Health officials, residents weigh in on Loyal water fluoridation

By Valorie Brecht Community members both for and against the fluoridation of city water spoke at the Loyal Common Council’s monthly meeting Dec. 17. The council did not reach a decision, but instead decided to refer the matter back to the utility committee, have the utility committee come up with a way to get residents’ input on the matter, collect the data and bring it back to the full council in April for discussion.

The issue of putting fluoride in the water has been an ongoing discussion in the city. It was first brought up at the Nov. 19 council meeting, with Loyal resident Donna Milz speaking against fluoridation and Clark County Health Department director/ county health officer Brittany Mews speaking for it. At that time, the council voted to recommend the matter to the utility committee for further discussion and to allow time to review the printed materials provided to council members. The utility committee meeting took place Dec. 3 and Milz and Mews spoke again, with two additional people speaking against fluoridation.

At the utility committee meeting, committee member Tim Froeba made a motion to recommend to the council that the city stop fluoridating its water, after the current supply of fluoride was used up, because it can’t simply be dumped out. He said his purpose in making that motion was to get the issue back before the whole council because he felt the whole council needed to deliberate on it. The committee — consisting of Froeba, Dave Geier and Curtiss Lindner, who are also on the council — voted unanimously for Froeba’s motion, which is what led to fluoridation being on the Dec. 17 agenda.

The Dec. 17 meeting saw six individuals speak in favor of fluoridation (including one submitting written comments) and five speak against it.

Background Starting in 1962, the United States Public Health Service (PHS) recommended that public water supplies contain between 0.7 and 1.2 mg/L of fluoride to help prevent tooth decay. This recommendation was updated in 2015 to a fluoride level of 0.7 mg/L (also referred to as parts per million or ppm), which remains the current “optimal” fluoridation level. The City of Loyal’s 2023 water report indicated a fluoride level of 0.7 mg/L.

Although 0.7 mg/L is considered “optimal,” the U.S. Environmental Protection Agency (EPA) has set a maximum contaminant level (MCL) of 4.0 mg/L to protect against skeletal fluorosis, meaning public water systems can have no more than that amount. States can opt to set maximum fluoride levels in drinking water that are lower than the national 4.0 mg/L standard. If the level is above 2.0 mg/L, water systems must notify consumers.

For fluoridation The people in favor of keeping fluoridation said it provided a public health benefit that was especially important in preserving children’s dental health in a low-income area where children may not have access to dental care.

Jordyn Cuddie spoke first and read some comments from Ashley Kaiser, who lives in rural Loyal and is a physician assistant at Marshfield Clinic Colby-Abbotsford Center. Kaiser said she had read up on the Cochrane review published in October 2024. Cochrane is an international not-for-profit health information network with headquarters in the U.K. that produces systematic data reviews. The Cochrane review reviewed the evidence from 157 studies which compared communities that had fluoride added to their water supplies with communities that had no additional fluoride in their water. They found that the benefit of fluoridation has declined since the 1970s, when fluoride toothpaste became more widely available. Specifically, researchers found that “the dental health benefits of adding fluoride to drinking water may be smaller now than before fluoride toothpaste was widely available.”

The Cochrane review was only conducted in high-income areas meeting a certain population threshold, thus it was inadequate for Clark County’s demographics, said Kaiser, as Clark is rural and low-income. The review states there is an “absence of recent research on low- and middle-income countries.”

Kaiser also addressed concerns about fluoride’s toxicity.

“Anything can be toxic at the wrong doses,” she said. “Even water can be fatal at high levels… I urge the Loyal council to keep fluoride in the water.”

Cuddie, a physician assistant at the Marshfield Clinic Neillsville Center and Loyal resident, also advocated for keeping fluoride in the city water.

“I think it’s unfair to the children in the community (to not have the benefit of fluoride for their teeth),” she said.

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She said there were options such as water filters or bottled water for those who did not want to drink city water. She reiterated that anything can be toxic in high amounts.

'We have to be careful when we throw words out like 'neurotoxin/ because it is fear mongering. What symptoms is this fluoride actually causing? To my knowledge, this just started becoming a topic of conversation, and there has been fluoride in the city water for decades,' said Cuddie.

Maryann Forsell, dentist at Family Health Center of Marshfield, Neillsville, also spoke. She said in her time working in Neillsville the past seven years, she had seen several dental needs present. She referenced the Clark County Seal-A-Smile program. In the 2023-24 school year, the program the identified 265 children with at least one cavity. Specifically in Loyal, 34 of 118 children had at least one cavity.

'The dental need is too great already, and will only get worse if you remove fluoride from the water... We do not have enough dentists to support the increased need,' she said.

Kathy Mann, dental hygienist at Dental Clinic of Marshfield, also spoke in favor of fluoridation. She said that at the recommended level of 0.7 ppm, even as little as 1 to 4 cups of water per day could have a beneficial effect on children's teeth.

'For some kids, this is the only help they're going to get. It's not a violation of rights; we adopt certain policies because they benefit the whole community,' she said.

She referenced a statistic from the Centers for Disease Control and Prevention which states that every dollar spent on fluoride saves an estimated $38 in dental treatment costs. Based on a Loyal population of 1,187, that would equal a savings of $45,106.

Mews also spoke. 'At the last meeting, it was brought up a suggestion of lowering the level of fluoride. I just wanted to mention that 0.6 to 0.8 milligrams per liter is the level the DHS (Wisconsin Department of Health Services) recommends for optimal benefit. So it may not make sense to have a suboptimal level, because you're not getting the full recommended benefits,' she said. 'And I just want to reiterate that in the beginning the council received several letters from reputable, non-governmental entities — the Wisconsin Dental Association, Wisconsin Dental Hygienists Association, Wisconsin Oral Health Coalition, American Dental Association and also from the American Academy of Pediatrics. And now you've heard from two local physician assistants, two local dentists, local hygienists — so I just hope the council will take into consideration the local experts in their field.'

She also said that with Loyal having a poverty rate of 11.5% and given the fact that children 2 to 5 years old living in poverty are three times more likely to have untreated cavities, it was important to provide this extra layer of dental protection for them.

'(Fluoride in city water) is one layer of the onion, a piece that needs to happen for our kids in poverty especially,' she said.

Mews provided a fact sheet courtesy of the health department which addressed some of the points of discussion surrounding fluoride. In regards to safety, the sheet stated the following: 'The safety and benefits of fluoride are well-documented and have been reviewed comprehensively by several scientific and public health organizations. The U.S. Public Health Service, United Kingdom's National Institute for Health Research, Centre for Reviews and Dissemination at the University of New York, and the National Health and Medical Research Council in Australia have all conducted scientific reviews. All concluded that it is a safe and effective way to promote good oral health and prevent decay.

'Warning labels on toothpaste reflect the fact that it contains a higher concentration (roughly 1,500 times as much fluoride) per milligram than fluoridated water. It is important to follow guidelines on the proper amount of toothpaste to use, and to teach children to spit rather than swallow the excess.'

The fact sheet also addressed a National Toxicology Program (NTP) report on fluoride that was released in August.

'The NTP study found that exposure to

high levels of fluoride may affect brain development. The studies evaluated in the NTP report assessed fluoride levels that are higher than the level recommended for use in drinking water to protect teeth. In their report, the NTP states that these findings

should not be used to draw conclusions about the safety of fluoride in community water fluoridation efforts... Studies do not show negative health effects from the level of fluoride used in community water fluoridation in the U.S.'

In addition, the fact sheet referenced an ongoing case, Food & Water Watch Inc. et. al. versus the United States Environmental Protection Agency (EPA). In September 2024, a U.S. federal district court ruled that the EPA must take steps to assess the potential risks of fluoride in drinking water. The ruling did not specify what action the EPA needs to take, but it may include updating product labels or water fluoridation regulations.

'The judge noted this court finding does not conclude that fluoridation is harmful to public health. While the NTP report is referenced throughout the ruling, it is im-

Iportant to note the report stated it should not be used to draw conclusions on water fluoridation policy,' the fact sheet stated.

The fact sheet also said that local health departments continually work with the DHS to monitor current research and policies and ensure water systems maintain the recommended fluoride level, and that DHS is committed to ensuring Wisconsin policies are based on the best available information and will suggest a change if evidence becomes available.

Against fluoridation

The main concerns of those against fluoridation were that the potential risks outweigh the purported benefits, and there were too many unknowns in regards to negative health effects.

Loyal resident Ken McEwen also referenced the Food & Water Watch Inc. et. al. versus the United States Environmental Protection Agency (EPA) et. al. lawsuit. According to materials provided by McEwen, the case that could have the potential to end artificial water fluoridation across America. Plaintiffs in the case allege that fluoridation at levels occurring throughout the country presents an unreasonable risk of injury to health under the Toxic Substances Control Act ('TSCA'), 15 U.S.C. § 2620(b)(4)(B).

McEwen referenced the advocacy group Fluoride Alert, which summarized the case this way: 'Simply put, fluoridation chemicals are drugs, which means Americans are entitled under the law to informed consent. This means that public water systems would no longer be able to automatically fluoridate everyone's water without each household's express permission.

'Every American household would have to be informed of the risks involved with consuming the drug, which has been linked to decreased IQ in children, neurodevelopmental damage and other health problems.'

McEwen mentioned that fluoride can cause fluorosis, or discoloration of the teeth such as white or brown spots.

'Fluoride is not meant to be ingested. It is an industrial byproduct. It can cause neurological problems, liver damage and bone problems,' he said.

Milz also spoke. She referenced a letter to the editor by Brenda Staudenmaier of Green Bay that appeared in the TRG in February 2024. Staudenmaier is a plaintiff in the Food & Water Watch et. al. versus the EPA et. al. case. She has a two-year environmental degree from Northeast Wisconsin Technical College and interned for Clean Water Action Council, and has worked in wastewater treatment and water research for over six years.

'Considering the ongoing litigation surrounding the neurotoxicity of fluoride chemicals, as evidenced by the federal fluoride trial against the US EPA, it is imperative that we reassess the risks and benefits associated with fluoridating our water supply. The trial, which includes us Wisconsin residents among its plaintiffs, underscores growing concern about the potential harm posed by fluoride exposure, particularly to the developing brain. Fluoride is the new lead; it lowers IQ and increases rates of ADHD,' wrote Staudenmaier.

She also referenced recent research funded by Health Canada highlighting additional health risks, including impacts on thyroid function and tooth damage with fluorosis-white spots. In an article for the Peshtigo Times, Staudenmaier noted research had also linked fluoride with Alzheimer's and osteoporosis, and said the issue was compounded by the increase in the number of fluorinated products people routinely use, such as mouth rinses, and the fact fluoride is contained in foods and beverages made with fluoridated water.

Milz questioned what negative effects fluoride was having on children's developing brains. She said she spent $1,248 a year on a water filtration system to filter out fluoride, because 'it's a neurotoxin and I don't want a neurotoxin in my body.'

Tony Horvath, a Greenwood area resident who attended a previous meeting, also spoke. He said he has been engaged in the fluoride debate for about 20 years. In 2006, the National Academy of Science (NAS) published a survey on all of the health impacts of fluoride.

'One of the problems is the cost. You heard about how much money it saves, $38 per dollar spent or whatever for teeth for dental care. But we don't know, and the NAS study made clear, we don't know what the cancer treatment costs are, what the thyroid treatment costs are, what the reproductive harm costs might be — none of that is factored in,' he said.

Horvath highlighted the precautionary principle, which is most notably used by the European Union as a core principle in its environmental law.

'This is a principle in the public health community and elsewhere. Basically it says, first, do no harm... If there is ambiguity or lack of clarity on the safety of a substance, you just don't do it,' he said.

He also noted there was a difference between calcium fluoride, sodium fluoride and hydrofluorosilicic acid (HFSA).

'The fluoride that you find in the ground is not the same fluoride. Fluorine is one of the elements. It joins to things. In the ground, it forms calcium and your body treats the calcium fluoride in a different way than it treats sodium fluoride, which is what a lot of the tests are done on.

'Calcium chloride, sodium chloride and hydrochloric acid are all chlorinebased, though sodium chloride is salt and hydrochloric acid is your stomach acids. No one would say that it's all the same

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thing.

'So the question is, what are you putting in your water? What you're putting in your water is hydrofluorosilicic acid, and it is produced through the cleansing process, the purification process, of phosphate. They capture all the vapors, and distill it down, and it's not a pure product that you get. And so a lot of the concerns that people have about fluoride is not just that it's fluoride, but that it's hydrofluorosilicic acid (HFSA). So if you're looking for one way to compromise, that might be to switch to the chemically pure sodium fluoride.'

According to Google, HFSA is used in the aluminum industry to produce aluminum fluoride, and in the hardening of cement and ceramics. It can also be used as a wood preservative. HFSA is a colorless, fuming liquid with a sharp, irritating odor. It's corrosive to metals and tissue, and can cause severe burns if inhaled or come into contact with the skin or eyes. It can contain impurities like arsenic and lead, which can be a problem for storage containers over time.

Horvath provided several printed materials. One World Health Organization study found that from 1970 to 2016, the rate of cavities (or specifically, 'decayed, missing and filled permanent teeth') declined just as quickly in several European countries as in the United States, if not faster, even though Europe does not fluoridate its water.

Loyal resident Coni Meyer also commented. She said that as of 2021, there were 261 Wisconsin communities withholding fluoridation, and she knew that number was higher now and included several communities in Clark County. In 2024, several Wisconsin municipalities stopped fluoridating their water, including the cities of Amery, Lodi, Schofield, and Tomahawk; villages of Hartland and Marshall; and town of Rome in Adams County.

'I took my kids to the dentist when they were young and made sure they had their care. And I know that not everyone takes on that responsibility as a parent or has the ability, but there are a lot of services available to everyone in the county. The Seal-A-Smile for one is for everybody in the school. All you have to do is tell them and your child goes and gets everything taken care of at the school. So those things are available to everyone, whether they're city or country residents.

'The issue I personally have is, if we are, if it's against the law to pour the fluoride in the ground to get rid of it, but we can put it in our water, I don't understand that. That doesn't make sense to me. It doesn't make sense to me that we have a hazardous warning on our toothpaste tube... Common sense tells me that something is not right.'

Council discussion

The council engaged in some back-and-forth discussion on the topic. First though, they asked if there was any state regulation dictating the fluoride level they had to put in the water. City clerk Shannon Toufar said no; she had talked to the Wisconsin Department of Natural Resources and it was the council's choice what they wanted to do.

Froeba made a motion to remove fluoride from city water as of Jan. 1, 2025. That motion was seconded by Kayla Schar.

'Steve (city water operator) says when he adds the fluoride to the water, the mixture I believe it says 3.5 gallons of water to 2.5 cups of fluoride, he can see the fumes coming off. He backs out and that's what's corroding everything,' said Froeba. 'I know the dentists are here and they're very good in their profession. But they have one good, the teeth. You can get fluoride in toothpaste, mouthwash, dental floss,' said Froeba.

He also mentioned that fluoride occurred naturally in groundwater.

'My question is, how much fluoride do we need?... With the new studies coming out, it's not a good chemical. It's good for your teeth and that's about it,' he said.

Schar agreed. 'Wisconsin communities passed the law of fluoridation in 1946. The first fluoride toothpaste was in 1956. The widespread use of fluoride toothpaste, provided by Crest, was in the 1970s, with varnish in 1994. Back in the 1930s and 40s, tobacco was also healthy and recommended by your doctors. They stated that it's healthy for you. When water fluoridation was put into effect, we didn't have the fluoride in the toothpaste. We didn't have it in the mouthwash. We have means now. My children have their enamels weakened, and we do use fluoride in our toothpaste and mouthwash to help with that. But I don't feel like it should be forced upon everyone,' said Schar.

She also mentioned that Greenwood's water system has the fluoride put in automatically, whereas Loyal's has to be done manually, presenting a risk in handling a toxic chemical.

'Here in Loyal, there's a severe chemical reaction that our employees have to go through each and every single day for the fluoride in our water. They don't want to endure that, and I wouldn't be happy if my employer made me do something I wasn't comfortable with,' she said.

She felt that drinking city water was not the be-all endall for dental health, as there were other means to preventing tooth decay.

Froeba said that if city workers got fluoride on their hair or their clothes, they would have to wash it off immediately.

'If we gotta mask up and put special suits on, what's it doing to our bodies?' he asked.

'Yes, but it is a concentrated amount,' replied Geier. 'I know it's a small amount, but it adds up,' said Froeba.

Council member Greg Brock said he was looking for a better way to gauge the community's temperature on the issue. The council tossed around the idea of putting a referendum question on the ballot, but didn't decide on anything. Eventually, Froeba motioned to rescind his motion so there could be more community discussion, and Schar seconded, so the motion was taken off the table.

'We have to see it from all perspectives,' agreed council member Jenae Weyer.

The council decided to send the issue back to the utility committee and gain more public input before bringing it back to the full council in April.

The Loyal Common Council is looking for feedback from residents regarding this issue. To weigh in, contact one of your council members or attend the next city council meeting, which is scheduled for Jan. 21 at 6:30 p.m.