Fluoride Action Network

San Antonio: In public health, fluoride is a big leveler

Source: MySA.com | October 5th, 2010 | By Veronica Flores-Paniagua
Location: United States, Texas

You would expect a bunch of dentists to wring their hands over the decision last week by the Bexar Metropolitan Water District board to stop adding fluoride to its water. But the ones I visited with Monday have a special interest. They’re the dentists who see patients in the city public-health clinic that’s primarily dedicated to pediatric dental care.

The bright, airy waiting room of the Ricardo Salinas Clinic, at the corner of General McMullen and El Paso Street on the city’s Southwest Side, was humming Monday afternoon. The acoustics are such that every sound and every baby’s cry is magnified. Even so, a nurse didn’t need a loudspeaker to call out patients’ names.

The clinic’s location and clientele, half uninsured, make it destined to see some of the worst cases of tooth decay in the city. It would be worse, were it not for the great leveler: a fluoridated water supply.

Data tracing the rate of dental caries, or cavities, in children is a bit dated, but there’s daily evidence in the mouths of the clinic’s patients that South Texas kids suffer a great deal more tooth decay — 30 percent versus 5 to 6 percent — than their counterparts elsewhere in the U.S, says Dr. Kevin Donly, chairman of the Department of Developmental Dentistry for the University of Texas Health Science Center San Antonio.

Donly oversees residents in pediatric dentistry care rotations at the Salinas Clinic, as well as those who treat patients at the Dr. Frank Bryant Health Center, an outpatient facility at Christus Santa Rosa Children’s Hospital and another clinic on the UTHSC campus. Donly, who hails from Iowa, arrived in San Antonio just ahead of the Great Fluoride Debate of 1999-2000, and finds it hard to believe that the community is again arguing over the value of adding fluoride to its water supply. He understands the concern that some have about fluoride’s toxicity. But after decades of research he’s conducted on the effects of fluoride on oral health, Donly’s convinced that the preventive benefits outweigh those concerns.

“There’s folks who probably don’t need it, but those most in need will get it,” he said. A map of BexarMet’s service area helps to explain health providers’ concern about the water utility board’s decision to yank fluoridation at the end of the year. Part of it includes the population-dense and socioeconomically depressed South and Southwest sides of San Antonio. “These are the areas that would benefit from communitywide fluoridation,” says Dr. Jennifer Bankler, Metro Health’s dental health coordinator.

The short-term budget considerations that BexarMet board members cited in their decision will have longer-term fiscal consequences for the local community over the lifetime of a child who isn’t afforded access to a fluoridated water supply, Bankler added. The warning is logical: 5 percent of the state’s $20 billion Medicaid budget pays for dental care.

Sometimes, an outsider’s view helps to put a local issue in perspective. Dr. Jennifer Borden works for the Indian Health Service on the Sisseton Reservation in South Dakota. American Indians, too, suffer from a high rate of tooth decay and the Indian Health Service has focused its efforts on prevention and fluoridating water supplies, she said.

On Monday, she was at the Salinas Clinic applying sealant to a teenager’s teeth to help prevent cavities.

“These people just aren’t seeing what we’re seeing,” Borden said.

Reality? I’m not sure the utility’s leaders understand the word.