Staff Recommends Delaying Decision on Fluoridation

fluoride-waterIt has become one of the more contentious issues in the city of Davis with a contingent of supporters in the heatlh community solidly behind the idea of adding fluoride to the city’s water supply, while another group of activists is strongly against the proposal, calling the use of fluoride in the water supply inefficient, ineffective and quite possibly hazardous to other aspects of one’s health.

An item on the city’s agenda this week asks for the council to determine not whether to add fluoride to the water supply but rather the timing of when that decision should be determined.

Staff states that they “feel” that “it would be appropriate to move Council consideration of whether to add fluoridation until after the DWWSP is constructed and has been operating at least a year. This will allow the Council to accurately assess the initial and ongoing cost for fluoridation that would be borne by the ratepayers.”

On June 27, 2013, the City of Davis Water Advisory Committee (WAC) voted to recommend to the City Council to add fluoride to the drinking water. As staff notes, during the course of the WAC deliberation, information regarding the range of potential capital, operations and maintenance cost were discussed.

Staff writes, “The estimations of capital cost to add fluoride to the City’s deep wells varies greatly depending on each well site and the type of chemical that is used to achieve fluoridation.”

As staff noted at the time, “In order to evaluate the cost of adding fluoride, two sources of information were used. One was 2009 cost estimates from Sacramento County and the other was a cost estimate for two of our deep wells, completed on June 18, 2013.”

Based on that, staff calculated, “The cost to add fluoride to our deep wells is estimated to be between $92,000 and $454,900 per well site. So to equip all six deep wells, the total cost would be between $837,000 and $2,067,400.”

Staff estimates the cost of adding fluoride to the water treatment plant would be $602,000 for both cities, which would put Davis’ portion at  40%, or approximately $240,800.

The Water Treatment Plant cost, added to the cost for the wells, results in a range of capital cost from $1,077,800 to $2,368,400 for the addition of fluoride.  These would be one-time costs.

Then they factor in ongoing costs.  Staff wrote in July, “Affinity Engineering used our two deep wells and estimated an average annual operational cost for a deep well is $29,800 for the fluoride saturator and $30,100 for fluorosilicic acid. For all six wells, this would approximately be $178,800 for the fluoride saturator and $180,700 for fluorosilicic acid.”

They add, “The annual O&M cost to provide fluoride at the Water Treatment Plant is estimated to be $50,000 and $60,000 per year. Combined with the O&M cost at the wells, this is a total annual cost of between $228,800 and $240,700 per year. This works out to be roughly $1.15 to $1.21 per customer per month.”

Staff did not discuss in the staff report whether this would be sufficient to trigger a new Prop 218 or whether it could be absorbed into the current capital costs.

“The current WAC was asked by Council to provide a recommendation on fluoridation prior to conclusion of their work. Because the Council will be re-forming the committee as a rate advisory committee at the end of this calendar year, the current WAC action needed to take place this year,” staff notes.

However, the actual timing would occur once the water supply project is on line, since “once a decision is made to add fluoride, every water source the city draws from has to be equipped to ensure proper dosing.”  As staff explains, “We cannot add it to some wells and not others.”

They add, “The recent promulgation of a maximum contaminant level (MCL) for Chromium 6 has the potential to render at least one of the existing deep wells unsuitable for potable use unless some form of removal or treatment is installed. Twelve of our intermediate wells would require treatment if they were to remain on-line.”

The city adds, “It may be a number of years before there is a determination of which wells will remain on line after adoption of the Chromium 6 MCL. If the City wanted to implement immediately, that would mean adding fluoride, at a cost up to $454,900 per well, to all of our existing intermediate and deep wells.”

The city further argues, “Until the DWWSP is complete and operational, the anticipated cost for initial installation and ongoing operations could vary greatly. Cost estimates to date are based on preliminary design and not an actual operational plant. Until the Water Treatment plant is completed, any capital and operational cost estimates are speculative.”

This pragmatism by staff may, however, run into politics.

A new surface water initiative circulated may tap into the fluoridation debate if the prospect of fluoridation continues to loom for several years.

Mayor Pro Tem Dan Wolk became the first Davis City Councilmember to publicly endorse the idea of fluoridated water.  Given that he is running for State Assembly, that is likely to inject politics into the fight.

In a piece that appeared in the Davis Enterprise and was co-authored by Julie Gallelo, the executive director of First 5 Yolo, and Art Pimentel, the former mayor of Woodland, Mr. Wolk and others argued, “Since the mid-20th century, community water fluoridation – the careful adjustment of naturally occurring fluoride levels in water to strengthen tooth enamel and reduce dental decay – has proved to be an effective preventative public health measure, reducing tooth decay by about 25 percent over a lifetime, per the American Dental Association.”

“Across the nation, more than 70 percent of people utilize community fluoridation, according to the Centers for Disease Control,” they write. “In California, fluoridation is mandated by state law, if funds are available. And, right next door, the citizens of West Sacramento, Vacaville and Sacramento, to name a few, enjoy the benefits of fluoridated water every day. Pediatricians in Davis prescribe fluoride drops to parents to give to their children.”

“Today, Yolo County’s public health community – dentists, pediatricians, public health officials and every major, local health care provider – is united in support of community water fluoridation in Davis and Woodland,” they continue. “These are the folks who are on the front lines of combating dental disease. They know what policies work and what do not.”

They argue, as well, that “cost should not be a reason to reject fluoridation.”

While Dan Wolk became the first Davis City Councilmember to back fluoridation, Brett Lee, in early July on the Vanguard, put forth an alternative proposal.

He noted that, while he was “impressed by the arguments and information put forward by both sides” of the fluoridation issue in their presentations to the WAC, “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,” he wrote.  “These countries appear to have more robust early childhood dental care programs than we currently do.”

The question remains as to whether either side in this political argument will accept the delay in the decision on fluoride.

—David M. Greenwald reporting

About The Author

David 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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  1. medwoman

    Whether one promotes or opposes fluoridation of the water supply, I am sure that we can all agree that it has raised the awareness of the issue of dental decay and it’s costs for both the individual and the community. Here we have a unique opportunity for our elected leaders to weigh in on a matter of local public health. While I personally support fluoridation, my bigger hope is that this debate will leave a strong impression upon our elected officials that public health is an issue that constituents care about and that they should perceive as one of their public responsibilities.

    My recommendation is that if the city council defers the decision on fluoridation, that Brett Lee be given the go ahead to start his fund raising plan
    Alternative to see if it is feasible. Or perhaps we could take up a more robust suggestion by taxing ourselves to provide fluoride for all who want it. Perhaps all those who oppose fluoridation would want to make large contributions of both money and time to ensure the success of such a program thus rendering the need for fluoridation a moot point.

  2. JustSaying

    “…another group of activists is strongly against the proposal calling the use of fluoride in the water supply inefficient, ineffective, and quite possibly hazardous to other aspects of one’s health.”

    Actually, this understates the case opponents are attempting to make. Since we don’t need to make this decision for years, perhaps a delay will allow us to sort out the claims of purposeful poisoning of our children as well as know the potential monetary costs when we eventually decide.

    At this point, I’ve gotten tired of the competing, mutually exclusive claims. Someone is not telling the truth. Continuing the discussion at its present level isn’t helpful. And, Lord knows, we wouldn’t want these kinds of decisions to “run into politics.”

  3. Mr.Toad

    This is Cr(VI)azy. Everyone is all worked up about Fluoride but what is the story on Cr(VI) a known carcinogen and what is treating with F got to do with it? Remember Erin Brockovich and Hinkley, it was Cr(VI) in the water. So the too smart and too cheap for their own good citizens Davis are all up in arms about water prices and the mostly benign addition of F but there is no uproar about Cr(VI). Go figure.

  4. Don Shor

    [quote]cost should not be a reason to reject fluoridation,[/quote]
    That would be a disconcerting statement without any context! It changes the meaning of ‘should’ from the authors’ intention.

    From the article:
    [quote]Although it may seem like a lot, cost should not be a reason to reject fluoridation, for two main reasons:
    * First, with responsive bids on the joint water project required to come in 20 percent below the engineer’s estimate, upon which we based our rates, rates most likely would not have to increase further to accommodate fluoridation.
    * Second, fluoridation is worth the cost, regardless of whether rates rise or not. The American Dental Association estimates that for every dollar invested in water fluoridation, $38 is saved in dental treatment, missed work and other costs. This is a classic example of an ounce of prevention is worth a pound of cure — an expensive, painful cure at that.[/quote]

  5. davisite2

    “…..the surface water project is doomed unless they remove the issue of fluoridation imo, this just punts it and keeps the issue alive.”

    I concur with above. You can be sure that as soon as the current water rate initiative has gathered enough valid signatures, the Council will reject fluoridation. If you are against fluoridating Davis’ water, immediately sign the water rate initiative petition and actively work to gather the signatures.

  6. Growth Izzue

    [quote]Or perhaps we could take up a more robust suggestion by taxing ourselves to provide fluoride for all who want it. [/quote]

    Medwoman, can you please explain to me why we should tax ourselves when Fluoride will be provided for free starting in January 2014?

  7. Barbara King

    In December, 2010–after decades of recommending giving fluoride supplements to most or all children in areas with relatively low fluoride levels in the water–the ADA changed to recommending giving fluoride supplements only to high caries risk children in those areas, and then only after assessing all their other sources of ingested fluoride.

  8. bviner

    [b]Not every health organization supports water fluoridation.[/b]

    American Cancer Society – [b]no [/b]to water fluoridation
    American Heart Association – [b]no [/b]to water fluoridation
    National Kidney Foundation – [b]no [/b]to water fluoridation
    American Academy of Allergy and Immunology – [b]no [/b]to water fluoridation
    American Diabetes Association – [b]no [/b]to water fluoridation
    Society of Toxicology – [b]no [/b]to water fluoridation
    Chronic Fatigue Syndrome Activation Network – [b]no [/b]to water fluoridation
    American Psychiatric Association – [b]no [/b]to water fluoridation
    American Chiropractic Association – [b]no [/b]to water fluoridation
    American Civil Liberties Union – [b]no [/b]to water fluoridation

    How do you ignore the over 4,500 medical, dental, scientific, and environmental professionals that save signed on to the Professionals Statement to End Water Fluoridation by the Fluoride Action Network (FAN)?

    “It is time for the US, and the few remaining fluoridating countries, to recognize that fluoridation is outdated, has serious risks that far outweigh any minor benefits, violates sound medical ethics and denies freedom of choice. Fluoridation must be ended now.”

  9. medwoman


    “As far as supporting other programs designed to improve the health of our children, I might add that I am passionate about curbing the skyrocketing rates of obesity, diabetes, hypertension, and dental disease along with many psychiatric/neurological disorders such as ADD/ADHD. So any program that claims to target children’s health will have to address the primary CAUSE of all of these conditions, which is diet, especially the consumption of high amounts of sugar, processed foods and refined carbohydrates. If a program does not have nutrition reform as it’s primary component, it will not gain my support. Nutrition reform includes, but is not limited to, overhauling the school lunch program as Lauren Ayers pointed out in her recent Vanguard commentary, as well as implementing policies to restrict sales of sugary drinks to children. I have suggested on this site on numerous occasions ways that the CC might go about developing such policies. Thus far I have seen no movement in that direction.”

    I certainly hope you would not take such a narrow approach to other medical problems. Would you recommend with holding insulin from Type II
    Diabetics or medications to prevent kidney failure from hypertensives because they do not “address the primary cause”? How about not providing antimalarials because this does not address the underlying cause of the presence of mosquitos?

    Medicine, both preventative and curative is multifactorial and is frequently incremental. As for your statement that “you have seen no movement in that direction” then you haven’t been looking very far. While it is true that most public health measures occur at the county, not the city level, that does not mean that those of us in the health community are not continuously promoting a healthier lifestyle. At multiple community events I have manned the Kaiser booth promoting health education for children featuring games centered around healthy diets, and exercise and my colleagues from other health organizations do similar activities. County programs are active in promoting breast feeding and eliminating sugary beverages and candy in favor of water and healthy snacks. I do not know any health care providers who do not counsel, and or provider literature on healthier choices.

    This is a false dichotomy that you are perpetuating.
    No one is suggesting fluoridation as a substitute for healthy choices. We are suggesting it as an adjunct to healthier choices. All of us are working on many levels to promote the public health. If you are truly passionate about this, state you proposal, and if sound, I will personally
    step up and support you whole heartedly.

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