Only one of the 10 largest cities in America is so backward that it does not fluoridate its water.

That would be San Jose, whose residents should be embarrassed that their city doesn’t provide one of the most basic services to improve public health.

Liz Kniss, a registered nurse and president of the Santa Clara County Board of Supervisors, understands that tooth decay is a serious problem throughout the county. She wants to work with the Health Trust — the valley foundation that makes grants to innovative and effective health care programs — to make fluoridating Santa Clara County’s drinking water a reality by 2015, without seeking public money.

The public health payoff for fluoridation is huge, especially for children. All city and county officials should get behind the goal.

Fluoridating drinking water is regarded as one of the top 10 public health advancements of the 20th century. It has the support of the Centers for Disease Control, the World Health Organization, American Medical Association and the Santa Clara County Public Health Department.

A vocal minority fights fluoridation, despite a lack of credible scientific evidence against it. Public officials need to stand up to opponents.

According to the most recent Health Trust survey, one in every three kindergartners and third-graders in Santa Clara County has untreated tooth decay. A 2005-2006 county study shows that one in three county residents

The respected Centers for Disease Control says there is clear evidence that fluoridation prevents tooth decay. It strengthens tooth enamel in children and helps reverse newly formed cavities in adults.has had at least one permanent tooth removed because of tooth decay or gum disease. Adding fluoride to drinking water would put a serious dent in those numbers.

The Health Trust and county officials are seeking private funding to cover the cost of fluoridating drinking water. The estimated price tag of 50 cents per resident is quickly dwarfed by the average cost of filling a cavity, which is around $150. The private San Jose Water Co. has said it will fluoridate the city’s water if it can find the money.

All of California’s drinking water should have been fluoridated decades ago. Lawmakers took a run at it in 1995, when they required water districts with more than 10,000 connections to add fluoride. They not only failed to provide money to do the job, but they also blocked water districts from using bond measures or increasing rates to finance fluoridation. That was a recipe for inaction. Since then many cities reluctant to take on the controversy have used lack of funding as a reason to ignore the state mandate.

Now Kniss and the Health Trust have a plan to just get it done in this county. Good for them. It will have as obvious a health benefit as brushing your teeth.

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