With President-elect Donald Trump’s selection of Robert F. Kennedy Jr. to head the Department of Health and Human Services, many Americans are wondering whether they’re in for a future without fluoridated water.
Kennedy, who has widely spread falsehoods about vaccines causing autism and other medical claims, has vowed that the Trump administration will “advise all U.S. water systems to remove fluoride from public water” as soon as the 47th presidency begins.
One place in the country that can offer a glimpse of the fluoride-free life sits just outside the Bay Area: Davis.
It is among a handful of communities including Portland, Ore.; Albuquerque; and the state of Hawaii that have made the choice to go without the cavity-preventing additive. Towns in Sonoma and Marin counties, as well as Gridley (Butte County), a small community, have also opted to go without fluoride.
But Davis, with its population of 65,000 and reputation for highly educated, liberal residents, stands out.
The city, home to UC Davis, has never fluoridated its water supply, former Mayor Joe Krovoza said. Before 2013, Davis sourced its water from numerous wells that would have made uniform fluoridation difficult. When the city embarked on an expensive project to bring in water from the Sacramento River to Davis and neighboring Woodland, the question of adding fluoride came to the city council.
The council formed a committee to issue a recommendation on fluoridation, which included Dr. Howard Pollick, a professor of dentistry at UCSF. Pollick said the committee recommended fluoridation to the council.
During the council’s vote, nearly two dozen people spoke in support of adding fluoride to the water supply, which would have cost about $2 per month per water customer. The comments emphasized how community fluoridation could improve public health and reduce disparities in dental problems between socioeconomic classes, with representatives from local health agencies and organizations emphasizing the lack of negative impact on the environment or people.
But Krovoza said that the opposition showed up even stronger, with 30 residents urging the council that it was their responsibility to provide “clean” water and not to force fluoride consumption on the public.
Given concerns with getting the broader, expensive water project funded by the public and the opposition from residents, the city council voted 4-1 to not add fluoride to the city’s water supply. Davis and Woodland both have the options to add fluoride to their independent water supplies in the future. The current facilities are set up to accommodate fluoridation.
Pollick said he was very disappointed in the result. He has seen more cities, including Santa Cruz, Redding and Modesto, reject fluoridation, as well as some cities, like Oroville, discontinue fluoridation after years of adding the chemical, though more than 57% of Californians are served by fluoridated water supplies.
“A lot of it is just political, who the decision makers are listening to and who they get persuaded by,” Pollick said.
Pollick, a former spokesperson on fluoridation for the American Dental Association for 20 years, said he feels compelled to share the benefits of fluoride from an evidence- and science-based point of view to counter emotional arguments against the additive.
Pollick said that water sources can also have naturally occurring fluoride of various levels and that many other countries that do not fluoridate their water instead opt to fluoridate their salt, similar to iodized salt in the United States.
Dr. Dagon Jones, a dentist with Davis Dental Practice, said that while Davis doesn’t see particularly stark effects on oral health due to the lack of fluoride, many other places could if widespread fluoridation is stopped.
“Community fluoridation primarily helps lower-socioeconomic-income children who really aren’t getting the best preventive care,” Jones said.
The patients Jones sees in Davis — which has a median family household income 50.4% higher than the California average — typically are less affected by the lack of fluoride in their water because they are getting regular dental cleanings, which include application of concentrated fluoride gels, and using fluoridated toothpaste, he said.
Jones expects that if community fluoridation is stopped nationally, however, the broad oral health effects would be very expensive for government insurance programs like Medi-Cal, which offers dental coverage for eligible Californians.
Fluoride, which the federal government authorized adding to water 75 years ago, plays a significant role in preventing cavities, Jones said. He said that fluoride helps make tooth enamel more resistant to decay, inhibits bacteria’s ability to produce acid and aids in the remineralization of teeth, which allows repair of early cavities — all of which reduce the need for further dental intervention.
“My concern is that it will just put a bigger strain on the Medi-Cal system,” Jones said. “It seems to me that, from a policy standpoint, that it would be an expensive decision.”
Fluoride only acts on the teeth through topical application, Jones said, meaning those who get fluoridated water are reaping dental benefits by the water touching their teeth, not through actually consuming it.
Fluoridation opponents argue that it can cause fluorosis, which in mild and moderate cases can cause spotting on teeth, but no health concerns. Severe cases can cause pitting on teeth, which can lead to cavities.
And those opponents just scored a big victory in a Bay Area case in federal court.
After seven years of litigation in a suit by anti-fluoride groups, U.S. District Judge Edward Chen of San Francisco ruled Sept. 24 that the current maximum fluoride concentration, 0.7 milligrams per liter of water, poses an “unreasonable risk” to children and must be reduced.
“There is substantial and scientifically credible evidence establishing that fluoride poses a risk to human health,” the judge wrote. He did not specify the amount of reduction, leaving the initial decision to the EPA.
Pollick said the opinion cited a study that highlighted concerns with higher levels of fluoride than are currently added to drinking water.
While Kennedy said the president will “advise” local water agencies to ban fluoride, the Environmental Protection Agency, whose chief administrator is appointed by the president, has the authority to determine the maximum concentration of fluoride in drinking water consumed by 200 million Americans.
As the EPA considers its next move, Pollick is wary about the potential path forward for community fluoridation.
“The disease of tooth decay can be very burdensome to the people that are suffering from it. There have been instances where people have died from untreated tooth decay. It’s not just a matter of a small cavity,” Pollick said.
Original article online at: https://www.sfchronicle.com/politics/article/fluoride-davis-california-19919310.php