SECOND OPEN LETTER TO THE PUBLIC HEALTH & HUMAN SERVICES COMMITTEE: PHHSC, PLEASE GET IT RIGHT!
Following is a message I sent to the Public Health & Human Services Committee, with copies to the rest of the City Council and various and sundry city staff. I'm sure they loved it:
November 30, 2011
To the Austin City Council Public Health & Human Services Committee: M. Martinez, L. Morrison & C. Riley
Dear Council Member:
I'm writing to address two issues that came up during the Public Health and Human Services Committee's proceedings of November 22.
Background: Since summer 2010, the city has posted a website notice to inform parents and caregivers about possible negative effects (dental fluorosis) from mixing formula with fluoridated tapwater during an infant’s first year. The notice follows from an advisory the ADA issued in 2006 in response to a National Research Council report which showed fluorosis to be widespread and increasing among American children. As the time nears for the website information to receive wider distribution, its specific wording becomes paramount.
I’ve previously expressed concern that the language has been crafted (“massaged” in Ms. Morrison’s terms) to convey a subliminal message far from the ADA’s intent: namely, that following the directive might result in a fluoride deficit, leading to the need for F supplements at the age of 6 months. Dr. Huang pointed to a CDC supplement schedule which shows an entry for 6-month-olds. However, that document is dated 2001, several years prior to the ADA/CDC’s newer guidelines of 2006. The crucial information, presented in the January 2007 Journal of the American Dental Association in bullet point form, makes it clear that the guidelines are applicable to the first 12 months of life. I’ve included the relevant pages as attachments. Furthermore, breast milk—highly recommended—contains virtually no fluoride, yet no supplementation is being proposed for breast-fed babies. The core message is: to avoid dental fluorosis, the less fluoride the better during the first year.
A notification more consonant with both the letter and spirit of the ADA’s guidelines is that found in the 2010 Sugarland, Texas annual water quality report. Many other entities from cities to state governments to dental associations, nationwide, are following this more realistic model.
Also of note: During the Public Health and Human Services Department presentation, Mr. Rivera stated that the National Kidney Foundation is the only organization ever to have withdrawn its endorsement of community water fluoridation. That is incorrect. The list of names removed within the past decade or so, in addition to the NKF, is substantial. It includes, but is not limited to, the American Academy of Allergy, Asthma & Immunology; Environmental Protection Agency; US Department of Agriculture; Mayo Clinic; American Veterinary Medical Association; Indian (Native American) Health Service; National Research Council; and National PTA. These changes are reflected in the most current version of the compendium, now on the ADA's website at. I've attached a searchable copy of that document. Nowhere do any of the following terms appear: bone, diabetes, kidney, arthritis, heart, thyroid, endocrine, toxicology, brain, neuro. ADA’s compendium is as striking for what doesn’t appear on it as for what does.
We appreciate your efforts to bring accurate information to a wider public, including the Spanish-speaking public. Many thanks for your attention.
3 Attachments: MMWR table; JADA Jan. 2007; ADA current compendium