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Brush to Judgment

Sonoma County officials consider community fluoridation— needless to say, there's opposition

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F NO Anti-fluoridation protesters in San Francisco make their views known.
  • F NO Anti-fluoridation protesters in San Francisco make their views known.

Do you realize that fluoridation is the most monstrously conceived and dangerous communist plot we have ever had to face?

That's a line from Dr. Strangelove— and if you thought fluoridation was an antiquated debate from a bygone era, you haven't learned to stop worrying and love the fluoridation.

Sonoma County is in the midst of a contentious process that could lead to the fluoridation of its drinking water. But wasn't this debate settled years ago? Apparently not.

A county fluoridation advisory committee is tasked with making a recommendation on "community fluoridation" to the Sonoma County Board of Supervisors, which would be done through the Sonoma County Water Agency (SCWA).

Flouridation, proponents say, will help fight tooth decay in a county where studies have found at least half the kids in need of better dental care. Opposing views, to put it mildly, run strong.

Judith Iam is a Sonoma County fluoridation opponent who cites what she calls "the precautionary principle," which says that "if there's any reason where something might give one pause, don't do it. Find another way to do this." She agrees with the goal—preventing kids from having tooth decay—but argues that "there are direct ways to do that without medicating everybody.

"There are lots of studies," she adds, that link fluoridation to "thyroid, bone and brain issues. I don't want any of that." Iam additionally cites costs to the county to study an issue that she says should be dead and buried.

Even as nearly three-quarters of Americans consume fluoridated water, strong viewpoints over community fluoridation render the issue as controversial as anti-vaccination activism, one of those intersections in American civic discourse where left meets right.

Opponents cite health hazards associated with fluoride—fluorosis, calcified glands, thyroid disease. More libertarian-minded opponents say they are being force-fed a drug against their choice.

Proponents say it's a mineral additive, not a drug, and one of the most common substances on earth. Like salt or vitamin A, they argue, you need fluoride, but too much of it can be toxic.

"It's effective, cost-effective and it's very safe," says Sonoma County Health Officer Dr. Karen Milman. "The more detailed reviews don't show negative health impacts. Both sides of this issue are concerned about health—we're all concerned."

Milman says that she respects opponents of fluoridation but believes that many offer "a values or belief argument over a science argument. It's a very passionate issue."

Fluoridation is a class and a cultural issue in Sonoma County. The county website heralds the benefits of fluoridation and highlights that the county's poorest residents, many of them Latino, have poor dental health. The biggest direct benefit, says Milman, would be in Santa Rosa, where the infrastructure would make it possible to give a full fluoride dose to residents. But residents around the county would benefit, she says.

The county is deep into a multi-year effort to provide enhanced dental health through community dental clinics and other measures. The final pillar is fluoridation, says Milman.

Here's some of the backdrop: In 1996, California lawmakers passed AB 733, which set the stage for today's fight over fluoridation. That law said that any water district with more than 10,000 hookups had to introduce fluoride into the water supply—but only if it could pay for it without passing the cost to consumers. Critics noted that the bill was essentially a voluntary fluoridation program with a huge loophole that places like Sonoma County jumped through.

But now, even if the supervisors vote in favor of fluoridation, the county would first have to commission an engineering study to figure out how to do it. County officials estimate fluoridating the water will cost upwards of $600,000 annually. They don't even know if flouridation's going to be enacted here, let alone how they'll pay for it.

"We're not there yet," says Milman. "The county board of supervisors is still assessing whether this is feasible and whether to go forward with it."

In 2006, Milman says, California ranked 48th out of 50 states when it came to statewide fluoridation. Between 2008 and 2013, California's fluoridated water supply jumped from 27 percent to 58 percent, according to the Centers for Disease Control and the California State Health Department.

Regionally, San Francisco and Oakland both fluoridate their water. Napa County does not. Santa Rosa and Cotati get water from the SCWA, and Cotati is on record in opposition to fluoridation. But local opposition may be moot. A 2004 amendment to the flouridation law would supersede local anti-fluoridation laws.

The fluoridation battle lines are hardening. As the county continues with its studies, the advocacy group Clean Water Sonoma-Marin is gearing up for the long fight ahead. They're crowdfunding an appearance by a former government scientist, who'll speak to the danger of fluoride in April. There's no timetable from the county about when it might come to a decision, says Milman.

Correction: This article originally stated that California passed further flouridation legislation in 2006 that would restrict localities' ability to ban flouridation. That legislation was signed in 2004.

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