The fluoride debate is once again popping up in the city of Athens, this time after at-large City Council member Elahu Gosney organized a forum on the subject last week.

Athens has been adding fluoride to its drinking water since 2002, according to Gosney, who serves as chair of City Council's environmental committee. The state of Ohio passed a law in 1970 requiring fluoridation of the public water supplies, exempting only cities that passed a referendum declining to fluoridate. Athens was one of those cities. Since then, there have been numerous efforts to fluoridate Athens' drinking supply.

A city law cleared the way in 1997 to add fluoride compounds to the water supply, but this wasn't accomplished until 2002. Most of the rural water suppliers in the area, including Le-Ax Water District, fluoridate their water.

Gosney said he invited both Paul Connett, an emeritus professor of chemistry and executive director of the Fluoride Action Network and an official from the Ohio Department of Health to debate the issue at the forum. Gosney said he was told by the ODH that they didn't participate in debates on fluoride.

"As the science advances and provides new evidence, I believe it is good public policy to periodically review public-health issues that impact our community," Gosney said of his decision to hold the forum. "This was an initial event aimed at educating Athens residents about the topic."

Gosney said he was disappointed that organizers could not find anyone willing to present the pro-fluoridation view in an open, public forum.

In an interview prior to the forum, Connett laid out some of his concerns about fluoride. He said that the major promoters of fluoridation "“ the American Dental Association and the federal Centers for Disease Control "“ now both concede that the major benefits of fluoride are topical as opposed to systemic. This means that fluoride is effective when applied to the teeth on the outside, and not when ingested, he said. (Most commercially available toothpastes contain fluoride.)

"Now that they've conceded that the major benefits are topical, in the context that fluoridated toothpaste is universally available, there should be no reason to put it in the water," Connett said.

Connett also cited risks, saying that 23 studies have now shown that moderate to high dosages of fluoride lowers IQ in children. Other risks he cited include problems with brain function, the thyroid and skeletal systems, and the fact that it can cause kidney damage and lower fertility.

"They argue, of course, that these are high dosages, but they're not," Connett said. "There's no way of ignoring the fact that there's no margin of safety. You can't control the dose. You can't control who's getting it. And you are forcing it on people who don't want it."

He said that other than fluoridation, the public water supply has never before been used to deliver medicine.

"You are depriving the individual of the right to informed consent to medication," Connett said. "Your council is doing to the whole of Athens what an individual doctor could not to do an individual patient."

Colleen Wulf, preventive services coordinator with the Bureau of Oral Health Services of the ODH, countered some of Connett's claims in a telephone interview.

"ODH does endorse fluoridation," Wulf said. "Our director has a policy statement that it is the single most effective thing that a community can do to improve the oral health of its citizens."

Wulf said fluoridation is safe, works and is effective, but sees opposition bubble up occasionally because it's the only public-health measure that is subjected to a vote.

"In the '50s it was a Communist plot. And then in the '70s it caused cancer. And then in the '90s it was linked with AIDS. They kind of take whatever the issue of the day is," Wulf said. "Now you hear about environmental impacts, but there is no true scientific controversy."

People have grown up for generations, Wulf said, with fluoride naturally in the water at a variety of levels.

"We know that at 10 parts per million, it causes staining," Wulf said. "But at one part per million, it's going to reduce tooth decay and not cause staining of the teeth."

In response to fluoride being effective topically and not systemically, Wulf agreed that the main action is topical, but said it's fine to get fluoride topically in the water as well as in toothpaste.

As far as an effect on IQ in children, Wulf said that she has not seen anything in the refereed scientific journals that have made such a link to fluoridation of water.

With regard to Connett's argument that fluoridation is a forced medication, Wulf compared it to seatbelt and helmet laws, saying that no court of last resort has ever ruled against bettering the public health.

Gosney said that Connett raised some important questions, both about the effectiveness of fluoridation and the possibility for adverse health effects.

"I will compile a list of relevant questions and send them on to the Ohio Department of Health, who I hope can follow through on an assurance that they can answer those questions with sound, scientific and documented responses," Gosney said.

More information from the Fluoride Action Network can be found at www.fluoridealert.org.

The American Dental Association has a section of their Web site devoted to community water fluoridation at http://www.ada.org/public/topics/fluoride/facts/index.asp.