The Alamo Heights City Council tried to avoid the contentious debate about adding fluoride to its water by doing a cost benefit analysis.
It didn’t work. The lively discussion is expected to continue at next week’s City Council meeting.
The city currently does not add fluoride to its water.
Public Works Director Shawn Eddy gave a presentation at the August meeting showing that of the 1,175 children in Alamo Heights, only 43 live below the poverty line, according to the U.S Census. With the best-cost estimates he could get, he estimated the city would spend $34,000 a year or $791 per child to add fluoride. It would be cheaper to buy each child a year’s supply of toothpaste and toothbrushes and send them to the dentist twice a year.
But Dr. David Cappelli, the director of Dental Health Residency at UT Health Science Center in San Antonio, argued fluoride in municipal water supplies benefits the entire population not just the poor.
“For over 60 years now scientific evidence clearly shows it is cost effective and provides an equitable prevention for tooth decay that can benefit everyone in a community,” he said in a phone interview after the meeting. “There is a preponderance of evidence.”
Based on that argument, the council voted on May 10, 2004 in favor of an ordinance to authorize the city staff to consult with the Texas Department of State Health Services and start adding fluoride to the water supply. But the city never got around to actually adding the chemical.
Last year, Councilman Bill Kiel started to look at the matter. The city soon will build a new water tower and if changes were needed for fluoride it would be cheaper to do them during the initial construction. Kiel said initially he was for adding fluoride.
Then he learned it was a hazardous waste product from the fertilization industry in Florida. When he started reviewing studies of the benefits he was not convinced. Europe has seen similar declines in tooth decay as the United States and many other countries don’t add fluoride. In 2006, a federal review of fluoride in drinking water found many people, including infants were exposed to unsafe levels of fluoride because of a combination of exposures from drinking water and other sources, such air pollution, pesticides and background levels in foods.
The American Dental Association and Centers for Disease Control now recommend on their Web sites to not use fluoridated water when mixing baby formula.
Kiel is a retired geophysicist and readily admits to enjoying research and having plenty of time to do it. Looking at fluoride became his “job” for more than a year.
He came to the Alamo Heights City Council meeting with a 53 page summary of what he had found.
“There is nothing out there that says absolutely this is good or this is a bad thing,” he said. “You have to look at the collective evidence … and I think in the end you pretty much come down on this cautionary stance.”
For almost an hour Kiel debated Cappelli and Tom Napier, a fluoridation engineer for the Texas Department of State Health Services. Because he heard their presentations before and knew their arguments, Kiel was prepared. In some cases he had the data from the studies the two referenced and could quote by page number the references they used.
As the rest of the council smiled at each other, Kiel pulled slide after slide contesting what the two fluoride advocates argued. Finally, Mayor Louis Cooper ordered that not another slide be shown, as the issue would be addressed at the next meeting.
Because of natural fluoride deposits in the Edwards Aquifer, Alamo Heights water has and average of 0.23 parts per million of fluoride in it already. Current federal fluoridation guidelines recommend 0.7 to 1.2 parts per million.
Even if the Council could come to a conclusion on the debate of if fluoride is or is not beneficial, the actual cost of implementing the program could prove even more difficult.
“There is more to this than meets the eye,” Councilwoman Jill Souter said.
The cost of fluoride has gone up 40 percent this year, forcing some cities, including Fort Worth, to temporarily stop adding the fluoride, Souter said. Second, the cost of having trained personnel on staff to do the required checks and record- keeping at the city’s six wells is not known. Neither is the cost of securing those sites so fluoride, in its concentrated form, does not pose a risk to neighbors or the environment.
When the San Antonio Water System added fluoride, it was done after a citywide vote. Voters were told it would cost $2 million, but it ended up costing twice that.
“We have to get to the nuts and bolts of this,” Souter said. “Otherwise we are voting with blinders on.”
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