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Tapping into Minnesota’s fluoride rules

September 11, 2018

For the past year, Minnesota has been in step one of a fluoride rule revision. The Post Bulletin consulted the Minnesota Department of Health to see what changes for public water may be coming down the pipeline.

What’s the amendment?

The proposed amendment will lower the average concentration of fluoride in public water to 0.7 milligrams per liter. The concentration will always remain between 0.5 and 0.9 milligrams per liter. The current rule has an average of 1.2 milligrams per liter, with an acceptable range of 0.9 to 1.5.

Remind me what fluoride does?

Fluoride is added to public water supplies to help prevent and control tooth decay. When fluoride comes in direct contact with your teeth, it helps reduce childhood cavities by 18 percent to 40 percent, according to the Centers for Disease Control.

Why change the rule?

The MDH thinks the new rule will better balance the use of fluoride to prevent tooth decay with the risks of receiving too much fluoride, said MDH compliance engineer David Rindal.

What risks are those?

Water fluoridation is very safe. However, there are two conditions (enamel fluorosis and skeletal fluorosis) that can arise occasionally. Enamel fluorosis is a cosmetic effect from consumption of fluoride that is rarely seen when water concentration is kept below 2 milligrams per liter. It can cause mottling or sometimes surface pitting on the teeth. Skeletal fluorosis, where bones weaken and can fracture more easily than normal, is even more rare, and is caused by high fluoride exposure over a lifetime.

Who will this revision affect?

Anyone who uses municipal water supplies. “The change is meant to be beneficial to people who are drinking water by public supply in Minnesota,” Rindal said. “The only cost we could think of for the owners or for the city … was occasionally a cost to replace pumping systems that were designed to pump larger rates of fluoride into the water system,” he said. “Sometimes there is a need to downsize those. … But on the flip side, there is often a reduction in cost for fluoride.”

Why’s the process only coming down the pipeline now?

The department of Health and Human Services recommended that communities shoot for 0.7 ppmL in 2015, Rindal said. The MDH waited for the final recommendation from HHS, and the rule revision process takes some time.

When will this go into effect?

MDH is in the “request for comments” phase of the rulemaking process, which is the first step of the change. And we’ve been in that phase since July of 2017, Rindal said. After the comments are collected, the revision will be reviewed. Then the MDH will demonstrate the need for the revision, there will be a notice of intent to adopt the rules, a 30-day comment period, and more, before it finally goes into effect.

In other words, this rule isn’t going to change for a while yet.

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