After San Marcos residents in November 2015 voted to stop putting fluoride in their water, Buda and other cities that drew from the same water source were also cut off, whether they liked it or not.

If they wanted to keep the fluoride, they were on their own. Buda officials say they are now just weeks away from launching a system that will again disseminate the additive, aiming to improve residents’ dental health.

“It’s something that we feel strongly about,” Mayor Todd Ruge said. “To me, this is more than anything a health issue. … The evidence that has been presented to us by trusted professionals is overwhelming that this is a good benefit to the city.”

Prior to the San Marcos referendum, Buda had been adding fluoride to its water since 2002 when it first became a customer of the Guadalupe-Blanco River Authority. The authority operates the San Marcos Water Treatment Plant and stopped fluoride treatment at the plant days after the referendum.

Buda receives 60 percent of its water supply from surface water bought from the authority; the other 40 percent is groundwater that comes from the Edwards Aquifer, which already contains some naturally occurring fluoride.

Anticipating the San Marcos vote, Buda City Council members passed a resolution in July 2015 cementing their preference for fluoridation.

The city has since been working with the Texas Fluoridation Program, a branch of the Department of State Health Services, to design and install a system at the Bonita Vista Pump Station that will adjust fluoride levels in surface water distributed to Buda residents.

The system will add enough fluoride to bring it to 0.7 milligrams per liter, the level recommended by the U.S. Department of Health and Human Services.

The majority of the costs of the system, plus its design and installation, are being covered by the Texas Fluoridation Program. The city will pay more than $6,000 for equipment and chemicals out of its water fund.

Utility customers received notifications in the mail about the change taking effect Dec. 1, but water specialist Brian Lillibridge said the process is taking longer than expected. The city still needs to choose a fluoride provider and make final preparations to the system, he said, which he expects will take a week or two.

Council Member David Nuckels, who was elected in December 2015 after the council had already voted in favor of fluoride, asked that the issue appear again before the council last month to increase public awareness. Nuckels said he felt the resolution should have been an agenda item so that the public could have input.

“I think the issue is of bigger concern to a lot more people than the City Council understands,” Nuckels said, adding that an online poll he conducted showed that more than 60 percent of about 80 participants preferred no fluoride. “We have naturally occurring fluoride in there; I don’t think we need to add it.”

The issue of water fluoridation has historically drawn debate in the U.S., though it has the support of leading scientific and health groups. Communities in the U.S. began adding fluoride to water about 70 years ago.

The practice has been heralded by the federal Centers for Disease Control and Prevention as one of the top 10 great public health achievements in the 20th century. As of 2014, 66 percent of Americans and 79 percent of Texans were served by community water systems with fluoridated water, according to the CDC.

Opponents claim fluoride is a health risk and also argue that it isn’t the role of the government to make a personal health decision for its constituents. Sam Brannon, who led the Fluoride-Free San Marcos Coalition campaign in San Marcos, spoke against Buda’s decision at its council meeting last week.

“If you put this in the water supply to medicate, to solve a medical problem, you’re going to be acting as a medical professional, for which you are not trained,” Brannon said. “You can’t do mass medication and meet the requirements of medical ethics.”

Several others spoke in favor of fluoridation, including Hays Caldwell Public Utility Agency chief Graham Moore, who represented himself, not the agency.

Moore urged the city to fluoridate as a way of serving the “greater good” and helping families that can’t afford good dental care. He added that he stands by scientific evidence that supports fluoridation as a safe practice.

“There is overwhelming, credible scientific evidence that shows that fluoride, when applied at the appropriate dosages and levels, is absolutely safe,” Moore said. “I don’t know why we would want to go backwards from something that has been good for so many communities for so many years. It’s just beyond my comprehension.”

Nuckels then made two failed motions — one to hold off on fluoridation indefinitely and another to hold off at least until it could be taken to a citywide vote. Both died for lack of seconds.

The San Marcos Treatment Plant also provides water for the city of Kyle and unincorporated areas along Interstate 35 in northern Hays County. Kyle officials have said their city has no plans to reintroduce fluoride.