Fluoridating Tap Water Is Still No Simple Matter : It Will Become Law Next Year, but Logistic Problems Linger and Many Question Its Safety

It’s in the toothpaste and the drops prescribed for babies. After a new state law takes effect in 1996, it will be in the drinking water as well.

But adding fluoride in Ventura County will not be simple. The county’s residents get their water through a web of water districts and a network of sources--underground basins, rivers and even Northern California streams.

The state must provide the money to pay for the project. And public opinion remains divided on fluoride.

A known cavity fighter, fluoride is promoted by its supporters as safe and effective, with benefits that far outweigh any risks.

“I see how terrible the public dental health is in Ventura County,” said Dr. Gary Feldman, the county’s public health officer. “Every year we spend about $200,000 trying to stem the tide of dental decay for poor children. I could easily spend five times that much.”

But others object on principle and for reasons of safety.

“It’s forced medication,” said Simi Valley Councilwoman Sandi Webb, who lobbied to defeat the measure before it was signed into law by Gov. Pete Wilson this month. “Medication should be left to doctors and prescribed for people who choose whether or not to take it.”

In the 1950s, some communities viewed fluoride in the drinking water as a Communist plot. That view has subsided, but many residents still express concerns.

Too much fluoride, dumped with industrial waste into a Russian town’s drinking supply, blackened children’s teeth. The chemical compound is also suspected of contributing to osteoporosis in older woman. In extreme cases, an overdose could cause death.

But the amount the state is prescribing for drinking water falls far below the danger level, say dentists and health officials.

“You can say the same thing about chlorine in the water supply and giving kids vaccinations,” said Dr. Jonathan Ziff, a dentist who lives in Oxnard. “But you’ve got to do what’s best for the majority of the people. Some people just seem to have it in for fluoride.”

He urged water districts to survey customers now and add fluoride to the water right away. “Don’t wait,” Ziff said.

Feldman predicted a “great improvement” in dental health with the addition of fluoride to drinking water.

But dentists, public officials and others still have months to debate the issue before the first drop is added.

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The law takes effect Jan. 1, but the California Department of Health Services, which will implement the law, must first develop regulations concerning dosage, monitoring and safety. Those regulations are not due until January, 1997.

In addition, the law states that only districts serving more than 10,000 households are required to add fluoride. That would include water suppliers for most cities in Ventura County, but exempt some of the smaller, mutual water companies serving rural areas.

The law also requires the state to provide financing for the program before water districts start adding fluoride.

Don Kendall, general manager of the Calleguas Municipal Water District, which delivers water to 500,000 residents, said the state will probably find a funding source, at least initially.

“I fear that the money may be allocated for the first couple of years but then dry up as the state deals with its budget problems,” he said. “Then the question is, do we continue to fluoridate? We will almost have to because the public will expect it.”

That could leave customers picking up the cost, which Kendall estimates in the range of a few dollars per year per household.

As important, he said, is how Calleguas would handle its water supply. The district receives its water from Northern California through the Metropolitan Water District in Los Angeles. Metropolitan may well add fluoride at its treatment plants and save Calleguas the headache.

Then Calleguas, as a wholesaler, sells its water to other districts and cities in Ventura County. For cities like Simi Valley, Moorpark and Thousand Oaks--which use Calleguas water exclusively--the problems would be minimal. The water would already be treated with fluoride by the time they receive it.

But for cities like Camarillo and Oxnard--which blend Calleguas supplies with lesser-quality ground water--the situation is more complicated.

Those cities would have to add fluoride to their water separately and in the appropriate amount, so that when blended with Calleguas water it would equal the correct dosage.

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And in Ventura--where water comes from the Ventura River as well as underground wells--fluoride would have to be added at the city’s three treatment plants or at city reservoirs, depending on the route the water takes from its source to delivery, said Frank Cincoine, lead operator at the Avenue Treatment Plant.

“It’s a very complex system,” he said. Still the water district goes through the same process when it adds chlorine to the water.

“It would be an additional component,” he said. “It’s a matter of the same type of equipment, just specialized for fluoride.”

Small cities such as Fillmore, which has fewer than 3,000 connections, will not be affected by the law. But Public Works Director Bert Rapp said the city could add a fluoride treatment component to its plant.

Feldman said that the amount of added fluoride would be so small that people could continue to brush their teeth with fluoridated toothpaste.

“There is enough of a margin of safety that people won’t get into trouble with that,” he said.

But pediatricians who prescribe fluoride supplements for babies may want to suspend the practice if the infants are drinking formula made with tap water. Doctors will probably still prescribe fluoride supplements for nursing infants, he said.

Feldman notes there are concerns that fluoride may increase the rate of osteoporosis, a disease prevalent in older women that robs bones of their mass. But studies so far are inconclusive, he said.

“There is nothing in life that is zero risk. But does the good outweigh the potential bad?”

In the case of fluoride, he said, the answer is, clearly, yes.