered the room — now a veritable gas chamber — and tightened a packing gland nut to stop the leak.

But I accepted chlorine because benefit clearly exceeded risk, and because in my mind it was straightforward in a way sodium fluoride was not — unlike the latter, chlorine was not being represented as anything other than what it was. Besides, if we had fluoride in our toothpaste, why did we need it in the water? And while typhoid, cholera and other nasty waterborne diseases are transmissible, tooth decay is not. If you contract a deadly communicable pathogen, you are a threat to others and there is valid community interest in prevention. Dental cavities seem a private matter.

It raises the perennial question of how and when individual rights supersede community rights or vice versa. A major purpose of government is to arbitrate such conflicts. My view was that if you can feed fluoride into drinking water, then why not vitamin C, or omega-3 fatty acids, or baby aspirin or melatonin? Silly? Yes, but why are we so worried about tooth decay? Actually, we are not. The citizens of Brainerd were not — they were concerned about sodium fluoride. In sorting out this particular individual-vs.-community debate, government officials decided — with lobbyist input — that industrial fluoride at the appropriate dosage was fine. That might be true.

I hadn’t thought much about fluoride until the political upheaval over COVID vaccines and masking. I was firmly on board with both, and grew impatient with those who weren’t, but given what I remembered about calcium vs. sodium fluoride, I understood why it was easy to politicize the pandemic. Public trust is fragile, and while mandates are a legitimate governing tool, they must be applied with wisdom and restraint, and not at the behest of would-be profiteers.

For me, COVID vaccinations occupy the same community-necessity category as chlorine. But millions of Americans spurned professional public health officials’ advice in favor of what may fairly be termed “snake oil” remedies from Trump in denial about the pandemic. The imposition of sodium fluoride into drinking water isn’t the proximate cause of that disconnect, but it’s an example of how to potentially undermine trust. “If,” said Barack Obama, “the people cannot trust their government to do the job for which it exists — to protect them and to promote their common welfare — all else is lost.” Ultimately, trust is a choice, and a half-century ago the public accepted fluoridation to a degree the COVID vaccines were not.

Was it right for me to send fraudulent fluoride samples to the Health Department? No. It was a breach of the very trust I was assigned to uphold. Is it right for anti-vaxxers and conspiracy theorists to discourage or even vilify COVID vaccinations? No. It’s your privilege to refuse a vaccination, but it’s wrong to impede the vaccinations of others.

Anton Chekhov wrote, “You must trust and believe in people or life becomes impossible.” Only individuals act — “the government” or “big business” are abstractions that don’t do anything. In the cases of sodium fluoride and COVID vaccinations, are there individuals purposely trying to poison their fellow citizens? I think not. That’s the starting point for all public policy debates: Do not assume malice; do not ascribe predatory intent as a default position. Governments, businesses, nonprofits, etc., are collections of individuals who mostly perform their duties as best they can and strive to do what’s right. They are sometimes mistaken, but are not typically trying to kill us.

Peter M. Leschak, of Side Lake, Minn., is the author of “Ghosts of the Fireground” and other books.