For $205,000 a year, Pinellas County adds fluoride to drinking water to improve the dental health of 700,000 residents.

When commissioners voted to end that practice come Dec. 31, however, they said they wanted an alternative to help those with little access to dental care.

But the solution they’ll consider today costs twice as much as fluoride and would benefit only a tiny sliver of the population.

The County Commission is scheduled to vote on a proposal to spend $532,339 for a mobile dental van to treat 5,000 poor children next year — less than 1 percent of those now getting fluoridated water.

It’s not the alternative some were hoping for.

“There’s no way I’m going to support a $532,000 item,” said Commissioner John Morroni, who voted in the majority in October’s 4-3 vote to stop adding fluoride. “You can buy a lot of toothpaste and help the dentists disperse it.”

Dentist Edward Hopwood of the Upper Pinellas County Dental Association, which supports fluoridation, criticized the van idea as “less bang for more buck.”

Commissioner Ken Welch, a fluoride supporter, also scoffed.

“It’s better than nothing. But it’s twice the cost, and it will affect a fraction of the customers of the Pinellas County water supply,” Welch said. “It’s certainly not anywhere near mitigating ceasing the fluoridation.”

The commission had asked its staff and the Pinellas County Health Department to consider options for using savings from fluoridation to boost dental care.

County Health and Human Services Director Gwendolyn Warren said the proposal is the most efficient option, noting that her department didn’t set fluoride policy. A written presentation says “numerous scientific studies and comprehensive reviews have continually recognized fluoridation as an effective way to prevent tooth decay.”

Said Warren: “We’re just trying to come up with a program that will help the children.”

Without fluoridated water, poor children are most at risk for cavities, often because parents lack transportation to take them to dentists, health officials say.

Under the program, the van would offer voluntary treatments to second- and seventh-graders at schools with the highest percentage of students on free or reduced-price lunches. The age groups reflect when permanent molars have erupted.

The health department, which says 47,600 low-income Pinellas kids have dental needs, would operate the vehicle with a hygienist, assistant and clerk.

The vehicle, which has a $300,000 purchase price, would have two dental chairs, X-ray equipment and waiting rooms. After the first year, the county pegs annual costs at $232,399.

“I think given the commission vote, I think this is an option we definitely have to look toward,” said Commissioner Karen Seel, who voted for fluoridation.

The October vote came after biting debate and was eight years after the commission voted in 2003 to add fluoride. Dentists strongly back fluoridation, which health organizations have endorsed for decades. But opponents complained about risks associated with high levels of fluoride and about government intrusion in their lives.

Besides the van, ripples from the vote led to another discussion: County Attorney Jim Bennett will report today on options for a referendum asking whether voters want fluoridated water.

“If it came back with a decided majority vote, that would be the right thing to do,” said Morroni, who favors a nonbinding measure.

But other commissioners are skeptical of putting such a complicated subject on the ballot. Some dentists worry a referendum risks their chances of long-term fluoride restoration.

Commissioner Susan Latvala, who had backed a referendum, said she wouldn’t support a ballot measure unless dentists are “100 percent behind it.”