1022 Commissioners Leonard & Fish
Authorize and direct the Portland Water Bureau to fluoridate the City of Portland’s public drinking water supply to the optimal levels beneficial to reduce tooth decay and promote good oral health as recommended by the Oregon Health Authority (Second Reading 1003; Ordinance introduced by Commissioners Leonard and Fish)
My comments at the vote on 9/12/12:
- I appreciate all of the input I have received from both proponents and opponents of fluoridation of ourBull Runwater.
- I commend the passions on both sides of this issue. Last week's six and a half hour hearing was one of my favorite experiences of my first term. So many people participating, so many valid points raised. So much civility, despite the passionate views held on both sides. Thank you to everyone who took time out of your regular schedule to participate last week, and thank you everyone who is back today.
- I have considered all the arguments on both sides. Thank you to almost 3,000 people who have given me your opinions on this matter - by far the most comments my staff and I have received on any issue since I took office in 2009.
- I know that whichever way I vote today, many, many Portlanders will be angry with me. I can't address all the issues raised over the past few weeks in my comments today, although by the time I finish this long speech you may think I’ve tried to. I have looked into every one of the concerns raised. I particularly thank Dr. Bill Osmunsen, who came to my office the day after the hearing last week and gave me information over a half hour that did not fit into the one minute he was allocated for testimony. Dr. Osmunsen has been a courageous voice, questioning the establishment in his profession of dentistry. I am not shy about questioning establishment myself, and I know the costs can be significant. Thank you everyone who spoke out on this issue
- As I considered my vote, I thought especially about baby Gwendolyn and her mom who spoke in opposition. I thought of Joseph and Amy Santos-Lyons and their two daughters who spoke in support. And I remember the very last speaker after six and a half hours, a dentist who probably came after work and evidently hates public speaking, but cares so much about this issue that he was willing to speak up.
- I am voting on the preponderance of the evidence, and the most good for the most people. But since this is an all-or-nothing choice, I recognize that the decision will be detrimental for some Portlanders.
- This issue should be about more than Fluoride - Yes or No? It should be about prevention, public health in its broadest sense, equity and looking out for the minority when the will of the majority is imposed. Because of the process chosen leading up to today's vote, many of those issues have received only token attention.
- The preponderance of the evidence, evaluated by medical experts, concludes that fluoride is helpful and not harmful in the recommended dilution in municipal water supplies. As a retired nurse, I am not qualified to make a medical decision. I am making this vote as an elected politician, charged with considering all opinions and voting for the long term public good. The question is, which choice is more in support of the long term public good?
- At best, the dental health problems of Portland's children are only partially solved by adding fluoride. Many experts, although certainly not all, believe that fluoride improves dental health for children and adults. But the disparities in dental health for people of color and people with low incomes persist in communities with fluoridated water. We cannot simply add fluoride and expect that all children and adults inPortlandwill have cavity-free teeth.
- Dental cavities are also caused by lack of proper nutrition such as fresh vegetables.
- It is caused by our children consuming too much sugar, such as being given juice in baby bottles.
- It is caused by lack of proper dental hygiene
- And most importantly, the real equity challenge is a lack of access to dental care.
- We need a public health campaign to urge parents to sign up for the Healthy Kids insurance program, and to get the twice-yearly dental checkups that are provided free of charge to families under that program.
- My first question when I heard about the fluoride proposal, at the same time when most Portlanders heard about it -- or actually later since I was out of the country when the announcement was made -- was, "why don't we just expand the fluoride tablet program my kids had in school in Portland 20 years ago?" I've heard that question from many others. The answer is - the fluoride tablet approach hasn't worked. It doesn’t start until kids get into kindergarten, and it’s intermittent – they don’t get the tablets on weekends or over the summer. We've tried it, it hasn't resolved the dental health problems. We can't continue to use the approaches that have failed in the past, and expect different outcomes. We are being asked to try a different approach.
- I have talked with Chair Jeff Cogen at the County about re-allocating the money currently spent on the school fluoride program, to public education about dental health. In particular, I want to see the County dedicate even more resources to educating mothers on the virtues of breast feeding for a full year. The American Dental Association recognizes that medical practitioners may advise their patients on up to 40% increased risk of fluorosis when infants are fed formula reconstituted with fluoridated water. I was surprised some of the health care practitioners testifying last week were unaware of this recommendation. Clearly, more education is needed both in the community and with medical and dental practitioners.
- We need to take this opportunity, while people are paying attention, to make certain that everyone realizes that fluoride isn’t a cure-all. We can add fluoride to our water and we will still have dental health disparities in Portland. The evidence shows that disparities persist in fluoridated communities. The bar is higher for all, but poor families still have higher rates of decay than affluent families after fluoridation.
- Severe dental decay is first and foremost a socio-economic problem.
- Parents need to be educated about the importance of proper dental care – brushing and flossing – and instill that importance in their children from a very young age. And then to continue prodding them after they believe they are old enough to make their own decisions, as I’ve discovered from experience with my kids.
- Parents need to be educated about the importance of limiting the amount of sugar their children consume. Soda is a major contributor to tooth decay for older children and adults. Fresh fruits and vegetables contribute to oral health.
- I am being asked to vote to add fluoride to our water supply by a wide range of public interest groups and medical/dental professionals, as well as my beloved Oregon Nurses Association. I am being asked to vote to add fluoride by communities of color. I cannot on one day call for greater voice for under-represented communities, then on the next day disregard the request of multiple minority groups. Like the Neighborhood Associations, no group speaks for all of its members. We heard empassioned testimony by people of color opposing fluoridation. The preponderance of the testimony from those most affected by dental health disparities was in support of fluoridation. I recognize some passionate disagreement on this factor, too.
- I find some of the concerns raised by opponents valid. I don't believe this measure is being funded by chemical companies, but I do recognize there are people who are sensitive to fluoride, as well as potential health impacts which are still under review in the scientific literature. There are extreme views expounded on both sides of this issue. There are also reasoned facts and studies that are being disregarded by some pushing one side or the other.
- Regardless of the merits of adding fluoride, we have lost public trust in this process. Decisions on important matters such as this should not be made behind closed doors. The voters have said No to fluoride three times. Before we had any conversation with the public, or heard from any opponents, the vote was already assured. That is not good public process and not how this Council should make difficult decisions that affect so many people in a personal way.
- Without consulting with our wholesale partners, the decision was made to fluoridate our water supply. That lacks the respect owed to our wholesale customers.
- I am disappointed that the debate on the merits of the proposal has been overshadowed by concern over the process. The way we get there matters.
- I believe the benefits of fluoridated water are significant. But we must do a more thorough evaluation of its impacts, and we must continue to evaluate evidence and recommendations from the Environmental Protection Agency, the Centers for Disease Control, the American Medical Association and the American Dental Association, moving forward. Last night, a participant at a community meeting I attended suggested setting up a citizen review committee to monitor implementation, advise on treatment options as well as public education, and keep current on recommended doses. This group should include both proponents and opponents of fluoridation and should advise on implementation as well as provide a report on the positive and negative impacts to customers and consumers. I believe an oversight group like this would be helpful.
- What the City chooses to put in its water, beyond what is required to achieve potable water, is an important issue that deserves public discourse. I trust the people of Portland. I trust the advocates on both sides to continue work educating everyone in Portland about the issues involved. I believe this matter will likely be decided by voters, even though there isn't support on the Council to refer the choice right now.
- I have to put aside my dismay at the process by which this proposal was put before the Council, and vote on whether after considering all the evidence, I believe fluoridation is a net benefit or net detriment to the majority of Portlanders. I am the daughter of a member of the first ever training class of dental hygienists in England. I am a nurse. I am a mother who cares about the health of every child in Portland. Because of who I am and what I have learned over the past four weeks, I vote Aye.