Sixty-two years after fluoridation was introduced in the United States, fluoridated water is scheduled to start flowing out of the faucets of most San Diego County residents today.
It’s a reality that thrills many public health officials and dentists, but infuriates many other people.
Fluoridation proponents, including the California Department of Public Health, the California Dental Association and the National Centers for Disease Control and Prevention, have said for decades that fluoridation is a proven, safe, effective way to prevent rampant cavities and dental disease, and the other illnesses they can exacerbate.
“We’re ecstatic; it’s only been 12 years,” said David Nelson, referring to California’s 1995 legislation ordering fluoridation. Nelson is an oral surgeon who has been the paid consultant and main advocate of the California Department of Health Services’ fluoridation effort.
“This could reduce the burden of dental decay by as much as 20 percent to 40 percent,” he said.
But fluoridation’s intense opponents, including San Diego’s Citizens for Safe Drinking Water, and some chemists, dentists and worried citizens, say putting fluoride in water supplies is forcing medication on the public that is ineffective against cavities, but which could cause all kinds of chronic ailments.
“I’ve invested in an expensive fluoride removal filter system,” said Richard Sauerheber, a chemist and fluoridation opponent who tutors in math and sciences at Palomar College in San Marcos. “I wish they would ban it.”
In any case, Southern California’s main water supplier, the Los Angeles-based Metropolitan Water District, is set to start adding fluoride today to the drinking water supplies churned out by the R.A. Skinner Plant near Temecula.
Metropolitan has already started adding fluoride in its other four treatment plants in the last few months, meaning that nearly 18 million Southern Californians in six counties are now getting fluoridated water.
In San Diego County, some areas don’t buy Metropolitan’s treated water, and will continue to have little or no fluoridation, including the city of San Diego, Oceanside, Poway, Olivenhain in Encinitas, the Santa Fe Irrigation District, San Dieguito Water District and Chula Vista’s Sweetwater Authority. However, those areas could soon be considering fluoridating their supplies. The First Five Commission of San Diego allocated $5.7 million in November to buy fluoridation equipment and supplies.
Metropolitan board members voted to start adding fluoride four years ago in 2003, but waited until after spending billions of dollars to upgrade its five treatment plants to implement fluoride systems .
Grand Rapids, Mich., was the first U.S. community to purposely add fluoride to its water supplies, in 1945 —- after, according to the National Centers for Disease Control and Prevention, dentists discovered low cavity rates in areas that had “significant amounts of fluoride.”
Since then, fluoridating community water supplies has been done throughout the country —- the CDC reported in 2002 that 60.5 percent of all Americans received fluoridated water —- but it has been slow to come to California.
The recent push to fluoridate California water supplies dates back at least 12 years, to then-Gov. Pete Wilson signing Assembly Bill 733 into law in 1995. That measure required all water agencies that served more than 10,000 customers to add fluoride to the water “if money became available.”
Because the mandate came without money to implement it, many water agencies in California virtually ignored it.
But in 2000, the California Endowment, the state’s largest health foundation, put up $15 million for water agencies to use to begin fluoridating. Part of that money was used by the city of Escondido —- the only community in San Diego County that currently fluoridates —- to start fluoridating in 2004. It is also funding Metropolitan’s fluoridation program.
Natural vs. synthetic
Metropolitan plans to add fluoride in amounts of 0.07 to 0.08 parts per million. Public health agencies say fluoridation is safe and effective if done in small amounts, less than 1 part per million.
According to the American Dental Association, fluoride administered topically can stop dental decay and harden tooth enamel to protect it from acidic decay. The association also says that ingested fluoride can remain in saliva to protect teeth.
Fluoride can be a naturally occurring compound, such as calcium fluoride. However, fluorosilicic acid, the fluoridation agent that Metropolitan and many agencies add to their supplies, is a synthetically produced fluoride. Opponents say synthetic fluoride is a dangerous waste product of fertilizer manufacturing companies.
Synthetically created fluorides have been used for decades in toothpaste to reduce cavities.
While fluoridation has been embraced by public health agencies and officials groups such as the National Cancer Institute, and the dental associations —- in part because they see it as the best way to protect children and adults who can’t afford to see dentists on a regular basis —- it has been, and remains, controversial for many people.
Arguments against fluoridation have ranged from charges that it would be used to make people docile and submissive, to health worries that excessive fluoride consumption could cause everything from fluorosis —- a mottling of people’s teeth —- to cancer, kidney problems, hip fractures and other problems.
Illustrating the enduring controversy around fluoridation, Metropolitan declined requests to have pictures taken of workers installing the fluoridation system at the Skinner Plant last week. Metropolitan officials said they feared public perception problems if photos showed workers wearing legally required protective clothing.
The American Dental Association also issued a warning this year that infants should not be fed baby formula with fluoridated tap water to protect them from getting too much fluoride. In October, California’s Department of Public Health recommended that doctors suspend prescribing fluoride supplements to patients in Metropolitan’s service areas for the next year to make sure they don’t get too much fluoride.