A broken Tucson promise is damaging the health of our children, say angry Tucson dentists, who want it fixed.
That promise — made 13 years ago but never fulfilled — was to fluoridate Tucson’s water to reduce childhood tooth decay, still one of the most common and costly health problems afflicting local youngsters.
Tucson’s City Council voted in 1992 to do just that. But the mandate got lost when the attempt to deliver Colorado River water to Tucson homes blew up only months later, exploding water pipes carrying the corrosive new water.
Many Tucsonans remain unaware that water fluoridation — named one the 20th century’s top 10 public-health advances — never happened here. Even many dentists didn’t know. And now that they do, they want it back on the front burner.
"Everybody here thought that had been done, that the water was fluoridated and our children protected," said Dr. Philip Mooberry, one of the many Tucson dentists and water experts who fought for fluoridation.
"But we came to find out six months ago it was never done. I was floored — the whole Dental Society was floored.
"This is a critical public-health issue for our children, and I really feel it’s a slap in the face to the people of Tucson that this promise was never kept."
During a recent meeting of the Southern Arizona Dental Society, complaints were aired about reports that tooth pain and decay is a top reason Tucson children miss school.
That’s when the fluoridation failure emerged as the reason the problem persists.
More than 60 percent of children ages 6 through 13 suffer tooth decay in Pima County, according to the state Department of Health Services.
"In communities that have (fluoride), the decay rate is so much lower — that’s been documented throughout the scientific literature over and over," said Dr. Robert Howard, a longtime Tucson dentist and a veteran of the fluoride wars in the ’90s.
"And we need it more than ever today, with so many kids almost addicted to acidic, sugary soft drinks that are so damaging to their teeth. We know, beyond argument, that the No. 1 product for controlling decay is fluoride. Every dentist you’ll ever talk to will tell you that."
U.S. cities have been adding fluoride — a mineral that occurs naturally in food and water — to municipal water systems since 1945, after studies proved its tooth-strengthening ability. Nearly all the nation’s 50 largest cities, including Phoenix, do it, and today almost 70 percent of Americans using public water systems have access to it.
Though the issue often stirs controversy — with opponents citing fears of cancer, brittle bones and government overreach — six decades of research have shown fluoride is safe, at correct levels, and has dropped tooth decay rates by more than 50 percent wherever it has been added to the water, according to the federal Centers for Disease Control and Prevention.
But because Tucson has not done so, elementary schoolchildren in the Tucson Unified School District still swish and spit little cups of fluoride once a week, with their parents’ permission. That helps some, say dentists, but it doesn’t come close to providing the systemic protection to developing teeth that small amounts ingested regularly in drinking water do.
However, the technical problems in Tucson’s water system that doomed fluoridation more than a decade ago persist today, making any attempt to do it now almost physically and financially impossible, Tucson Water officials say.
In fact, because of those problems, Tucson is the only unfluoridated community in Arizona that is not being urged to implement fluoridation — at least not now — according to a just-released report commissioned by the state’s Office of Oral Health.
That is because Tucson Water — the system that delivers water to three-quarters of Pima County residents — still uses some 130 wells to deliver it, after the attempt to deliver Colorado River water via the Central Arizona Project went bust in 1993.
Because fluoridation equipment would have to be installed at each of those wells, the total up-front cost is estimated to top $1 million, according to the "Report on Water Fluoridation for Communities over 10,000 Population for the State of Arizona."
No other unfluoridated Arizona city even approaches those costs, and not just because Tucson is the biggest municipality. Fluoridating Yuma’s main water system, which serves about one-sixth Tucson Water’s population, would cost only $68,000 — because it would require equipping only two plants that deliver Yuma’s water.
Noting water fluoride levels here are too low to prevent tooth decay, the report said Tucson Water should fluoridate, "but because of difficulties with the turbidity in the CAP water, the new surface water plant (which does have fluoridation equipment) has not been used — yet. Therefore, it is recommended that the city not fluoridate until this problem has been resolved."
No one knows if, much less when, the problem will be fixed. Since 2001, most of Tucson has received a blend of groundwater and recharged CAP water, still using 130 wells to deliver it, instead of a single treatment plant. That mix varies widely in different areas of Pima County, as do the natural fluoride levels.
"So the issue is, how would we achieve a stable level of fluoride for all customers?" asked Tucson Water spokesman Mitch Basefsky.
"The bottom line is, this is a complex system with variable blends of water. You have to treat all water before delivery and you need a central plant to do it. That’s what we thought would happen 13 years ago, but that delivery method is not in operation.
"If we tried to fluoridate now, we’d have to find a totally different strategy to make it work, and we don’t know if we could find a way that’s cost-effective. We do know it would be very expensive to fluoridate on a well-by-well basis."
But that’s not good enough for those still fighting for it. Many note Tucson Water manages to get the disinfectant chloramine into the water supply.
"More than 65 percent of children do not get adequate dental care, and if you fluoridate the water, that helps everybody," Mooberry said. "If you factor in what it takes to fix all these kids’ teeth and all of the missed days of school, I think we’ll find it will be more than worth it to make this happen."