State Law on Fluoride Has No Teeth

In the two years since California mandated that water districts fluoridate tap water if they can afford it, no city in Orange County or the rest of the state has added the tooth decay-preventing substance to the water supply.

California continues to lag far behind the rest of the country in fluoridating its water. Sixty-two percent of people nationwide consume fluoridated tap water, compared with 17% of Californians, according to the California Department of Health Services.

In Orange County, where fierce political battles were fought in the 1960s and 1970s over the value of fluoridation, only two cities--Huntington Beach and Fountain Valley--add the substance to water. That puts the county about on a par with the rest of the state, where concerns about government intervention kept water agencies from installing fluoridation treatment systems decades ago, when most of the country did.

The two-year old state law--which applies to water agencies serving more than 10,000 residents--has done little to sway widespread opposition to fluoridation in California. The law does not require local water agencies to spend any money on fluoridation. So far no state or federal money has been allocated for the program.

“We are doing all we can to take things out of our water to make it clean and pure,” said Garden Grove Councilman Mark Leyes. “Now the state wants us to add things to it. What’s next? Adding vitamins or Prozac to the water? I don’t think it’s right.”

Leyes and other officials also worry that adding fluoride will result in higher water rates for customers. They argue that parents who want fluoride protection for their children can buy special toothpaste, drops or pills.

The fluoridation debate dates to the 1950s, when some critics including the John Birch Society asserted that fluoridation was a Russian plot to “weaken” the U.S. populace.

Huntington Beach and Fountain Valley began fluoridation in the early 1970s only after loud protests from opponents who wanted drinking water to remain “pure.”

Other cities such as Garden Grove and San Clemente considered adding fluoride but ultimately rejected the idea, despite overwhelming medical evidence that fluoride is safe and effective in preventing tooth decay and in strengthening tooth enamel among children.

Opponents in those cities called the process a blatant invasion of individual rights.

With fluoridation politicized, many water providers simply didn’t pursue the issue, said Dan Smith, manager of regulatory affairs for the Assn. of California Water Agencies, a Sacramento lobbying group.

Today the fluoridation debate in California is considerably more tame, revolving mainly around cost.

Los Angeles, the largest city in the nation without fluoridation, pledged in 1995 to start adding fluoride to the water that flows out of its 639,000 customers’ faucets. Officials said this week that fluoridation equipment will cost $10 million, and they still aren’t certain when the process will begin.

The bulk of water agencies in the state say that with less than 3% of household water used for drinking, fluoridating the water would cost too much. And since the state law leaves the decision about whether fluoridation is affordable up to local agencies, the movement has languished.

“It’s kind of a paradox for water system directors to be told to put something in the water that is a contaminant and that has nothing to do with maintaining the safety of the water supply,” Smith said.

“So some have difficulty accepting a state mandate to do it. They feel it should be left to the local community to decide whether ratepayers want their money spent in that fashion.”

Fluoridation costs about 54 cents annually per person, according to the California Dental Assn. But installing fluoridation systems is much costlier in California, according to the state Department of Health Services. That cost ranges from about $3 per household to as much as $453 per household, depending on whether water agencies need to purchase land for the fluoride treatment systems, according to state estimates.

“It is a very practical matter, a matter of cost benefit,” said Karl Kemp, general manager of the Mesa Consolidated Water District, which supplies water to Costa Mesa.

“A small percentage of the water supply is consumed by young people, for whom fluoride is important. Most water is used outside anyway.” Because the real fluoride benefit is to children’s teeth, “Our point of view is that all the money and all the effort that is being spent on fluoridation the water should be spent on outreach efforts instead.”