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