The city of Cambridge is considering eliminating the addition of fluoride to its water treatment, but Indiana dental and health experts are urging the city council to reject the change.

During the Aug. 12 council meeting, City Clerk Chris Stapleton proposed removing fluoride. After discussion, members voted to adjourn the matter until their Sept. 9 meeting at 6 p.m. at City Hall, 127 N. Foote St.

According to Stapleton, “numerous studies” indicate that additional fluoride is no longer needed to prevent tooth decay and strengthen teeth, as was the case in the 1950s and 1960s, and that this would save the city money.

But Doug Bush, executive director of the Indiana Dental Association, and Dr. John Roberts, a Connersville dentist and former IDA president who currently serves on the American Dental Association’s Council on Government Affairs, disagree.

Bush said that adding fluoride to toothpaste (an invention of researchers at Indiana University) is certainly important, but research indicates that it supports, not replaces, fluoride levels in drinking water.

Adding fluoride costs much less than repairing tooth decay, Roberts said. Cities generally pay 50 cents to $3 per year per person for fluoride treatment, while each filling costs $100 plus tooth damage. Even when fluoride is available in toothpaste and supplements, optimal fluoridation of drinking water reduces tooth decay by an additional 25 percent, Bush said.

Roberts said his hometown of Connersville was part of the Crest toothpaste study because the water there did not contain fluoride at the time. One of the main reasons Roberts returned after dental school was to advocate for adding fluoride to city water.

Roberts recalls conducting dental exams for children in Fayette County’s Head Start program before fluoride was added to the city’s water. Out of 40 exams, he found only one or two children who did not have cavities.

However, several years after fluoride was introduced, the exact opposite was true. Roberts said nothing had changed, including more thorough brushing or less soda consumption.

Roberts added that fluoride is not only important for children, as older people often have weak spots in their tooth enamel or exposed tooth roots that are more susceptible to tooth decay without fluoride.

Bush found that there is a connection between dental disease and social and economic status.

“Fluoridation of drinking water has been cited in numerous studies as a strategy to reduce dental disease in at-risk populations,” Bush said.

Bush said some Indiana communities have stopped fluoridation or are considering it, but he suspects that’s because of outdated equipment that needs to be replaced. Roberts said newer fluoridation machines are much more efficient and less costly than earlier models.

According to the Pew Charitable Trusts, research shows that fluoridating drinking water offers “perhaps the highest return on investment of any dental care strategy.”

The decision is not just about money.

Stapleton told the city council he was concerned about the addition of a chemical to the water that had a “large skull and crossbones” depicted on the container.

But Bush said anything in the wrong amounts can be harmful, and he suspects similar warnings could be found on chlorine containers used to make drinking and swimming pool water safe.

Roberts said it is not possible to ingest a toxic amount of fluoride through tap water because the amount of water ingested would already be fatal.

IDA, ADA and the Indiana Department of Health are all strong supporters of drinking water fluoridation, Bush said.

Ken Risch, director of public works for the city of Cambridge, said he agreed with Stapleton that now is a good time to remove fluoride.

Risch said the city’s water naturally contains about 0.2 mg/l and daily tests of the treated water typically show a value of about 0.5 to 0.8.

However, Bush said the Environmental Protection Agency recommends setting community water fluoridation at 0.7 mg/L. If fluoride levels in the city were above 4.0 mg/L, defluoridation could be recommended.

Cities have the right to remove fluoride without holding public hearings, said attorney Bob Bever. He said he would prepare a written resolution that could be adopted at the September meeting if the council favors that decision.

Because removing fluoride represents a change in the water treatment process, the City of Cambridge must inform both the Indiana Department of Environmental Management and the public of the reasons for the change, according to Adam Sitka of Wessler Engineering.

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