Lawmakers heard hours of testimony Wednesday on a proposal to add fluoride to Hawaii water systems to help prevent tooth decay, but the proposal quickly died when members of the Senate Judiciary Committee rejected the idea.
Water fluoridation has a long and controversial history in Hawaii, in large part because the state has very high rates of tooth decay in children.
A report entitled “Hawaii Smiles” by the state Department of Health concluded in 2015 that the state has the highest rate of tooth decay among third graders in the nation. More than seven out of 10 third graders here were affected by tooth decay, which is significantly higher than the national average of 52% nationwide.
That report credited fluoridation with making a “significant contribution” to the large decline in cavities in the U.S. since the 1960s, and the federal Centers for Disease Control and Prevention named community water fluoridation one of 10 great public health achievements of the 20th century.
But the only systems here with fluoridated water are on military bases, and for decades many Hawaii residents have resisted any effort to add fluoride to the drinking water supply, in part because people fear it would have other harmful health effects.
Nuuanu resident Dawn Poiani, the mother of three boys, said testified today that there is “no scientific evidence that shows that ingesting fluoride is safe.” The problem of child tooth decay is concentrated among poor people, and Poiani suggested lawmakers are proposing the wrong approach to that problem in Senate Bill 2997.
“What if you just provided really good dental care to people that can’t afford it?” she asked the Senate Judiciary Committee this morning. “It would almost cost the same.”
“If you can come up with the money to fluoridate our water, use that money go and access the kids that don’t have good dental care,” she said.
In fact, lawmakers heard testimony that the state has been moving in the opposite direction. A representative of the Health Department reminded lawmakers that until 2009 the department had a dental health division that worked with schools to provide fluoride drops to students, but that division was dismantled in the wake of the Great Recession.
Dr. Malia Shimokawa, a pediatrician who practices in Aiea, supported the fluoridation proposal. She said she is forced to prescribe fluoride supplements for children because the water here does not have it, which adds another cost and another chore to parenting in Hawaii.
“Without regular fluoride supplementation, I have seen my young patients with mouths full of cavities, some so serious and numerous they require sedation to address, which comes with safety risks and at high cost,” she said.
“This is not only a public health issue, it is a social justice issue,” she said, because cavities disproportionately affect disadvantaged families.
“Fluoridation of water in Hawaii is long overdue,” she said. “As a mother and as a pediatrician, I am deeply invested in the health of our keiki in Hawaii, as I know all of you are. Fluoridation is safe, effective, and would be one of the greatest public health achievements of our time.”
But Senate Judiciary Chairman Karl Rhoads announced after the hearing there was not enough support on the committee to move the bill forward, which means it likely will die for the session.
Lawmakers did not take a public vote on the bill today, but committee member Sen. Donna Kim (D-Kalihi Valley-Moanalua-Halawa) expressed serious concerns about fluoridation at the hearing, and Sen. Mike Gabbard (D-Kapolei-Makakilo) introduced a bill this year to ban fluoridation in public water systems.
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