Fluoridation Debate Turns Raucous in a Michigan Group — ProPublica

On the far east aspect of Michigan, the way forward for fluoride in ingesting water — lengthy an odd follow for stopping tooth decay — has abruptly provoked passionate debate.

Public conferences in St. Clair County, about an hour northeast of Detroit, have stuffed with individuals weighing in. One man waved his Fixodent denture cream earlier than the county commissioners, suggesting that his personal expertise confirmed what would occur if native communities stopped remedy.

“I’m an unfluoridated little one,” he declared, “with a set of uppers and lowers.”

One other man, chatting with the county’s Advisory Board of Well being, mentioned that non-public duty needs to be factored into the dialog. “I believe there are some 3 Musketeer bars, Snicker bars that needs to be accounted for. Some Coca-Colas.”

And a younger man used his time within the public feedback to deal with not simply fluoridation, however the county medical director who’s making an attempt to eliminate it. He accused him of grandstanding to land a job with Robert F. Kennedy Jr., the U.S. well being and human providers secretary, by making strikes that “lowered the standard of life for underserved individuals.”

The raucous arguments have been spurred by a three-page memo despatched in June to the Advisory Well being Board by Dr. Remington Nevin, the medical director of St. Clair County’s Well being Division. It urges the division to take steps to “prohibit the addition of fluoride” to public water methods as a result of, he wrote in daring print, the additive is “a believable developmental neurotoxicant” — a declare that runs counter to the evaluation of many main consultants and well being companies, which have lengthy celebrated fluoridation as a public well being triumph.

Nevin beneficial fluoride restrictions that may apply to any system situated within the county and serving county residents. Probably, that might embrace the Nice Lakes Water Authority, which offers water to almost 40% of the state’s inhabitants.

Ingesting water fluoridation, which was pioneered in Michigan in 1945, led to an enormous drop in tooth decay. Even with the rise of fluoride in toothpaste and different merchandise, it’s credited with a 25% lower in cavities. However skeptics more and more maintain sway in authorities, as ProPublica not too long ago reported. These opponents embrace Kennedy, the nation’s prime well being official, who has known as fluoride “industrial waste.”

Now the Facilities for Illness Management and Prevention and the Environmental Safety Company are reviewing their approaches to fluoride in ingesting water, and Utah and Florida turned the primary states to ban fluoridation.

Native communities, although, are on the entrance traces of the fluoride wars in most states, sometimes deciding whether or not or to not proceed fluoridating their ingesting water by council vote or neighborhood referendum. The general public dialog in St. Clair County provides a vivid instance of how contentious the difficulty can grow to be. Advocates from effectively past its borders are getting concerned, saying that what occurs within the county has implications for your complete state.

Residence to about 160,000 residents on the base of Michigan’s Thumb, St. Clair County shares a watery border with Canada. Some 67% of its voters selected President Donald Trump within the 2024 election. (Kennedy received below 1% of the vote.) About 110,000 residents obtain fluoridated ingesting water, in accordance with the state’s environmental company, whereas an extra 6,510 are served by water provides with naturally occurring fluoride.

In his memo this summer season, Nevin, who’s a doctor epidemiologist, cited a state-of-the-science report from the Nationwide Toxicology Program final yr that described an affiliation between greater ranges of fluoride publicity and decrease IQs in youngsters. (The NTP is an interagency program throughout the Division of Well being and Human Providers that’s centered on toxicology analysis.)

Nevin additionally referenced a courtroom determination in a case filed towards the EPA by teams against fluoridation, the place a district decide relied, partially, on the NTP report in ruling that fluoride offered an “unreasonable danger.” Even because it appeals the choice, the EPA mentioned its assessment of latest science on fluoride in ingesting water “is being accomplished in coordination with Secretary Kennedy and HHS.”

The NTP report, although, is contested and based mostly on restricted research involving fluoride ranges which might be greater than twice the quantity beneficial by the federal authorities. Its personal summary says there isn’t sufficient info to hyperlink decrease fluoride publicity with youngsters’s IQ.

Nevin’s memo mentioned that the EPA might take months or years to behave on fluoride, however that didn’t imply native officers needed to wait. “Throughout the Michigan Thumb, a number of townships have expressed a want for related measures,” he wrote, “and inside St. Clair County, I’ve obtained quite a few resident considerations associated to this difficulty.” He beneficial new laws that may prohibit the addition of “any type of fluoride” to public water methods within the county that serve residents.

In Michigan, every neighborhood decides for itself if it is going to preserve fluoride in its ingesting water system. However in an electronic mail to ProPublica, Nevin laid out a course of the place the St. Clair County Board of Commissioners may approve laws that, within the title of public well being, limit the power of suppliers to make use of the additive — in impact, enacting sweeping change all through the area.

“Simply as gadgets manufactured in California are sometimes topic to extra stringent California environmental and well being laws, even when the bulk are bought outdoors the state; so too may ingesting water produced in St. Clair County be topic to extra stringent county laws, even when the bulk is exported to different counties,” he wrote.

Whether or not or not this is applicable to any future fluoride laws depends upon the language that’s adopted and authorized, he added.

The state Division of Well being and Human Providers says it is aware of of no native well being departments which have tried such restrictions. In response to ProPublica’s queries, the Nice Lakes Water Authority shared a Might assertion about fluoride, which says that the company is required by its proprietor, the town of Detroit, to fluoridate its water provide. The present dosage is effectively under the utmost established by the Secure Ingesting Water Act and the EPA, the assertion mentioned, and is in step with the beneficial goal for oral well being advantages.

The water authority, which serves southeast Michigan, didn’t tackle the St. Clair County proposal. And it’s unclear whether or not the push for broad county laws will acquire traction.

As medical director, Nevin has an influential voice with county officers and shares steerage with Liz King, the county’s well being officer-director. King, nevertheless, expressed reservations about Nevin’s proposal at a July assembly of the Advisory Well being Board, in accordance with the minutes.

In a press release to ProPublica, King mentioned: “I don’t assist county-wide mandates to take away fluoride or actions that override the authority of native jurisdictions, except there’s an emergent or pressing public well being want.”

Nevin was new to Michigan when he joined the Well being Division in his part-time place about two years in the past. He quickly established that he can be an lively power. He describes it in an electronic mail to ProPublica as “counter-activism,” including: “I’m largely working to counter the unconventional agendas of many previous and present state public well being officers.”

On the January assembly of the Advisory Well being Board, Nevin supplied members with a 2022 e book by Kennedy — “A Letter to Liberals: Censorship and COVID: An Assault on Science and American Beliefs” — that’s vital of the Democratic Get together and authorities restrictions enacted in the course of the COVID-19 pandemic. (To the notion that he desires to work for Kennedy, Nevin advised ProPublica that it’s “baseless conjecture” and that he’s pleased in St. Clair County.)

Lower than a yr into his tenure as HHS secretary, Kennedy’s strategy was challenged by six former surgeons normal who served below each Republicans and Democrats. In a current op-ed, they mentioned that Kennedy is “endangering the well being of the nation.” His company criticized their monitor information in workplace when contacted by ProPublica concerning the op-ed, saying they failed to enhance public well being.

Nevin has moved to make vaccine exemptions simpler to get, saying in an April memo that it will “enhance the general public’s belief in public well being.” These efforts helped earn him a tribute signed by 10 Republican state legislators, which additionally highlights his fluoride suggestions. Nevin additionally efficiently pushed for the division to wind down providers in school well being clinics, arguing, partially, that offering direct major care isn’t a core operate of public well being.

Supporters level to his coaching within the army and at Johns Hopkins College. Along with a medical diploma, his CV lists a grasp’s diploma and doctorate in public well being. On his web site, Nevin additionally highlights his potential to function an knowledgeable witness and guide in authorized circumstances that contain antagonistic results from sure antimalarial medication.

Nevin advised ProPublica that previous expertise taught him that it may well take years for neurotoxic results of sure substances to be acknowledged. “I’ve each confidence that, sooner or later, fluoride will even be seemed upon as a neurotoxicant that has no place being ingested,” he wrote in an electronic mail.

He added that the response he’s obtained to his proposal from the neighborhood “has been overwhelmingly constructive.”

However there’s been robust pushback. Dr. Randa Jundi-Samman, a not too long ago retired dentist in St. Clair County, was one of many well being professionals talking in assist of fluoridation at public conferences. She advised ProPublica that dropping fluoridation can be a severe hit to neighborhood well being.

“You’d 100% get extra decay, particularly in youngsters in low-income communities that don’t get the possibility to go to the dentist each six months,” Jundi-Samman mentioned. “We actually will see that. We already see it in individuals who don’t have fluoride of their water.”

Dr. Mert Aksu, president of the Michigan Oral Well being Coalition’s board and dean of the College of Detroit Mercy’s dental college, mentioned he’s hustling as much as the general public conferences in St. Clair County as a result of it’s the obligation of execs “to make it possible for the selections which might be being made inside our communities are being made based mostly upon scientific advantage.”

Talking broadly concerning the affect now wielded by fluoride skeptics, Aksu mentioned, “Now we have opened ourselves as much as alternatives from misinformed individuals who need to use this difficulty for political functions.”

At an August assembly of the county commissioners, Kimberly Raleigh, interim government director of the Michigan Oral Well being Coalition, learn a letter in assist of fluoridation that was signed by the College of Michigan College of Dentistry, the Michigan Dental Affiliation, the Indiana Dental Affiliation, the Pennsylvania Coalition for Oral Well being and dozens of others.

Nevin mentioned in an electronic mail that the dental neighborhood “should acknowledge that neighborhood water fluoridation can now not be relied upon to masks the dental issues created by our neglect of poor dietary selections.”

He argues that he has science on his aspect. “Scientific advantage favors a advice to ban fluoride,” he wrote to ProPublica. “I’ve each confidence it will grow to be a lot clearer within the coming months, as additional federal steerage is inevitably launched.”

Nevin’s advice is earlier than the Advisory Well being Board, which additionally was supplied a truth sheet on fluoridation from the Well being Division, submitted with Nevin’s approval. If the board endorses his proposal, King might then determine whether or not to suggest laws, which the Board of Commissioners would then weigh, in accordance with the Well being Division. Nevin estimated that the method may take six to 12 months.

Fluoride was on the agenda for the Advisory Well being Board’s September assembly, which ended early as a result of the members failed to succeed in a quorum. Nevin advised ProPublica that he expects it to be mentioned at this week’s assembly, and that he’ll current further info then.

In the meantime, Nevin has already influenced one of many county’s townships, Kimball, which receives handled water from Port Huron, the seat of St. Clair County.

At an August assembly, the place Nevin spoke to the Board of Trustees, Kimball Township unanimously handed a decision calling for Port Huron to discontinue fluoridation and direct any funds saved to assist entry to topical dental fluoride remedies.

Port Huron’s metropolis supervisor declined to remark for this story, saying the township has not offered the town with any decision or request. Nevin mentioned in an electronic mail to ProPublica that he’s “trying to deal with each municipality within the county” with related testimony.

After voting on the measure, one Kimball trustee made some extent to indicate assist for Nevin, saying “we’re blessed to have him making choices.”

Nevin, he mentioned, has needed to overcome resistance from employees “pushing laborious to make his life reasonably uncomfortable.”

“They’re not used to management,” the trustee mentioned. “They’re not used to boldness. They’re not used to perhaps some male vitality that’s essential to get issues accomplished.”