PD Editorial: Let's fluoridate our water now

In our editorial Friday ("The Problem: Our dental crisis"), we detailed the deteriorating state of oral health in Sonoma County, particularly among low-income children. As the county Task Force on Oral Health notes in its final report - to be presented to the Board of Supervisors on Tuesday - the county is experiencing "a staggering burden of suffering and a growing oral health divide between rich and poor."

The good news is that many of the solutions to the county's dental crisis are within our grasp.

Some of the task force's recommendations are already in the works, including expanding public-private partnerships to reach more people, particularly in low-income areas. Other efforts include opening up more community-based facilities - existing health centers, the Santa Rosa Junior College, etc. - to create more dental clinics. Vista Health Center in northeast Santa Rosa, for example, is looking into opening a clinic. The Petaluma Health Center has launched a WIC (Women, Infants and Children) Dental Days and will soon be starting a version of the successful Mommy and Me program, sponsored by the St. Joseph's Foundation.

Meanwhile, health care leaders, including the Sonoma County Medical Association, are embracing the need to encourage primary care physicians to include oral health assessments as part of their regular patient visits.

All of these measures are needed and should be pursued. But all of them pale in comparison to the single most cost-effective way that Sonoma County can combat its dental crisis - by fluoridating our water.

The Centers for Disease Control and Prevention has recognized water fluoridation as one of the "10 great public health achievements of the 20th century," ranking in importance with the advent of seat belts and birth control and the recognition of the dangers of smoking. And yet Sonoma County lives in the dark ages on this critical public health issue.

Adding fluoride to public water supplies has been going on for more than 65 years, and the number of communities that are embracing the idea continues to grow. Today, 72.4 percent of the nation's population - or nearly 200 million people - served by public water systems are receiving fluoridated water. More than 8 million live in areas where their drinking water is naturally fluoridated. And yet in Sonoma County, only the residents of Healdsburg and the adjacent Fitch Mountain area benefit from fluoridation.

The health benefits are widely documented. The American Dental Association has called water fluoridation "the single most effective public health measure to prevent dental decay." In areas such as the North Coast where there is already widespread availability of fluoride - from toothpaste and other sources - studies show fluoridated water would reduce tooth decay 20 to 40 percent.

It's also the most cost-efficient way of addressing this kind of community-wide challenge. The average cost of fluoridating water in areas of large population is roughly 50 cents per person per year. Even if it turns out to cost twice that, studies show that every $1 invested in water fluoridation ends up saving $38 in dental treatment costs.

Nationwide, those without dental coverage now outnumber those without health care insurance nearly three to one. Meanwhile, government agencies at all levels are slashing budgets, leaving them with fewer resources to confront this kind of crisis.

Given all that, fluoridating our water supply is the best hope for addressing what has been identified as Sonoma County's No. 1 unmet health need for children.

So what's the hang-up?

In a word: fear. The issue of fluoridation is often mired in refuted claims of dire health risks, fears based on mumbo jumbo science. But in an era of distrust, they succeed in paralyzing decision-makers and blocking meaningful progress.

The only real health concern is fluorosis, which is caused when someone consumes too much fluoride, possibly resulting in staining and pitting of the tooth surface. Severe fluorosis is rare in the United States. Nevertheless, concern about fluorosis is one of the reasons the U.S. Department of Health and Human Services and the Environmental Protection Agency recently announced a reduction in the recommended level of fluoride in drinking water from 0.9 parts per million to 0.7 parts per million. The lower levels still provide the health benefits of fluoridation, while abating public fears about fluorosis. The net benefit for Sonoma County is that it will make the cost of fluoridating less expensive.

To put this in perspective, 1 part per million of fluoride is equivalent to 1 inch in a 16-mile journey -- an extremely small amount. But all journeys begin with a single step. Sonoma County needs to take this one.

Fortunately, county health officials have already been heading down this road. They're planning to work with the Sonoma County Water Agency this year in identifying the steps and costs that will be needed to fluoridate the county's water.

But this issue has been debated for years and progress has been slow. An update on the local cost of fluoridation isn't expected to come before supervisors until January 2013.

This process needs to be put on a faster track. It's clear Sonoma County can't afford an alternative - and its children can't afford to wait any longer.

It's time to fluoridate.