Vanguard Commentary: How Public Health Officials Lost the Fluoridation Debate

Mobile_Dental_VanIn response late Tuesday night to the Vanguard tweet declaring that fluoridation had gone down by a vote of 4-1 on the Davis City Council, Supervisor Matt Rexroad, a strong proponent of fluoridation, tweeted, “pathetic” and followed it up, “The City of Davis and State of Jefferson both can fight fluoridation of water. Let them be one.”

Later on Facebook he would post, “Davis is going to oppose fluoridation of water. I am no longer listening to anything coming from that community regarding public health.”

But Mr. Rexroad does not represent the city of Davis.  If he did, he might view things a bit differently.  The city council may have followed “politics” over what some believe to be smart health policy, but the politics here is very clearly messy.

The overwhelming public sentiment was against fluoridation.  We’re not talking a few people here, we are talking about hundreds of correspondences.  Councilmember Rochelle Swanson said it was running 10 to 1 against, but another councilmember told the Vanguard privately it was probably closer to five or six to one.  That hardly changes things.

As we reported, of the more than fifty people who spoke on Tuesday in the Chamber, 63%, nearly two to one, opposed fluoridation.

More importantly, it was noted that the content of the letters were not simple canned responses that citizens were spreading around.  Rather, they were intelligent, well thought out, and often very personal accounts as to why they oppose fluoridation.

This is a community that strongly supports organic food, and many residents are not about to accept fluoride added to the drinking water.

And then there is the cold, hard political reality.  It could be expressed as Lucas Frerichs did: “I advocated for Measure I and when I was out trying to convince my fellow Davis friends, neighbors, citizens, to support what I believed was a much needed project to provide clear and reliable surface water, nowhere was there a mention or discussion ever of fluoridation of the water supply.”

He noted that, while things change, “it just feels, though, almost like a bait and switch in some ways to come forward now after the success of Measure I.”  Most pointedly he noted, “I think that had it been included in Measure I, it could well have resulted in Measure I’s failure.”

Mayor Joe Krovoza would add, “This project was approved 54-46, there is no question in my mind that if we had let the public know that fluoride would be put in the water, the project would not pass and the great good that’s being done for this community by moving forward with this water project would not be happening.”

The strange thing is that both Supervisor Rexroad, as well as Supervisor Don Saylor, representing Davis, were both strong proponents of the water project and somehow they failed to recognize the danger that fluoridation posed to the water project.

The public health community came out on Tuesday, but while they made strong and impassioned pleas, they failed to move beyond the elite membership of their group.

The public health community has talked about a public education campaign, but failed to come down from their 40-thousand foot perch to engage.

In early September, wishing to engage the community more, the Vanguard reached out to several of the members of that group – Michael Wilkes from UC Davis and Yolo County Health Council, Julie Gallelo from First 5 and Katie Villegas from the Yolo County Children’s Alliance.

While I remain sympathetic to their overall cause, I believe their failure to engage in the past month was probably the death knell for fluoridation.  The issue may not come back now.

What was expressed was that there has been a “great debate and the medical, public health, dental, and education communities are united around the importance of fluoridation for our community and our county.”

And while this might be true, they were never able to move beyond those constituencies to address the broader concerns.

They believe there was not “more need for prose.”  And that “all the MISinformation has been addressed and corrected by national experts who are part of our education team.  There are a few very vocal opponents do not understand, nor do they care to be educated on this topic.  They wish to be fear mongers and use one source repeatedly (fluoridealert.com) as their source of misinformation.”

The truth is that, as the debate went on, I went from thinking the notion that fluoridation was a problem was ludicrous, to questioning whether fluoridation was really going to provide the preventative health care that the community needed.

While I have no doubt of the devotion and conviction of those involved, I have to wonder how much they are aware of what goes on in the community.  The questions remain about whether low-income communities – that everyone agrees are in need of additional services – are going to consume enough tap water for the fluoridation to help their decay, while not consuming enough to cause health problems.

In short, the arguments made by Alan Pryor last night, looking at quantities of fluoride to water, the impact of fluoridation, and the comparative statics of tooth decay in communities with and without fluoridation were more compelling to me than what the health communities presented.

Now, maybe Alan Pryor is wrong, but when the health community had a chance to respond and rebut, they did not.  They assumed that their argument would carry the day.  They refused to engage.  And they failed to mobilize those in the community who might support their position – and that ultimately included 80 percent of the council.

Troubling to me as well was the refusal of the health community to consider alternatives.  They presented fluoridation as though it were the only solution.  They left Councilmember Brett Lee perplexed and baffled that his proposal for an alternative was a non-starter.

I greatly respect the work that many of these individuals do – but their utter failure to recognize political realities, to mobilize the grassroots, and to seek out alternatives is baffling to me as well.

In short, I believe that the public health community needs to re-think their engagement in this community, and come off their lofty perch, because I believe there is a huge public health crisis not just here in Davis, but throughout the county – and that they are not in the position to address it.

They lost this fight and, frankly, my support wasn’t even in play, and somehow they lost that too.

—David M. Greenwald reporting

Author

  • David Greenwald

    Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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45 comments

  1. [quote]In short, the arguments made by Alan Pryor last night, looking at quantities of fluoride to water, the impact of fluoridation, and the comparative statics of tooth decay in communities with and without fluoridation were more compelling to me than what the health communities presented.[/quote]

    Alan Pryor’s presentation was most impressive. He had the science on his side and did an excellent job of presenting it in a coherent and well-reasoned manner.

    Thankfully, water fluoridation is rather quickly going the way of mercury amalgam filling (another darling of the American Dental Association), into obscurity fore.

  2. Any group expressing complete 100% agreement on a position for a complex issue having and abundance of substantial conflicting data should be considered suspect for being objectivity-challenged.

    At the very least you would expect some notable internal conflict… one where there would at least be some acknowledgement of the facts supporting opposition. But mostly what we saw was dismissal and deflection of these facts and a sort of dogged determination to push the old standard come hell or high water (pun intended).

    Frankly, I am a bit disappointing with some of our public officials and our medical leaders… mostly our medical leaders. Never before have I felt so strongly about the need for strong patient advocacy considering how this fluoride issue played out.

  3. Even if the dosage could be controlled (it can’t) and even if there was scientific proof (there isn’t) of the efficacy of fluoridation via the water supply, the environment should not be sacrificed for such a human centric matter (the way it so often is) as this. Not only have humans conducted themselves as if everything else is simply there to serve their needs at the expense of all other species (and sometimes even each other), but this particular problem has much better actual solutions if they were to be embraced.
    Mr. Rexroad, why don’t you try opening your mind to more broad aspects and consequences of this practice when it is implemented. And Dan, you too.

  4. In listening to the proponents argue for fluoridation I heard that tooth decay was a serious health issue and that fluoride was good for it. Reasonable enough.

    But they never addressed whether water fluoridation actually worked as a delivery method for fluoride. Specifically , they failed to address the lack of correlation between declining caries rates around the world and the presence of fluoridated water. This is a fundamental argumentative failure: if you can’t say that it works for sure, why do it?

    Instead they gave us a set of circular reasoning, listing all of the organizations and agencies that support it. The CDC says its great, and the AMA endorses it too, and the ADA, and so on. A great mutual admiration network, an “appeal to authority” approach. They repeatedly endorse water fluoridation because they repeatedly endorse water fluoridation, rejecting any critique of the policy with an out-of-hand dismissal, because “look at all the wonderful groups who have endorsed it, it must be good.” Circular reasoning.

    If the proponents addressed the reasonable critiques of fluoridation, critiques most nations in the world have accepted as such, they might find more success in their activities. Then again, they might see that water fluoridation is antiquated, expensive, inefficient, and perhaps even harmful policy based remediation and admit that it is time to abandon it.

  5. The Council voted for political survival bucking the conventional wisdom on public health. In a town where 44% of Waldorf students lack compliance with vaccination requirements it should be no surprise that adding F to the water would meet dogged opposition. Certainly Mr. Rexroad understands that the leaders can’t lead where the people he represents won’t go. I’m sure in Rexroad’s day job as a big time Republican consultant there are many things he wishes the members of his party wouldn’t take on. Perhaps he would prefer a friendlier position on immigration from members of the Republican electorate so that his party can become competitive again in this state. So while I understand and appreciate Rexroad’s frustration I think he understands the concept of political survival.

    The funny part of this is Matt Rexroad being on the same side of this as Dan Wolk while the people of Davis are allied with the position of the old John Birch Society. One has to wonder what will be next calls from Davisites as the old Bircher bumper sticter said to “Get the U.S. out of the United Nation.”

  6. Kudos must be given to Barbara King who was the driving force behind Davis Citizens Against Fluoridation. Every single link to every scientific journal I read and referenced was dug up by Barbara in her relentless search for facts. Truth be told…I was only the front man who dished out what Barbara dug up. She was amazing and the thanks of the community should go to her.

  7. “The Council voted for political survival bucking the conventional wisdom on public health. “

    the conventional wisdom may be wrong. i was not impressed with the argument and no one ever really addressed the key question: will fluordiation in the water get to the kids who need it who are not drinking water?

    and toad, yes, the old jbs did support it as a communist influence, but the left has also opposed it for some time citing a lot of the concerns expressed here.

    just because the left and the right agree, does not make something wrong. look at some of the anti-war folks, is that a reason to invade iraq or syria?

  8. 40% of Democrats in the House and 58% of Dem Senators voted to authorize it, and then Democrats voted to fund it.

    I think Nancy Pelosi wanted us to go to war first so she could see what was about.

  9. [i]Kudos must be given to Barbara King[/i]

    Kudos must also be given to Alan Pryor. Alan is well-armed and dangerous with respect to making a public policy arguments. I think I will need to call in reinforcements to protect my right to generate a little smoke every now and then on my private property. Otherwise I want him on my side!

  10. [i]Yeah they went along but if the neocons in the White House hadn’t pushed it.[/i]

    Compared to Obamacare in which no Republicans went along but the socialists crammed it down our throats anyway. My, how would the left have squealed if the same had been done by Republicans on any public policy 1 tenth the impact of Obamacare!?

    It would be like the city council preventing any open debate on Fluoride and then voting to add it to the water… because they know what’s best for all us little people.

  11. LOL! Ok… sometimes I need pictures to understand a point.

    Thanks for the educational soft touch Don!

    Mr. Toad and I will have to take our partisan bickering elsewhere.

  12. Toad, from the looks of all the people of Davis that spoke on the anti-fluoride side of the issue in our council chambers I’ve got to say that either liberals were soundly against it or there are more conservatives in Davis than anyone knew.

    Oh that’s right, us neocons forced them against fluoride. They had no idea what they were doing.

  13. We lived in Madison, Wisconsin when my kids were little. We drank fluoridated water. Our pediatrician also gave us fluoride drops or pills, some extra treatment. They also used special toothpaste. Their secondary teeth were all mottled and ugly.

    The dentist told us it was because they had received TOO MUCH fluoride when their teeth were forming. So I am sure people mean well, but there can be too much of a good thing.

  14. Frankly:
    [quote]But mostly what we saw was dismissal and deflection of these facts and a sort of dogged determination to push the old standard come hell or high water[/quote]

    I had to laugh at some of the supporting “experts”. They took so much of their 2 minutes talking up their education, jobs and experience that it left them no time to state their case. I guess they thought that their backing of fluoridation should be enough based on their credentials alone.

  15. I don’t see how this can be categorized into conservatives against and liberals for. It isn’t that simple. I have a conservative friend who supported fluoridation of Davis water and I am a left liberal and I oppose it based on what the excessive fluoride did to my children’s teeth!

    There are more precise ways of administering it.

  16. I agree Growth Issue regarding the listing of credentials and Father (Big Brother) Knows Best attitude of the proponents. It got a bit creepy as more and more came to the podium; our tax dollars at work!

  17. There is a lot to be learned from the anti-fluoridation campaign. They said “no” in a compelling and powerful way, and came out in the kinds of substantial numbers that other efforts at saying “no” have yet to muster.

    One explanation may be that their “no” argument may truly have had the critical mass that other “no” arguments simply do not have.

  18. I think there are quite a few fiscal-conservative / social-moderate people living in Davis. They are mischaracterized as liberals when they:

    – Vote for Democrats (because they don’t like the Republican candidate)
    – Vote for slow or no growth (to protect their home values and lifestyle)
    – Vote for tax increases (to protect the perceived quality of schools)

    These are generally educated people that share many values and goals with educated liberals. When they disagree is usually just the on the question of how. Meaning “how” we should protect our values and “how” we should achieve or goals.

    The fluoride issue was both a social consideration and a fiscal consideration. It seemed to divide the community not so much along ideological lines, but more from an individual perspective of perceived best method. I could understand the emotional drivers for some personality types to stick with the shotgun approach of putting fluoride in the water. For them, that one kid with painful dental problems caused them enough emotional turmoil to demand the most handy approach… putting fluoride in the water. What is still very perplexing to me… 100% of advocates from the medical community, and almost all of our public servants, were so dogged in pushing fluoridation as the ONLY method they would support. Were there others that disagreed but felt unsafe to comment?

    I am always suspicious that an entity is facing dysfunction in decision processes with that entity pulls 100% in one diagnosis or solution-direction for a very complex problem. Frankly, this is what bothers me about the theories of man-made-global warming. The closer to 100% I hear the scientific community is tracking, the less I believe we are hearing everything we should hear. I expect a lot of inter-entity conflict when there are so many issues and variables to contend with. The entity starts to look like a flock of sheep following each other when there is not enough internal conflict.

    But back to fluoride. I am very disappointing in our medical community because: 1 – there were no advocates for alternative approaches, 2 – they are the experts in ALL the alternatives for prescribing and administering treatment and medication to solve health problems.

    I think our local doctors and dentists get a black eye from this fight. Hopefully they get over it quick and help us put together alternative programs to help those 50-100 Davis kids out there that need help with their dental care.

  19. Frankly, there is plenty of disagreement on climate change in the scientific community, but it’s more about the impacts and dimensions than whether it is really happening.

  20. Ernesto, I am no scientist, but I know a thing or two about multi-criteria, multi-factor, predictive models. And climate models have an order of magnitude greater number of criteria and factors than the number of seconds in his life that Edison regretted not listening to Tesla. We don’t know what we don’t know and what we don’t know is a very large pile. All we really have is a record of rising temperatures in a relative micro time period (compared to a 5-billion year calendar that has seen its share of hot and cold periods) and rising carbon dioxide levels.

    Climate scientists love their climate models like dentist love fluoride in our drinking water. Their credibility would rise substantially with some more internal debate made public.

  21. Ivan Illich once observed that up until 1910 you had a better chance of surviving if you didn’t go to the doctor than if you did. In the last 100 years however the art of medicine has improved dramatically so although the conventional wisdom can be wrong in general the advise of the medical community should have some credibility.

    Still it is interesting that those who disbelieve the medical community on F in the water are the same ones who feel we must live up to unreasonable standards on wood smoke, using as their supporting criteria, the opinions of the same medical community they choose to ignore on fluoridation.

  22. [quote]Still it is interesting that those who disbelieve the medical community on F in the water are the same ones who feel we must live up to unreasonable standards on wood smoke, using as their supporting criteria, the opinions of the same medical community they choose to ignore on fluoridation. [/quote]

    Well said Toad, you’re so right. So what about that Mr. Pryor?

  23. I find myself agreeing with much of frankly’s 3:49 comment, both in terms of liberals/ fiscal conservatives as well as the health community.

  24. [quote]Still it is interesting that those who disbelieve the medical community on F in the water are the same ones who feel we must live up to unreasonable standards on wood smoke, using as their supporting criteria, the opinions of the same medical community they choose to ignore on fluoridation. [/quote]

    Sorry I could not respond earlier. I do not listen to the “opinions” of medical or scientific experts. I read the peer-reviewed journals and often plot out the raw scientific data myself to come to my own conclusions and opinions. Sometimes I agree with the “consensus” (wood smoke, global warming, plastic bag contamination, etc) and sometimes I disagree (fluoride). But my guiding philosophy remains consistent and unchanged…”keep man-made toxic substances out of the environment” and I always try to back up my writings with hard scientific facts.

  25. “But my guiding philosophy remains consistent and unchanged…”keep man-made toxic substances out of the environment” and I always try to back up my writings with hard scientific facts.”

    So you like the data you agree with. This seems more like an outcome in search of a process. You like the scientific method when you think it supports your position but don’t when it doesn’t. How convenient.

  26. Toad, there is plenty of data and research to support an anti-fluoridation position. In America though the public health apparatus simply waves it off with appeal-to-authority arguments: the CDC says its good, the AMA says its good, and so on. That isn’t science, it’s religion.

    In science, if you take a minority opinion it is your job to justify your basis for doing so. In the case of the international record the US is in the minority, so the US needs to make an articulate justification for its beliefs. “The CDC says its good” is not a valid scientific argument.

  27. [quote]So you like the data you agree with. This seems more like an outcome in search of a process. You like the scientific method when you think it supports your position but don’t when it doesn’t. How convenient.[/quote]

    From what I saw of the Great Davis Fluoride Debate, that is what D**N NEAR EVERYONE was doing.

  28. [quote]Toad, there is plenty of data and research to support an anti-fluoridation position. In America though the public health apparatus simply waves it off with appeal-to-authority arguments: the CDC says its good, the AMA says its good, and so on. That isn’t science, it’s religion. [/quote]

    “Medical experts” and associations change their recommendations. The American Academy of Pediatrics used to recommend all baby boys undergo circumcision. The OBGYN mantra used to be, “Once a c-section, always a c-section.” Such examples are endless.

    Things change. Some “medical experts” may balk at lay people deciding not to toe the line, but at one point women had to fight for VBAC’s.

    Plus it’s a fallacy that there is a united consensus. Just because the AMA says something is good doesn’t mean that all literature universally points to that conclusion…and it certainly doesn’t mean that all physicians are in agreement. Add to that the fact that these governing bodies are CHARGED with having to make a recommendation, a yea or nay, a thumbs-up or thumbs down, a readily palatable conclusion the masses can consume…it is all far more complicated than a first glance might suggest.

  29. Ginger

    [quote]Plus it’s a fallacy that there is a united consensus. Just because the AMA says something is good doesn’t mean that all literature universally points to that conclusion…and it certainly doesn’t mean that all physicians are in agreement. Add to that the fact that these governing bodies are CHARGED with having to make a recommendation, a yea or nay, a thumbs-up or thumbs down, a readily palatable conclusion the masses can consume…it is all far more complicated than a first glance might suggest.
    [/quote]

    I agree with every word you wrote. No one was claiming that there is universal consensus in the scientific community everywhere that water fluoridation is the best strategy. What I said to the council is that there is virtually universal consensus in the Davis community health providers and public health personnel that fluoridation of the water was the right solution for Davis at this time. Please notice we were not talking about whether it was best for any other city, or state, or country. Only what is best for Davis best on the fragmented nature of our health care, the resources available for care for the underserved, the present statistics of dental decay amongst the underserved as measured by the CommuniCare providers and the amount of fluoride currently available in our water supply. And you are right, it is far more complicated that a first glance might suggest. The folks on the water fluoridation committee ( of which I have never been a member) had been researching this for years. I do not believe that anyone made their recommendations callously or after ” a first glance”.

  30. Who is the “water fluoridation committee”? I am aware of the WAC, but in all these debates I never heard of a WFC. Are they chartered by the City? Are they self-appointed? What is their purpose? Who formed this committee and when? Who is on this committee? Do they meet publicly?

  31. I googled “water fluoridation committee” and “davis” and got nothing. Is there such a committee but with a different name? Are they secret? If this is the name, it sounds as though their intention is to fluoridate Davis water. I would like to know who they are and how they formed. This issue will arise again as soon as the water project is in place (no longer threatened by citizen lawsuits) and the “water fluoridation committee” sees a political shift on the council that could favor fluoride. Keep those non-scientific studies handy and your tinfoil hats well polished!

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