Oral Health Without Fluoride

news2A look at the future of dental health in the wake of the Watsonville fluoridation debate

Ten years of debate over whether or not to add fluoride to Watsonville’s public water supply came to an end on Wednesday, Feb. 1 when the California Dental Association Foundation (CDAF) withdrew its promise to fund the fluoridation project.

“The CDA Foundation notified the City of Watsonville that its planned fluoridation facilities were too costly to be accomplished within the required time frame,” Alicia Malaby, director of communications for CDA, writes in an email to GT. She goes on to say that the foundation would have had the funding necessary if the bids came in at $1.6 million, the estimated cost determined by the original design firm. “Unfortunately, construction bids were significantly higher and additional funding could not be secured within the time frame of the contract,” she adds.

As Watsonville moves into a fluoride-free future, opponents and proponents of fluoride find some common ground in looking to the possibilities for Watsonville’s oral health. While remains of the argument over the effectiveness, safety and necessity of fluoridating the public water supply are still present between Watsonville residents, all agree that the next step toward dental health is to focus on the city’s alternatives to fluoride.

Laura Marcus is executive director for Dientes Community Dental Care, one of two low-income dental clinics in Santa Cruz County. Marcus has been active on the pro-fluoridation side of the debate for years and considers it to be the most viable, cost-effective way to promote dental health. However, she has invited some of the most vocal fluoridation opponents in the region to sit down with Dientes and discuss what’s next for dental care in Watsonville. These opponents include members of the group Citizens for Safe Drinking Water (CSDW), which is vocally anti-fluoridation, and John Martinelli of local apple juice and cider company S. Martinelli & Co.

 “Whatever side you stand on, the bottom line is we have a really serious problem in this community and we don’t have a good solution,” Marcus says. “So, fluoridation isn’t going to be a solution we see anywhere in the near future. What are we going to do to help the community so that we don’t see the disease and the infection and the kids missing school, etc., etc.? We’re smart people around the table. I think we can come up with some good solutions.”

The question at hand, she says, is “How, as a community, can we support preventative efforts since the cheap, effective option is not going go through right now?”

David Kennedy, former president of International Academy of Oral Medicine and Toxicology, a nationally and internationally recognized lecturer on toxicology and restorative dentistry as well as a practicing dentist for 20 years, now works with the anti-fluoridation group CSDW. He sees the fluoridation project falling through as a good thing.

“Fluoridation has no beneficial impact on tooth decay so it is a total waste of money,” he says, “Many areas with long-term fluoridation suffer with chronic high tooth decay and early childhood caries crisis. It is a fake oral health program that causes mottled teeth that stain rapidly.”

While Kennedy and CSDW do not agree with Marcus that fluoridation is the “cheap, effective option” to prevent tooth decay, they can agree on some things. Jeff Green, national director for CSDW, also says education and prevention are the most important steps Watsonville can take at this time.

Green has owned and operated his own consulting firm since 1972, where he has provided services to more than 400 dentists and other health professionals and has been vocal in fluoridation debates in Santa Cruz County “from the beginning.”

“We don’t believe the [CDAF] would put up any money to provide dental care,” he says. “That’s one thing they could do if they had those millions of dollars, they could certainly hire dentists if they wanted to, but more importantly we think they could incorporate public policy. My question to the city council would be, why haven’t they instituted any other public policies to prevent the increase in tooth decay?”

According to Kennedy, the most effective ways to prevent tooth decay are “… daily oral hygiene with a Bass brush, and to remove sugar and food from the hallways of schools.”

The issue that emerges in educating and providing dental tools to the public is primarily monetary for clinics like Dientes.

“How do we serve the needs of tens of thousands of children when our public health system has cut every education prevention program?” asks Marcus. “Whether it’s oral health, behavioral health, for everything preventative, the money is gone. We’re treating disease instead of addressing education beforehand so we prevent disease.”

Though the budget is tight, Marcus says throughout the fluoridation debate, Dientes was working on other ways to increase prevention of and education about dental issues for the community.

For example, Dientes partnered with Second Harvest Food Bank to distribute 10,000 hygiene packets that included toothbrushes, toothpaste, floss and basic oral health informational sheets in Spanish and English once a quarter at Second Harvest’s various locations.  

Looking to the future, Dientes and the county’s other low-income dental clinic, Salud Para La Gente, are working together to improve their oral health programs and determine ways in which the two organizations can provide more care to more people.

“Sixty-thousand people in the community need a source of dental care, and Salud and Dientes together see about 20,000 of them,” says Marcus. “So there’s a huge need that’s still unmet. We’ve been talking about somehow collaborating in the school-based health clinics, and community programs going out to neighborhoods, working with people in their own homes that can help teach health programs.”  

Marcus says another idea Dientes has for the future is to seek help with oral health education from primary health care providers in the community.

“I don’t care about what you think about fluoridation,” she says. “What I do care about is what you think about oral health and making sure that the public realizes how important it is that everyone, including poor people and poor kids, have access to the dentist.”

Photo: Keana Parker

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