Should Phoenix continue adding fluoride to its drinking water?
The issue is on the agenda for Tuesday's City Council meeting.
Supporters of adding fluoride to the city's water supply have long maintained that fluoridation supports oral health by helping to prevent tooth decay. Low-income families who cannot afford dental care are the biggest beneficiaries, advocates say.
Fluoridation was actually started as a way to prevent cavities in young children.
Not only has the American Dental Association has stood behind fluoridation since the '50s, the "CDC has recognized water fluoridation as one of 10 great public health achievements of the 20th century."
Opponents of the process, however, point to the potential hazards of ingesting too much fluoride, including weight gain, tooth discoloration (dental fluorosis), arthritis-like symptoms and thyroid-related muscle pain, not mention side effects that doctors have not yet discovered.
The Fluoride Action Network, a group that would like to see cities stop adding fluoride to their water, says fluoridation is a "form of medical treatment," pointing out that individual doses cannot be controlled because people drink different amounts of water. FAN goes a step further to call fluoridation unethical because the government is "forcing people to take a medicine irrespective of their consent."
FAN members also say fluoride comes from many sources and thus is not needed in city water.
According to the city of Phoenix, the City Council and then Mayor Paul Johnson approved making fluoridation part of the city's water-treatment process in June 1990.
While the fight over fluoridation is not new and certainly not limited to Arizona, Phoenix is the largest city in the country to consider suspending its municipal fluoridation. Phoenix is the six-largest city in the U.S.
Flagstaff and Page said no to adding fluoride to their water in 2001 and 2006, respectively. When Gilbert put the issue on the its ballot, voters opted to keep the fluoride.
In January 2011, the Department of Health and Human Services and the Environmental Protection Agency recommended lowering the amount of fluoride in drinking water to 0.7 milligrams per liter -- "the optimal level for preventing tooth decay," according to the CDC. Up until then, the recommended range had been between 0.7 and 1.2 milligrams per liter -- a level that was set in 1962. The maximum is 4 milligrams per liter.
The Safe Drinking Water Act is what regulates the amount of fluoride that can be added to water.
While fluoride is a naturally occurring mineral, the fluoride that is added to water is usually fluorosilicic acid (FSA), a liquid by-product of the manufacture of phosphate fertilizers. Other options include sodium fluoride and sodium fluorosilicate.
The fluoridation process costs the city of Phoenix more than $580,000 per year. Several council members says discontinuing fluoridation is a good way both to save money and limit the government's reach.
More than 1.4 million Phoenix residents will be affected by the City Council's decision.