BOTTLED WATER: GREAT TASTE, MORE FILLINGS?

Byline: Daily News Staff and Wire Services

It sounds like another can't-win situation for the health-conscious consumer.

Bottled water, missing bad stuff, is also missing something most scientists say is good. Millions who have turned away from the tap are giving up a primary source of fluoride, the public health system's main weapon against tooth decay.

In Los Angeles, where bottled water is widely used, tap water contains only trace amounts of fluoride - although Department of Water and Power officials say that could change next year when they hope to add the anti-decay chemical to the city's water.

Americans drink almost 3 billion gallons of bottled water a year, a gush from a trickle a dozen years ago. Some home filters also remove fluoride.

Is that bad for dental health? Scientists are not sure. People get fluoride in other ways.

Fluoridated community water, now available to a majority of Americans, has been achieved over fierce objections that it intrudes on individual choice if not liberty itself.

``The great communist plot thing is over with, I think,'' said Al Warburton of the American Water Works Association, recalling debates that lasted decades after pioneering Grand Rapids, Mich., fluoridated in 1945.

When it's good, tap water is a bargain - a penny for five gallons, on average.

Still, Americans flock to the bottle. Among other things, they like the absence of chlorine that can give tap water a temporary aftertaste or odor.

Their verdict: Tastes great.

More fillings?

``I'm concerned about people who are relying on bottled water,'' says Dr. Michael Easley, speaking for the American Dental Association. ``They're not getting enough fluoride and may not realize they're depriving their children, who will pay the price their entire lives.''

That link has not been thoroughly studied, some dispute it, and the government has not taken a position on it.

``I can't help but think that unless an individual uses enough of other (sources) of fluoride, it's going to be a problem,'' says Dr. Alice Horowitz of the government's National Institute of Dental Research. ``But nobody knows that.''

Officials with the Metropolitan Water District of Southern California have not taken a position on fluoride because of the controversy surrounding it. The agency, which supplies two-thirds of water to the Southern California region, does not want to force fluoride on any community, but says its water already naturally contains about 0.2 parts per million.

Mark Beuhler, director of water quality, said the water is just as safe, if not safer, than bottled water.

``The fluoride is a misperception if that's why they are (buying bottled water),'' he said. ``There's really no significant difference in safety between bottle and tap water. There is an issue of taste and perception. Consumers feel the water is safer even if we tell them there's no difference.''

The agency's water quality lab is one of the best in the country, said Bob Gomperz, a spokesman for the agency.

``We are under very strict department of health services regulations that are monitored on an ongoing basis to make sure we meet those standards,'' he said. ``Metropolitan has a sophisticated water laboratory which conducts 300,000 tests a year to make sure the water we deliver is perfectly safe to drink.''

Charles Lembke, water quality inspector for the Los Angeles Department of Water and Power, said the agency is moving toward adding more fluoride to its water by 1998.

Currently, its fluoride content ranges from 0.2 to 0.6 ppm. In the San Fernando Valley and places that receive its water from the Sierra Nevada, the content is high, anywhere from 0.3 to 0.9 ppm. But in places like San Pedro and South Central where water comes from the Colorado River, the content is between 0.2 and 0.3 ppm, said Lembke.

Legislation was passed in 1995 and signed by Gov. Pete Wilson that required water districts serving 10,000 or more residents to fluoridate their tap water to 1 part per million. But districts, including the city of Los Angeles, have some flexibility and depend largely on when funding is found.

At issue is whether people who drink bottled water get enough of the enamel-toughening element from toothpaste, rinses, sodas, canned goods and other products where fluoride is present naturally or as a water additive.

The dental association says relying solely on those sources ``is not an effective or prudent public health practice.'' At the federal Centers for Disease Control and Prevention, Dr. William Kohn isn't sure.

Fluoride is especially important for children and its continued use benefits teeth throughout life, he said.

``Still the most cost-effective way to get fluoride is through community fluoridation, but there are other ways of getting it,'' Kohn said. ``We don't know about the bottled water connection.''

The International Bottled Water Association recommends customers talk to their dentist or doctor about supplements if they are concerned about fluoride deficiency.

The dental association says tablets - or, for babies, drops - are the best alternative to fluoridated water, but pricey.

Only about 20 of the more than 500 brands of bottled water sold in the United States have added fluoride.

Dr. Steve Levy at the University of Iowa, who has tested bottled water for fluoride, says most brands are way under the optimal level of 1 part per million. Most are under 0.3 ppm, the level at which supplements have been recommended.

Levy says parents who use only bottled water and have children at risk of tooth decay should consider supplements or tap water. Others may be getting enough fluoride already, he said, and adults who eat and brush properly might get by with fluoridated mouthwashes.

Risk can be hard to assess, but factors include improper brushing or diet and a history of cavities in the child or siblings.

Too much fluoride can be bad for teeth. Someone taking fluoride tablets and drinking bottled water should not assume the water is free of fluoride, but check with the bottler. A few may have too much naturally present.

A minority scientific view persists that even the recommended concentrations are bad for health. The U.S. surgeon general says proper levels are safe.

With the science on bottled water uncertain, dentists reach their own conclusions.

At his Chantilly, Va., practice, Dr. Mark Grimes tells patients bottled water is probably OK for grown-ups. ``But if they're into giving their kids bottled water, I'd discourage them.''

Our water supply

OUR WATER SUPPLY: San Fernando Valley tap water ranges from 0.2 to 0.6 parts per million. By 1998, officials plan to increase that to 1 part per million, which dentists say is a recommended level.

BOTTLED WATER: Bottled water is usually purified and contains no fluoride. Dentists are concerned that bottled water is not as good for children as fluoridated water.

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Box: Our water supply (see text)