by Brett Lee
The Water Advisory Committee recently made their recommendation on the issue of water fluoridation for our future drinking water system. Over the course of three meetings, they had several presentations made to them. At the first meeting a presentation was made by those in favor of fluoridation. At the second meeting, a presentation was made by those opposed to water fluoridation. The third meeting was devoted to general discussion amongst the members of the WAC as they tried to decide what recommendations to make.
As a member of the City Council and a member of the community, I watched these proceedings with great interest. We will soon be deciding what path we should take regarding this issue in the near future. And while the WAC is not composed of experts in this specific area of science or health policy, the WAC is composed of very knowledgeable and thoughtful members of our community. Their recommendations do carry a lot of credibility.
In the end, the WAC decided to recommend that our future drinking water supply be fluoridated.
Here are some of my observations:
The pro-fluoride argument is based upon the improved dental health of our community, especially for those children who lack consistent and proper dental care. Water fluoridation has been shown to provide positive dental health benefits. In the past (40-50 years ago) the positive effect was more pronounced, but even today with improved diet, improved access to dental care and widespread use of fluoridated toothpaste the scientific literature continues to show some positive dental health effects.
The anti-fluoride argument is multi-faceted, but the core argument seems to be two fold: first, there may be negative health effects associated with the fluoridation of water (in addition to that of dental fluorosis, where the connection is quite clear). The second argument is that there are far better and cost effective means of improving dental health, namely direct preventative dental care.
I was impressed by the arguments and information put forward by both sides. Having said that, it does seem that adding fluoride to the drinking water supply would improve the dental health of many in our community. What was interesting though was that many countries around the world have been able to achieve the same or better dental health without water fluoridation. These countries appear to have more robust early childhood dental care programs than we currently do.
I was also quite surprised by the estimated cost of adding fluoride to the water system. The estimated cost of water fluoridation has an initial capital cost of between $1,000,000 to $2,000,000 and an ongoing operational expenditure of around $150,000 to $200,000 per year. These are very serious sums of money. The average ratepayer would be paying an extra $15/yr for the operational costs alone.
So one might ask, instead of using the money to pay for water fluoridation, why not use that money for early childhood dental care programs? The problem with that approach is that we are not allowed to use people’s utility fees to pay for things other than the running of the utility system.
The proponents of water fluoridation rightly understand that if we add fluoride the dental health of the community will be improved for many; if we do not add fluoride those funds will not automatically be available for other dental health programs.
So here are some additional facts that provide context on this issue. The opponents of water fluoridation are unlikely to accept a council decision in favor of fluoridation as the final word; they will likely seek to have the issue placed on the ballot for an upcoming election. The outcome of a citywide election on the issue is unclear. What is clear is that an election would be expensive and time consuming for both sides.
The water project is due to be completed in 2016, so even if we decide to add fluoride to the water, the earliest people would potentially see a benefit would be 3 years from now.
In this decision I am guided by what I would want for my family. Would I want fluoride added to the water system or would I want my child to receive yearly preventive dental care and be taught proper dental hygiene? I know that this is not a strictly either / or decision, but it does help to think about it this way to get a sense of prioritization.
For the same amount of money that would be spent on a non-targeted fluoridation program, we could target those funds towards low income families with children and provide them with proper preventative dental services. Yes, per household the cost of fluoridation is only around $15/year, but what percentage of households do not have access to dental health care? If we estimate that percentage to be 10%, then for the same amount of money, we could be providing those families with approximately $150/year to help provide them with dental care.
I must confess to being an optimist when it comes to our community. As a result, I have the following proposal. I would like to have a voluntary check off box on the city services bill where our community can voluntarily donate a dollar or two each month to early childhood dental care programs. It is my hope that sufficient funds could be raised in this manner so that we could provide robust early childhood dental programs for our children. This would be the most efficient way of dealing with the dental health needs of our community and would result in all of us saving money on the cost of water fluoridation. In addition, the benefits of this approach would be immediate; there would not be a delay until 2016.
Should the community not be supportive at the level needed, we can always revisit the fluoridation issue in a year or two. The basic design and construction of the plant is such that the decision to add or remove fluoridation can be done at any time. The new plant will not be complete until 2016.
So the question is will we as a community be willing to voluntarily help provide for improved dental access and care for the children in our community?
Brett Lee is a member of the Davis City Council
Question:
Since our well water hasn’t been flouridated are there any statistics on where Davis ranks in tooth decay compared to other communities that do flouridate?
That would be a tricky statistical analysis because you would have to account for income and educational disparities in the comparison in order to get a valid comparison.
Brett
[quote][quote]For the same amount of money that would be spent on a non-targeted fluoridation program, we could target those funds towards low income families with children and provide them with proper preventative dental services. Yes, per household the cost of fluoridation is only around $15/year, but what percentage of households do not have access to dental health care? If we estimate that percentage to be 10%, then for the same amount of money, we could be providing those families with approximately $150/year to help provide them with dental care.[/quote][/quote]
First, I want to thank you for the time, interest and thought that you have put into this issue. I agree that this is not an either/or situation and that as a community we would probably best be served by both fluoridating and provision of improved dental care, not only for young children, but across all ages. Also, $ 150 /year to help with dental care would cover the cost of approximately one filling ,of one cavity, one time. I honestly do not see this as a comparable benefit.
Your idea of a voluntary means of provision funding for a dental health care program is of a lot of interest to me. I would like to see details of how you would envision such a plan. How would you identify which families to help? What group would you envision implementing and administering the program? ( Communicare has already stated that they do not have nearly enough resources to meet the demonstrated need ).
Also, another couple of points. Water fluoridation helps not only those children in the lower income group, but also those who are not as meticulous with dental hygiene, who have difficulty with performing activities of daily living, and all age groups including the elderly. Your plan as stated would not help any of these groups.
Compromise, by its very nature, means that each side is giving up something in order to achieve a mutually desired goal. While I see the very good intention behind your proposal, I do not, in any way see this as a
compromise. In this proposal, the opponents gain their goal of blocking fluoridation with no guarantee that they will not be equally as obstructionist if this were to be brought forward again for “another look” in one to two years. The proponents are being asked to drop the issue, with no guarantee that it will be addressed again, for a proposal that will not have, even if the community were at its most generous, nearly the same impact.
I agree however, that looking at what one would want for one’s own children is a valuable exercise in decision making. So I will share what I would want for my family. I would want my children, and everyone else’s to have full health and dental care provided from our taxes. If a preventive health care measure can be provided through the public water system, I would want that for my children thus saving me the expense of supplements and dental care that benefit only my family. If I did not want that for my children, the answer is simple. I would buy them non fluoridated water and appreciate the fact that in this country we have ready access to as many choices as we have and that I can be a part of providing a health benefit for others, even though I may not avail my family of it.
Good article David. However, you did leave out one other important argument against fluoridation of our drinking water. It is a moral one. Just like the arguments in opposition of Proposition 8, a majority benefit is no excuse for causing harm to a minority. Of course I will always argue that with equal rights civil unions there is no material harm (only emotional impacts which I consider de minimums and more the problem of those emoting.) In the case of fluoride in the drinking water, there is indisputable physical harm done to a minority. fluorosis is a genuine and serious health problem that has been proven as being caused by fluoridation of the drinking water. This fact was not known 60 years ago when we started the practice.
Medical doctors that continue to demand that we add this drug to our drinking water are guilty of breaking their Hippocratic Oath for not causing harm, and are suspect of having a propensity to over-medicate their patients.
It is immoral to force medicate a population when there is clear evidence that the practice causes real material harm. That real material harm should effectively cancel out the justification based on benefits derived… especially when there are other solutions like you suggest.
I support your suggested solution.
Related to this, what in the hell good is Obamacare if we cannot expect it to deliver health improvements to those currently lacking access to healthcare? The political left won this massively complex and costly god-pile of legislation, so why are we not leveraging the win to solve the type of health challenges that are the claimed justification for dumping toxic fluoride drugs into our drinking water?
My apologies, somehow the byline did not get into the article. Brett Lee wrote this piece.
Conceptually, this is similar to the proposition made to WAC by the anti-fluoridation forces 2 months ago. But rather than a check-off box (which most people don’t even see when they are paying bills in a hurry); I would instead make it a tax and subject it to an election which would be binding. As the voluntary Co-Chair and Treasurer of both Measure D (the recent Parks Tax) and Measure I (the Surface Water Project), I would be happy to similarly devote myself to getting an issue of this type passed.
To Medwoman re:
[quote]CommuniCare has already stated that they do not have nearly enough resources to meet the demonstrated need[/quote]
This seems incongruous. What Councilmember Lee is saying is that money (resources) would be provided to them to meet that demonstrated need.
[quote]…the opponents gain their goal of blocking fluoridation with no guarantee that they will not be equally as obstructionist if this were to be brought forward again for[/quote]
For the record, thus far it has been the relentlessness of the pro-fluoridationalists who have been repeatedly, time-and-time-again, brought this issue back to the Davis community for reconsideration. It is their unending and adamant attempts to impose fluoridation on unwilling communities that I am worried about. I think the more likely scenario would be that even if a huge contribution were made by the Davis community to fund, say, a mobile dental van for the disadvantaged Davis community, that CDA and First 5 would be back in a year or two saying, “here’s the money…now by law you have to fluoridate too”. There should be assurances that if the substantial monies are raised and spent as suggested on community low-income dental needs, that we are not two-timed later by fluoridation zealots.
[quote]Compromise, by its very nature, means that each side is giving up something in order to achieve a mutually desired goal. While I see the very good intention behind your proposal, I do not, in any way see this as a
compromise[/quote]
The compromise is that the anti-fluoridationalists impose a tax on themselves to avoid contamination of their water. The pro-fluoridationalists gain improved dental access for disadvantaged communities which have been demonstrably proven to result in better dental health than fluoridation. If better dental health care is medwoman’s primary objective, this would provide that. It was, in fact, medwoman who only yesterday posted that Europe had as good as or better dental health than the US without fluoridation because they provided better access to dental care than in the US. Well, Councilmember Lee’s proposed solution is a chance for Davis to provide just that improved dental access. And we can do so without dumping an extra 12 tons per year of a toxic waste into our environment and not exposing the Davis community to the proven adverse effects of fluoridation such as fluorosis and hypersensitivities. What is not to like about that? It seems to be the best of both worlds.
[quote]Water fluoridation helps not only those children in the lower income group, but also those who are not as meticulous with dental hygiene, who have difficulty with performing activities of daily living, and all age groups including the elderly. Your plan as stated would not help any of these groups.[/quote]
Why not, improved dental health care could also be provided to seniors in this type of program and doing so would undoubtedly better their dental health. In fact, there is NO evidence showing that fluoridation would similarly do so why should we assume that it would. Saying fluoridation helps everybody is a completely unproven and unscientific statement and discredits those promoting fluoridation.
[i][b]Sorry, but I now have to leave for the entire day and will not be able to join in or respond to later posts.[/b][/i]
Brett….
Thank you for your wonderful suggestion.
Water fluoridation is neither safe nor effective as I have pointed out on the many comments that I posted on various other Vanguard fluoridation articles. Preventative dental services are the solution to dental health issues.
[quote]Compromise, by its very nature, means that each side is giving up something in order to achieve a mutually desired goal.[/quote]Yes, for those who espouse fluoridation, the ‘compromise’ is a new baseline including not only fluoridation, but ALSO new contributions (voluntary, but if that is ineffective,taxes) for universal dental and medical coverage for those not already covered…
My kids were raised on un-fluoridated water from our private well. They brushed regularly with one toothpaste or another. They are now adults and their teeth are fine.
To add fluoride to our water and then remove it from the waste stream seems expensive and unnecessary.
But Keith, in all fairness, your kids are not the ones that are of concern by those who favor fluoridation. When we got our nephew, he was only six (this was in 2010), his mouth was full of cavities. The question is not whether your kids would have benefited, but whether kids like my nephew would have.
Ok David, and how many of your nephew’s teeth will still have cavities when he is 15? And so we should cover the costs for the neglect your nephew’s parents?
In addition to the proposals above, I would like to see the school district launch, if not already in place, a good pre-school and K-12 educational program on best practices in regard to good nutrition and good hygiene for improved dental health. Additionally, there could be better education of new mothers so that infants and toddlers are not left sucking on bottles of milk and sugary drinks at nap and bedtime and sure way to impact dental health.
I for one would like to see some kind of baseline study of dental health and need for fluoridation in Davis. I know such a study might be difficult, but it should be done to demonstrate the need, rather than using general information and statistics in from many countries, communities and sources, often from past years and not contemporary data to really demonstrate need in this community.
Money down the Drain????
Question: if there is not a demonstrated need for or support for fluoridation of all Davis water, after water treatment at the new surface water plant, can fluoride be added to the pipe delivering water to Woodland, if Woodland wants fluoridation, and not to the pipe delivering water to Davis?
Thank you, Brett, for this thoughtful piece. I agree that preventive dental services would be a vastly superior use of the city’s limited financial assets compared to water fluoridation. As I have previously stated here and elsewhere, I am even more interested in addressing the CAUSE of dental disease (which is the same thing that causes obesity, heart disease, hypertension, diabetes and many cancers), which is the over-consumption of sugar and refined grains by most Americans. Perhaps the City Council would be interested in tackling this problem by proposing restrictions on the sale and purchase of sugary drinks along the lines of New York City? I and other physicians I know would certainly be supportive of such a move.
The cost of fluoridation is high. I’m also not sure how they would equalize the distribution, since we’d be using a mix of surface water and deep well water and the proportions would vary. It isn’t clear to me that there is actually a funding source for this for installation or ongoing costs. Finally, I’m still not clear how Davis would comply with state law on this issue. And we don’t actually know the extent of the problem of inadequate dental care in Davis.
It seems to me there are some practical concerns that need to be addressed. Meanwhile, Brett’s proposal can begin to address the issue of dental care for those who need it.
“chemicalizing”everyone and everything is not a solution to the problem (except perhaps chemical co’s bottom line), so I like the proposal to aid those in need without putting toxins in our soil as well as out mouths. We all could rethink “one size fits all” as a general answer to problems. Targeted solutions work for everyone.
[url]Ok David, and how many of your nephew’s teeth will still have cavities when he is 15? And so we should cover the costs for the neglect your nephew’s parents? [/url]
Too many of them are on permanent teeth, I assume, that’s what you were asking?
You are covering the costs for the neglect. My guess is that the state pays a lot more for his Medi-Cal dental coverage than they would for fluoridation.
Permanent teeth? @ six? I welcome a dentist to correct me, but baby teeth don’t avulse until ~ 5, and take about a year to “bud out”. The most trouble-prone teeth (molars) avulse and grow later. The state may pay for the dental care (why don’t you?), but the question is does Davis pay for fluoridation? Those who genetically have ‘soft-spots’ on their molars do not benefit from fluoridation. I consumed nothing but fluoridated water from infancy to my twenties, brushed fairly regularly with fluoride toothpaste, and got molar cavities.
The state never paid for my dental costs, nor those of my children.
Hope you are working with your nephew to brush well, with a fluoride toothpaste.
I only oppose the current proposal as it is completely inefficient on a cost/benefit ratio to the target purpose. I do not buy the “poison” theory, but it occurs to me that there may be some out there who are super-sensitive to fluoride. Peanut butter is a good protein, yet it may kill some.
[quote]Perhaps the City Council would be interested in tackling this problem by proposing restrictions on the sale and purchase of sugary drinks along the lines of New York City? I and other physicians I know would certainly be supportive of such a move. [/quote]
Here we go, once you open the door for curtailing wood fires, plastic bag bans and other liberal feel good agendas there’s no end to it.