Molokai dentists favor
fluoridation measure

The island will be the first
in Hawaii with fluoridated
water if the proposal passes

By Helen Altonn
Star-Bulletin

Molokai's dentists, who advocate fluoridation of the island's water supply, are concerned about what will happen in the future if tooth decay there remains the same.

They fear dental services will not be available on the Friendly Isle as they retire from their four offices, said Dr. Dana Takashima. He has been caring for residents' teeth there for 25 years and will be close to retirement in 10 years, he said.

Hawaii has more than twice the national average rate of tooth decay, and Molokai and Lanai have the worst problems, according to the state Health Department.

Takashima's dental hygienist, Debra Mapel, organized a Dental Health Coalition of doctors, dentists, hygienists, midwives and nurses to try to get the water system fluoridated.

A Committee of the Whole of the Maui Board of Water Supply heard testimony for and against the fluoridation proposal at a meeting attended by more than 100 people on Molokai Tuesday night.

The committee will make a recommendation to the board at a meeting Thursday.

Molokai would be the first Hawaii civilian population to have fluoridated water if it is approved.

A state-supported measure to fluoridate water systems with more than 5,000 service connections died this year in the House Finance Committee. Even if it had passed, Molokai would have been excluded, said state Health Director Bruce Anderson.

He said efforts to pass a bill will continue next year, probably limited to water systems with more than 25,000 service connections.

Honolulu is the only one of the nation's 50 largest cities that is not receiving fluoridated water, except on military bases, Anderson pointed out. "It's just incredible."

Anderson said the state will pay estimated costs of $142,000 to install and operate a fluoridated water system on Molokai the first year. Annual operating costs are estimated at $10,000, he said.

"We may be willing to pay for another year of operating costs if the county went along with it," he said. "Ultimately, we would expect the county to absorb the costs."

He said the costs translate to about $1 to $1.50 per person, "which is less than the cost of a single dental filling over a lifetime."

Molokai has four water systems, two county-owned and two privately owned.

The private Maunaloa system was fluoridated between 1961 and 1972, resulting in a 62 percent reduction in tooth decay among children, he said.

Sixteen years after the fluoridation was discontinued, the decay rate among children had zoomed 95 percent, he said.

Dr. Emmett Aluli, co-executive medical director of Molokai General Hospital with Dr. Phillip Reyes, said: "People even today know who grew up in Maunaloa because of their smile. They've got healthy and attractive teeth ... and the personality that goes along with it. That's the message I want to get across."

Anderson said it is "mind-boggling" that there is any controversy on the issue.

"Health professionals have followed this for 50 years, and it has proven benefits with no adverse health effects ever documented with use," he said.

Opponents argued at the meeting that they do not want chemicals added to their pure water. They suggested just putting it in bottled water.

A religious movement was mounted against fluoridation by a family church on Molokai, Aluli said. "Their expression is: 'God gave us teeth; God gave us clean water. Don't mix the two.'"

JoAnn Johansen, certified nurse-midwife on Molokai, said she grew up with fluoridated water, and when she moved to the island in 1987, "I had never seen kids with metal teeth before. I was pretty shocked at what I saw there."

She said she has delivered hundreds of babies on Molokai. "I hate to see them suffer with rotten teeth when this is so easily preventable," she said.