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A narrow "therapeutic margin" is doctor talk meaning that the amount of drug that helps is very close to the amount of drug that can cause harm. In the old days we use to treat asthma with a drug called theophylline. Because the amount of theophylline that helps asthma is very close to the amount of theophylline that is toxic it was a difficult drug to prescribe and eventually as better drugs were found it was phased out.

Dr. J. William Hirzy of the EPA has stated, "The difference between the levels of fluoride causing toxic effects and the levels added to water to prevent tooth decay is vanishingly small and deeply troubling."

Given all we now know, it is time to phase the medication fluoride out of our water. Medicating our water supply does not allow us to control dose.

However, on a positive note, Proposition 2 has focused a lot of energy on kid's teeth in Juneau. I would like to take some of this energy and work together as a community to encourage:

• All kids in Juneau to have a dental home.

• All dental offices to accept Denali Kid Care.

• All medical and dental offices to provide reasonable cost fluoride varnishes.

• The city of Juneau to hire a dental hygienist to provide fluoride varnishes and dental education to our highest risk preschool children at HeadStart, St. Vincent's, the Glory Hole, the AWARE Shelter, and other social service agencies.

• Juneau Public Health to publicize that they have fluoride supplements available for free for children who receive their comprehensive well child health screening services at the health center.

• SEARHC to publicize that they can provide dental care to all Denali Kid Care recipients.

• Juneau School District to periodically evaluate adherence to its Nutrition Policy (Adopted June 2006).

• School district to encourage all students to brush or rinse after lunch and snacks.

• School district to hire a dental hygienist to work with our school nurses to teach kids how to brush and floss and to provide fluoride varnishes for those kids without a dental home.

• Juneau stores to remove candy from check out lines (where it is often tempting to children).

I am uncomfortable with water fluoridation because it is like writing a prescription that says, "Fluoride some unknown amount." Vote no on fluoridating Juneau's water but yes on taking care of Juneau's teeth.

• Monica Gross is a pediatrician and Juneau resident.