Juneau’s no-fluoride decision costs Medicaid $300 per child, per year



Four out of five Americans have access to optimally fluoridated water, according to Healthy People 2020. That figure comes from Assistant Professor of Health Sciences Jennifer Meyer.

But Alaska underperforms that national norm by a large margin that has gotten even larger.  Access to optimally fluoridated water in Alaska communities dropped from 60 percent to 42 percent in the decade from 2007 to 2017.

Among the communities without fluoridated drinking water is Juneau, which voted to end community water fluoridation  in 2007.

The capital city’s decision to remove fluoride intrigued Dr. Meyer and was the impetus for her recently published paper about the impacts on children and adolescents eligible for Medicaid.

[Read the complete story and see charts at Green and Gold UAA at this link]

“The Centers for Disease Control and Prevention identified community water fluoridation as one of the top 10 most important and effective public health interventions of the last century,” said Meyer. “That’s why I was interested in looking at the community effects of removing it. Also, as a mom with a newborn, I was concerned about my son growing up without optimally fluoridated water and what that might mean for his future oral health.”

In the study, Meyer and her co-author, oral health epidemiologist, dentist, and Walden University faculty member Dr. Vasileios Margaritis, examined the Medicaid dental claims records of two groups of children and adolescents aged 18 or younger.

Group 1 consisted of 853 patients who filed Medicaid dental claims in 2003, four years before Juneau’s removal of fluoride. This group represented what the researchers considered optimal exposure to community water fluoridation.

On the opposite end was group 2, representing patients living under sub-optimal community water fluoridation conditions. This group was 1,052 patients with Medicaid dental claims records from 2012, well after Juneau’s fluoride cessation.

The age group that underwent the most dental caries procedures and incurred the highest caries treatment costs on average were those born after Juneau stopped adding fluoride to the water supply.

For many children and their parents, the idea of having to visit the dentist one extra time each year isn’t a welcome one. Meyer estimated that the average inflation-adjusted cost of each additional cavity procedure was approximately $300 per year for each child in this young cohort.

“We thought that cost was a good proxy for severity,” said Meyer. “There’s also broader community cost because the children analyzed in the study were on Medicaid and that is a taxpayer-funded program.”

[Editor’s note: 1,052 Medicaid recipients multiplied by $300 per year is a cost of $315,600 per year for Juneau’s Medicaid enrolled children.]

Despite Dr. Meyer’s study, Juneau officials remain unswayed. In a story published one month after the release of the research, The Juneau Empire relayed that the capital had no plans to reintroduce fluoride into the community’s drinking water.

Condensed from a story written by Matt Jardin, UAA Office of University Advancement, and used with permission under a Creative Commons Attribution-Non-Commercial 4.0 International License. This story appeared Feb. 5, 2019 at UAA’s Green and Gold website.


    • So is ethyl alcohol found in beer and wine, caffeine in our coffee and tea, and aspirin for head aches.

      Basic rule of toxicology: “The dose makes the poison”.

      Fluoride, at the optimal concentration of 0.7 ppm in public water is not toxic.

  1. Thnx for reposting-
    The University of Alaska has some top-notch researchers and fluoridation at appropriate levels has been shown over and over to be both safe and effective for dental health.

    Pseudo-science is just as appealing to conservatives, liberals, and moderates.

    Some people buy silver blankets and drill holes in their cabins and run copper wires from their bed to outside…


    others allow their kids to get measles for the fun of it.

    takes a village I guess to spend a village worth of benjamins.

  2. DB Cooper, go to PubMed and enter the search terms “fluoride” and “neurotoxicity.” You will find over 300 peer-reviewed, published research articles cataloguing serious declines in IQ and other mental deficits following introduction of fluoride to drinking water, even at “optimal” levels. The supposed benefits of fluoride to dental health are always studied in isolation from its costs to total health and the health of the neurological system, which it is known to be bad for as it is in fact a neurotoxin capable of passing the blood brain barrier, particularly in children, whose blood brain barriers are far more permeable than those of adults (90% sticks out in my memory, but it’s been a while since I read the articles so don’t quote me). In addition, anyone with a thyroid condition can tell you that fluoride is destructive to the thyroid. It’s not surprising, therefore, that we have seen rates of thyroid disease skyrocket since the large scale introduction of fluoride to drinking water across the nation decades ago.

    I have a thyroid disease and another disease that causes nerve damage. I don’t want to be medicated with fluoride in my drinking water against my will. If Dr. Meyer is so concerned about her child receiving “optimized” amounts of fluoride, I’m sure it shouldn’t be a problem for her to afford supplemental fluoride, which you can get from your local drugstore.

    The real driver behind mass fluoridation is the fact that public health advocates are concerned some parents might not be proactive enough about their children’s oral health. If you’re a responsible parent and you’re feeding your child a healthy diet and taking them to checkups, they will likely have healthy teeth. Mass fluoridation, honestly, is for those parents who are not responsible with their children’s health. We shouldn’t be mass-medicating to meet the lowest common denominator. There are other ways to take care of those kids and encourage parental involvement.

    I’m disappointed by how slanted this article was, Suzanne! It’s an issue that bears research, not just adoption of the standard line.

    • ECG – It appears you simply copy/pasted nonsense from some anti-F propaganda and never actually bothered to go to pubmed , search for, examine and understand what you claim to be “published research articles cataloguing serious declines in IQ and other mental deficits following introduction of fluoride to drinking water, even at “optimal” levels.”.

      I have made that search and found absolutely no peer reviewed studies that prove drinking optimally fluoridated water (0.7 ppm F-) has caused a decline in IQ or any other health issues. Quite the contrary – the overwhelming majority of studies over the last 70 years found drinking optimally fluoridated water reduces dental decay and related health problems. That is the reason over 100 nationally and internationally recognized science and health organizations (and their hundreds of thousands of members) support the scientific consensus that community water fluoridation is safe and effective public health measure.
      ~> search on: I like my teeth – what do water fluoridation supporters say

      Cite a study (complete with author quotes in context) you believe proves drinking optimally fluoridated water is harmful. Before you reply, actually read the study and carefully examine the conclusions and limitations of the study. Then search on: open parachute fluoridation

      Ken Perrott of “Open Parachute” has already examined most of the studies (and arguments) anti-F activists claim support their beliefs, and he explains how they do not meet basic criteria for legitimacy or credibility. The lack of credible, reproducible scientific evidence is the reason there are no well recognized science or health organizations in the world that accept the anti-F propaganda as legitimate.

      The question rational individuals should ask is whether it is logical to believe the unsupported opinions of you and other anti-science activists (and groups like INFOWARS [Alex Jones] and Natural News [Mike Adams], or to accept the conclusions of the World Health Organization and the 100+ credible science and health organizations in the world.
      ~> Read the 2016 World Health Organization report: Fluoride and Oral Health
      ~> Search on: cyber-nook fluoridation references

      • Randy, you seem to be confusing my right to share research which is publicly available from the National Institutes of Health with the responsibility you and other public water fluoridation proponents have to prove the 100% safety and effectiveness of any mass medication mandate. Though I think the case against fluoride is sound and have good reasons for thinking so, I’m not the one who needs to prove the argument here—you are. Nobody has the responsibility to disprove the ideas behind a campaign that forces us to ingest or be injected with something against our will. However, since you seem to have had trouble finding the info and since I like sharing it:


        A few excerpts: “Epidemiological studies carried out in geographical regions in which fluorine content in drinking water is high showed that children who live in those areas have a statistically significant decreased level of intelligence in comparison to children from regions not contaminated with fluorine” (in the introduction). 

“The analysis carried out with the usage of experimental animal models more than once confirmed that the accumulation of fluorine in the central nervous system initiates inflammatory and degenerative processes through the activation of oxidative stress in both young and adult specimens” (under section entitled “Oxidative Stress and the Activity of Anti-Oxidative Enzymes”).

        “Fluorine also causes changes in the secretion of neurotransmitters such as serotonin, dopamine, norepinephrine, acetylcholine and epinephrine…” (bottom of section entitled “The Metabolism of Neurotransmitters”).

        “In the organisms of infants and children, about 80–90 % of the absorbed fluorine is accumulated. A smaller amount is stored in the organisms of adults [60 %]….”

        “Fluorine exposure in the prenatal and neonatal periods is dangerous because this element has the ability to penetrate through the placenta and it is able to cross the blood-brain barrier. Young individuals are less resistant to the toxic influence of fluorine due to the fact that their defensive mechanisms are not fully developed and the permeability of their blood-brain barrier is higher than among adults”.

        And, in the conclusion: “In the childhood period, exposure to this element may cause permanent damage to the functions of all brain structures. Among both young and adult specimens exposed to the toxic influence of high doses of fluorine, we can observe impaired ability to learn, disturbances in memory and information processing and behavioural problems. All of these cause a decrease in the quality of life. Numerous reports concerning the occurrence of endemic fluorosis lead to the establishment of an accepted concentration of fluorine in drinking water by the World Health Organization (WHO) at a level of which the element does not accumulate excessively in the human organism and does not cause adverse effects. The current value is set at 1.5 mg/L. However, recent findings concerning the toxic influence of this element on the nervous system, especially dangerous in relation to developing organisms, lead to higher restrictions in countries where fluorosis occurs frequently.”

        Here’s another one: https://www.ncbi.nlm.nih.gov/pubmed/22820538

        Excerpt: “Results: The standardized weighted mean difference in IQ score between exposed and reference populations was –0.45 (95% confidence interval: –0.56, –0.35) using a random-effects model. Thus, children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas.”


        Excerpt: “Fluoride and arsenic exposure affects spatial memory and activates the ERK/CREB signaling pathway in offspring rats,” “These data indicate that exposure to fluoride and arsenic in early life stage changes ERK, p-ERK, CREB and p-CREB protein expression in the hippocampus and cerebral cortex of rat offspring at PND21 and PND 42, which may contribute to impaired neurodevelopment following exposure.”

        I’m not “anti-science” (that was rude, by the way—and yes, with two research and writing-intensive college degrees and having worked as a writer, I know how to cite, but for goodness’ sake, it’s dinnertime and my family is hungry), but I seriously question the integrity of many of the organizations you reference. Science is never settled, after all, by its very definition, and most of these organizations exist to keep individuals in lockstep with “standard procedure.” If you have never questioned a medical organization or the CDC or WHO, I must congratulate you on your excellent health since you’ve apparently never had cause to doubt the authorities. I’ve been bopping around the health system for 12 years now and have four or five chronic diseases, and I’m constantly amazed by the stupidity and ignorance of doctors.

        Peace out.

        • ECG – You certainly have the right to share research, but you are engaging in blatant, disingenuous fear-mongering when the studies you “share” do not demonstrate any harm from drinking optimally fluoridated water with concentrations of fluoride ions 0.7 – 1.0 ppm.

          You are simply providing evidence that fluoridation opponents have no legitimate evidence to change the scientific consensus that community water fluoridation is safe and effective and that anti-science activists don’t understand the concept that any substance is harmful at high enough exposure levels.

          Let’s look at the references you “share”
          1) 2017 – The Influence of Fluorine on the Disturbances of Homeostasis in the Central Nervous System.
          This study does not apply to or reference any harm from drinking optimally fluoridated water.
          Conclusion: “Excessive exposure to this element can cause harmful effects…” –––– Note the term “excessive”. Excessive exposure to anything will cause harmful effects.
          Fluoride ions in water at 10mg/L – 250 mg/l were shown to cause harm – those are excessive levels that are over 10 to 250 times the levels found in optimally fluoridated water.
          Exposure to fluoride ions at 13 mg/kg/24 hours were shown to cause harm – That’s equivalent to a 10 pound child drinking about 58 liters of water in 24 hours.
          The “Epidemiological studies carried out in geographical regions in which fluorine content in drinking water is high” are all of extremely limited quality and do not account for many other unmeasured factors that might be the cause of any observations made.
          2) 2012 – Developmental fluoride neurotoxicity: a systematic review and meta-analysis. This “review” of 27 studies by anti-science activists is widely referenced by other anti-science activists. However none of the studies had anything whatever to do with drinking optimally fluoridated water. Even a major anti-F activist, Paul Connett, has conceded the poor quality of many of the studies considered in this review (while of course still scare-mongering that fluoridation is somehow going to make us all dumb). The authors of the study itself warned their paper was not relevant to the fluoridation issue.

          I challenged your claim that there are “over 300 peer-reviewed, published research articles cataloguing serious declines in IQ and other mental deficits following introduction of fluoride to drinking water, even at “optimal” levels.” The references you provided proved no such thing.

          So, you are, in fact anti-science, when you distort the proper interpretation of studies to try and sell your propaganda, and you clearly demonstrate your disdain for the science and health communities with your statement, “I’ve been bopping around the health system for 12 years now and have four or five chronic diseases, and I’m constantly amazed by the stupidity and ignorance of doctors.”

          Of course “Science is never settled”, but it does not progress by accepting as true every belief and opinion presented that question any scientific consensus. Legitimate science progresses when legitimate, reproducible evidence is presented by legitimate scientists that challenges the consensus. If that evidence is, in fact legitimate, accurately presented and reproducible, the consensus will begin to change. That is science.

          When the presented evidence is not legitimate, accurately presented or reproducible, the consensus will not change. Legitimate scientists who disagree with the consensus will continue to try and come up with evidence that will change the consensus.

          On the other hand, anti-science activists will exit the scientific community take their flawed “evidence”, adjust and inflate the conclusions (or simply fabricate claims) to cause maximum fear in people, try to con the public into accepting their “evidence” as true and hijack the democratic process by initiating and fueling public demonstrations against the legitimate science.

          Do you really believe the references you provided prove drinking optimally fluoridated water causes harm?

  3. Comparing the costs of a Socialist Nanny State program to justify another Socialist Nanny State program is stomach turning. How about no forced Fluoride and no Medicaid as an option?

  4. I get plenty of fluoride in my toothpaste thank you. Its curious that some of the originators of the campaign to remove fluoride from the water were employees from Juneau’s municipal water department. If not sold to a utility to be used as a water additive, fluoride must be disposed of as a toxic waste.

  5. You know what protects your teeth? Brushing them 2-3 times per day for 2 minutes each and every day. Flossing helps a lot too.

    Most any toothpaste has enough fluoride in it to protect your teeth. It says right on the label not to swallow the toothpaste, you know why…because the toothpaste has fluoride in it.

  6. Couldn’t have said it better, Mongo. Thank you, Lance and ECG, as well. Excellent feedback. DB Cooper, how disappointing that in order to disagree with concerns over flouride you mock people with unique approaches to their health and well being, especially when those approaches have no impact on you. Suggesting parents let their kids get measles for fun is nice vitriol. I’ll acknowledge some parents are truly neglectful, but many who avoid vaccinations for their children actually think and do research, putting time and education into their children’s long term health. Imagine if the silver blanket/copper wire people pushed those methods on all of humanity in the form of a mandated update to the electrical code (kinda like mandating flouridated city water for all the people’s “health”). Nanny state indeed. My takeaway from your article, Suzanne, is that nutty liberal Juneau could have healthier kids’ teeth and lower Medicaid costs (for all of us who pay into it) if they would just re-mandate flouride in the CBJ water system. How backward is that? More big brother control for the sake of keeping Medicaid costs down? Really?
    Does that end justify the means? I, too, am disappointed by how slanted this article was. this truly is an issue that bears research and not just adoption of the standard line. The effects of flouride (and yes, vaccinations for that matter) are NOT clearly defined liberal/conservative issues. I am a huge fan of you and your website, so there is still a sizeable balance left in my Suzanne loyalty account, but I’m afraid this article was a big drawdown. So much so that I was inspired to comment for the first time on your site. Please reconsider and keep an open mind.

    • I appreciate your comments. It is a reprint article that I picked up from UAA because it has policy implications. I do not have a strong opinion on the fluoride issue but find that the fiscal impact is a new piece of information. Thanks again for being a reader.

  7. I find it interesting that anti-fluoridation is an issue that brings people from across the political spectrum together. like puppies and benjamins raining from the sky

  8. What about all the thousands of children raised on private wells? My teeth are fine. I have relatives raised on fluoride and most of them have dentures. Hmmm. Maybe it’s not the fluoride, but genetics and oral hygiene.

  9. Whether it is good or bad, Me/Myself and I decides what to put into my body … NOT a municipality! If I am stupid, that’s what freedom is all about. Suppose I extolled the medicinal value of, say brandy or whisky, and insisted that everyone in town give some daily to their kids and themselves? Blind spots are not limited to liberals. And we wouldn’t be worrying about Medicare/Medicaid cost$ if we obeyed the Constitution and kept the Nanny State obedient to the 10th Amendment.

  10. AK Grown: you nailed it. There are a lot of factors in dental problems and tooth decay. The least amount of additives to my H2O the better. We all know there are crappy parents out there and sadly, that is never going to change. Even good parents have kids with bad teeth. I’ve seen every scenario you can think of. I myself am a hyper-flosser, diligent brusher, consumer of forced fluoridated water, and an oral hygiene freak by most standards, but haven’t been exempt to caries. I would have rather eliminated the extra chemical from my body because good lord, I put enough crap in this temple of doom!
    Thanks for the reprint on this Suzanne. Makes for a good discussion.

Comments are closed.