In a recent notice, Public Water Supply District No. 2 in High Ridge announced it would stop adding fluoride to its water supply on Jan. 20, 2027.
The district said in a statement to the Leader that hydrofluorosilicic acid, better known to the public as fluoride, is becoming harder to source.
“The cost has doubled, and we were told it would be coming from China now, which (means) shipping costs and delivery times will be more and longer,” the district stated. “(The acid) is very dangerous to handle and is a danger to our employees and the building it is housed in.”
According to the Environmental Protection Agency, hydrofluorosilicic acid is a strong, corrosive acid that must be stored in cool, well-ventilated areas. It has a shelf life of one month.
The leading producer and exporter of the chemical is China, according to the EPA. As of 2017, there are only five manufacturers of the chemical in the U.S.
Community water fluoridation has been in practice in the U.S. since the 1940s, according to the Centers for Disease Control and Prevention. The agency says the water treatment practice is a “cornerstone strategy for the prevention of cavities” and reduces oral health disparities.
However, community water fluoridation is not federally mandated.
PWSD No. 2 officials said the district has not received any comments from customers regarding its notice to stop fluoride treatments, adding that fluoride is now commonly added to toothpaste.
The district stated that most studies on the effectiveness of community fluoridation were completed from 1930-1950, when fluoride in toothpaste was not as common.
The U.S. Public Health Service acknowledged the widespread use of fluoride in drinking water and oral products in 2015, advising water supply districts to treat their water with 0.7 milligrams per liter of fluoride. Prior to that change, the agency recommended 0.7-1.2 milligrams per liter, which had been the standard since 1962.
Per the CDC, 67.1 percent of the U.S. population has access to fluoridated tap water as of 2012, with the U.S. Department of Health and Human Services setting a goal to increase access to fluoridated water to 77.1 percent of the population by 2030.
In addition to federal government agencies, the Missouri Department of Health and Senior Services also recognizes community fluoridation as an important public health initiative.
Gwen Sullentrup, chief of the Office of Oral Health, said starting, continuing or stopping water fluoridation is a local decision, and her office works with communities to offer support and resources regardless of their decision.
According to Sullentrup, water fluoridation is cost-effective, helping avert $32 in dental treatment per person per year. People who live in a water district that treats its supply with fluoride have about 25 percent fewer cavities than people in non-fluoridated areas, she said.
“Modern ways of obtaining fluoride are important and have a place, but fluoridated toothpaste or fluoride varnish applications cannot fully substitute for water fluoridation,” Sullentrup said. “Think of fluoride sources as tools in a toolbox. A hammer, screwdriver and wrench each have a purpose; one cannot replace the others, but together they form a complete set.”
Sullentrup said a complete oral health “toolkit” includes brushing twice a day with fluoridated toothpaste, flossing daily and using a fluoride mouth rinse; seeing a dentist twice yearly for cleanings and preventative care such as fluoride varnish and sealants; and drinking fluoridated tap water.
“When one piece is removed, the toolkit becomes less effective,” she said. “Modern fluoride products like toothpaste are important, but they do not replace the consistent, community-wide protection provided by fluoridated water. Each source plays a different role, and together they offer the strongest prevention.”
Fluoridation in the county
Of the 66 water systems in Jefferson County recorded by the CDC, half do not fluoridate their water. However, the largest water districts that serve the most customers do fluoridate, such as the Jefferson County Water Authority, which provides water to Festus and Herculaneum, and Public Water Supply District No. 1, which serves Arnold.
Brad Bryant, manager of Public Water Supply District No. 12, said his district does not fluoridate, and to his knowledge, never has. The district provides water for customers south of Festus and Crystal City.
“We have never had customers request (fluoride treatment) in my 20-plus years here,” Bryant said. “I see no need for the extra expense it would create when the current thoughts are questionable that it does more good than harm. If we were to get multiple requests for fluoride, I’m sure we would consider it.”
According to the American Cancer Society, some studies have analyzed a possible link between the over-consumption of fluoride and bone cancers such as osteosarcoma. Lab studies have shown a “weak link” between fluoride and male rats exposed to extremely high levels of fluoride.
Sullentrup said fluoride use stops early decay and helps rebuild tooth enamel by aiding in the remineralization process. Regular use of fluoride through tap water, toothpaste or professional treatments lowers the number and severity of cavities throughout a person’s life, she said.
“Stronger teeth and fewer cavities mean individuals experience less pain, reduced time missed at school and work, and require fewer dental procedures, saving both time and money,” Sullentrup said.
What this means
PWSD No. 2 stated the change in treatment will not affect the water’s taste, smell or appearance.
“We will continue to produce high-quality water,” the district stated.
The public is welcome to comment on the change or express their concerns by calling the district at 636-326-0200, emailing leslie@pwsd2.com, or attending the board meetings, held at 5 p.m. on the third Wednesday of every month at the main office, 195 Old Sugar Creek Road in High Ridge.
“We are accepting public comments at this time if they want to,” the district stated. “The public is welcome to do their research on hydrofluorosilicic acid, and we are open to hearing any opinions or concerns they have with phone calls, emails, and they are welcome to come to board meetings. The board is set on stopping the addition of hydrofluorosilicic acid.”
Sullentrup said trusted sources for information on fluoride include the CDC, the American Dental Association, the American Academy of Pediatrics and the American Fluoridation Society. For more localized information, those interested can go to oralhealth.mo.gov for dental health best practices and contact information for Sullentrup’s office.