Insistent complaints may force city government to have another public referendum on the issue.

The mail-in referendum could cost taxpayers more than $45,000. But the real costs may be borne by children and adults who could see less protection from tooth decay from their water, long a source of such protection.

Fluoride skeptics have raised many health concerns. One thing is clear, however: Since the addition of fluoride to many public drinking-water sources, dental decay has became less common.

The U.S. Centers for Disease Control said the addition of fluoride to drinking water was one of the 10 greatest public-health improvements in the United States in the previous century.

Further, there have been no major findings that fluoride in drinking water represents a serious public safety threat. Critics, however, have been unrelenting in questioning the safety of fluoride and the city’s provider of hydrofluorosilicic acid.

Commissioner Troy Kent questioned some of the providers via the mail about compliance. He did not hear back from them. The vendors should have responded to his queries. There is nothing wrong with a city commissioner asking questions if he has the interests of the city and his constituents in mind. However, city officials should defend their own practice of fluoridation.

Yet even Kent worries about the cost of a referendum.

Ormond Beach residents should also weigh the costs of removing fluoride from their drinking water. The CDC estimated that for every $1 invested in fluoridating water, there is $38 in savings on dental costs.

Any person who has ever needed fillings, root canals, crowns, dentures, etc., knows full well the very real costs of dental work. And there is a cost beyond cash — bad or weak teeth can have an effect on enjoyment of life. Dental problems also can lead to more serious health problems.

Fluoride is a way to alleviate those public health care costs, both financial and personal.

Critics say fluoride is a form of medical treatment without consent, but that argument is akin to saying enriched flour is a form of medical treatment given without consent. Fluoride — like other essential minerals and compounds we take in, from copper to the B vitamins — is more comparable to nutrients we need for good health.

Mayor Ed Kelley said he is tired of hearing about fluoride at every public meeting. It’s hard to blame him for getting weary of the complaints.

So the city may settle the issue with a $45,000 mail-in referendum next spring. It’s an expensive way to settle what should not be an issue. But the great costs will be to the collective dental health of Ormond Beach should fluoride be removed from drinking water.

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