On the far east facet of Michigan, the way forward for fluoride in ingesting water — lengthy an atypical apply for stopping tooth decay — has instantly provoked passionate debate.
Public conferences in St. Clair County, about an hour northeast of Detroit, have stuffed with folks 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 therapy.
“I’m an unfluoridated baby,” he declared, “with a set of uppers and lowers.”
One other man, chatting with the county’s Advisory Board of Well being, stated that non-public accountability ought to be factored into the dialog. “I feel there are some 3 Musketeer bars, Snicker bars that ought 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 attempting to do away with 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 folks.”
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 techniques 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 specialists and well being companies, which have lengthy celebrated fluoridation as a public well being triumph.
Nevin really useful fluoride restrictions that might apply to any system positioned within the county and serving county residents. Doubtlessly, that would embrace the Nice Lakes Water Authority, which gives water to just about 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 lately reported. These opponents embrace Kennedy, the nation’s high well being official, who has referred to 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 strains of the fluoride wars in most states, usually deciding whether or not or to not proceed fluoridating their ingesting water by council vote or group referendum. The general public dialog in St. Clair County presents 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 entire 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 obtained 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 time, Nevin, who’s a doctor epidemiologist, cited a state-of-the-science report from the Nationwide Toxicology Program final 12 months that described an affiliation between larger ranges of fluoride publicity and decrease IQs in youngsters. (The NTP is an interagency program inside the Division of Well being and Human Companies that’s centered on toxicology analysis.)
Nevin additionally referenced a court docket resolution in a case filed towards the EPA by teams against fluoridation, the place a district decide relied, partly, on the NTP report in ruling that fluoride introduced an “unreasonable danger.” Even because it appeals the choice, the EPA stated its evaluate of latest science on fluoride in ingesting water “is being accomplished in coordination with Secretary Kennedy and HHS.”
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The NTP report, although, is contested and primarily based on restricted research involving fluoride ranges which can be greater than twice the quantity really useful 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 stated that the EPA could 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 comparable measures,” he wrote, “and inside St. Clair County, I’ve acquired a lot of resident considerations associated to this situation.” He really useful new rules that might prohibit the addition of “any type of fluoride” to public water techniques within the county that serve residents.
In Michigan, every group decides for itself if it can keep fluoride in its ingesting water system. However in an e-mail to ProPublica, Nevin laid out a course of the place the St. Clair County Board of Commissioners might approve rules that, within the identify 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 rules, even when the bulk are bought exterior the state; so too might ingesting water produced in St. Clair County be topic to extra stringent county rules, even when the bulk is exported to different counties,” he wrote.
Whether or not or not this is applicable to any future fluoride rules is determined by the language that’s adopted and authorised, he added.
The state Division of Well being and Human Companies 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 stated, and is consistent with the really useful goal for oral well being advantages.
The water authority, which serves southeast Michigan, didn’t handle the St. Clair County proposal. And it’s unclear whether or not the push for broad county rules will achieve traction.
As medical director, Nevin has an influential voice with county officers and shares steering with Liz King, the county’s well being officer-director. King, nonetheless, expressed reservations about Nevin’s proposal at a July assembly of the Advisory Well being Board, in accordance with the minutes.
In an announcement to ProPublica, King stated: “I don’t help county-wide mandates to take away fluoride or actions that override the authority of native jurisdictions, until there may be 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 energetic power. He describes it in an e-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 essential of the Democratic Occasion and authorities restrictions enacted through the COVID-19 pandemic. (To the notion that he needs to work for Kennedy, Nevin instructed ProPublica that it’s “baseless conjecture” and that he’s pleased in St. Clair County.)
Lower than a 12 months into his tenure as HHS secretary, Kennedy’s strategy was challenged by six former surgeons common who served below each Republicans and Democrats. In a latest op-ed, they stated that Kennedy is “endangering the well being of the nation.” His company criticized their observe data in workplace when contacted by ProPublica in regards to 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 might “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 at college well being clinics, arguing, partly, that offering direct major care isn’t a core operate of public well being.
Supporters level to his coaching within the navy 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 skill to function an professional witness and marketing consultant in authorized instances that contain antagonistic results from sure antimalarial medicine.
Nevin instructed ProPublica that previous expertise taught him that it will probably take years for neurotoxic results of sure substances to be acknowledged. “I’ve each confidence that, in the end, fluoride may also be seemed upon as a neurotoxicant that has no place being ingested,” he wrote in an e-mail.
He added that the response he’s acquired to his proposal from the group “has been overwhelmingly optimistic.”
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However there’s been sturdy pushback. Dr. Randa Jundi-Samman, a lately retired dentist in St. Clair County, was one of many well being professionals talking in help of fluoridation at public conferences. She instructed ProPublica that dropping fluoridation can be a critical hit to group 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 stated. “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, stated he’s hustling as much as the general public conferences in St. Clair County as a result of it’s the responsibility of pros “to ensure that the choices which can be being made inside our communities are being made primarily based upon scientific benefit.”
Talking broadly in regards to the affect now wielded by fluoride skeptics, Aksu stated, “We now have opened ourselves as much as alternatives from misinformed individuals who wish to use this situation for political functions.”
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At an August assembly of the county commissioners, Kimberly Raleigh, interim government director of the Michigan Oral Well being Coalition, learn a letter in help of fluoridation that was signed by the College of Michigan Faculty of Dentistry, the Michigan Dental Affiliation, the Indiana Dental Affiliation, the Pennsylvania Coalition for Oral Well being and dozens of others.
Nevin stated in an e-mail that the dental group “should acknowledge that group water fluoridation can not be relied upon to masks the dental issues created by our neglect of poor dietary decisions.”
He argues that he has science on his facet. “Scientific benefit 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 steering 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 could then resolve whether or not to suggest rules, which the Board of Commissioners would then weigh, in accordance with the Well being Division. Nevin estimated that the method might 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 achieve a quorum. Nevin instructed ProPublica that he expects it to be mentioned at this week’s assembly, and that he’ll current extra 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 help entry to topical dental fluoride therapies.
Port Huron’s metropolis supervisor declined to remark for this story, saying the township has not introduced the town with any decision or request. Nevin stated in an e-mail to ProPublica that he’s “making an attempt to deal with each municipality within the county” with comparable testimony.
After voting on the measure, one Kimball trustee made a degree to point out help for Nevin, saying “we’re blessed to have him making selections.”
Nevin, he stated, has needed to overcome resistance from workers “pushing exhausting to make his life relatively uncomfortable.”
“They’re not used to management,” the trustee stated. “They’re not used to boldness. They’re not used to perhaps some male power that’s essential to get issues accomplished.”
