• Place:Zoom (registration required)
  • Time:10 - 11:30 AM PDT
  • Date:

In this Share & Learn, we built on previous webinars on community water fluoridation and the California Fluoridation Manual. UC San Francisco’s Fluoride Team presented on community water fluoridation, including fluoride misinformation, issues with prior studies, and recent evidence on its benefits and safety. Sacramento County’s Local Oral Health Program (LOHP) shared communication strategies for navigating a shifting fluoride landscape. Presenters also shared practical outreach tools and resources to strengthen community and partner engagement. The session concluded with a Q&A featuring fluoride experts. 

Learning objectives: 

  • Describe recent evidence, controversies, and public perceptions related to community water fluoridation. 
  • Identify communication strategies, tools, and resources to support community water fluoridation efforts.
Speaker Bios

Susan Fisher-Owens, MD, MPH, FAAP Professor of Pediatrics, UCSF School of Medicine, Professor of Preventive and Restorative Dental Sciences, UCSF School of Dentistry, Chief Consultant, California Fluoride Susan Fisher-Owens, MD, MPH, FAAP is Clinical Professor of Pediatrics at the UCSF School of Medicine and Clinical Professor of Preventive and Restorative Dental Sciences at the UCSF School of Dentistry, in San Francisco California. Clinically, she works as a primary care pediatrician and faculty preceptor. She spends the remainder of her time serving as a children's oral health advocate and researcher, working with medical providers to increase their knowledge and interventions in oral health and with dental professionals to increase their understanding and application of contextual factors to care, and working with children. Her paper on "Influences on Children's Oral Health: A Conceptual Model” has led to other work being conducted to investigate and reduce oral health disparities and improve care, and "Primary Teeth," the clinical program she started to introduce oral health care into the pediatric practice setting, was recognized with the Academic Pediatric Association's Health Care Delivery Award in 2011. She served on the American Academy of Pediatrics National Section on Oral Health, and is lead author of an upcoming AAP clinical review on this Adolescent Oral Health. 

Marjorie Stocks, MPH Consultant, California Fluoride Marjorie Stocks, MPH, directed the California Fluoridation Implementation Project, a statewide endeavor funded by a $15 million award from The California Endowment, through which she assisted over 10 California communities in implementing fluoridation including Sacramento, Los Angeles, Santa Monica, and the Metropolitan Water District of Southern California. As a Fluoridation Consultant for the California Dental Association Foundation, Ms. Stocks collaborated with local advocates to achieve fluoridation in the City of San Diego and the Santa Clara Valley Water District serving the San Jose area. Currently, Ms. Stocks works with the California Department of Public Health, Office of Oral Health on contract at the University of California San Francisco. Ms. Stocks is an author of the California Fluoridation Manual. 

Jennifer Fitzpatrick, BSDH, RDH Dental Health Program Coordinator, County of Sacramento Jennifer Fitzpatrick is a Registered Dental Hygienist with 25 years of experience who transitioned from clinical practice to public health 17 years ago. She currently serves as Health Program Coordinator for the Local Oral Health Program in Sacramento County, focusing on prevention, education, and community partnerships. Since 2021, she has led the region’s community water fluoridation promotion efforts to advance oral health equity. 

Slides - available upon request

Recording (1:21:50)

Links and resources shared:

Q&A: 

  1. A topic that has been coming up a lot in our county has been around the California Welfare Institutions Code 1700. This requires indigent care, largely forgotten about with the expansion of Medicaid. However, due to HR1 there are concerns that our county would have to cover costs for certain populations, for example, the costs of emergency dental care. Is there any data or information about the costs of dental emergency care (i.e., how much a county may be expected to pay in dental emergency care)?  
    • A CareQuest report, Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions, found that the average cost of an emergency department visit for non-traumatic dental conditions was $2,437. 
    • The ADA Emergency Department referrals page states that emergency department visits for dental pain can cost $400 to $1,500, compared to $90 to $200 for a dentist visit. 
    • The ADA Health Policy Institute issued the following research brief: State-Level Costs of Removing Fluoride from Community Water Systems. This brief estimates the increased dental care costs of removing community water fluoridation (CWF) for the 50 states and DC. 
    • HCAI published Oral Health Professional Supply and Non-Traumatic Dental Emergency Department Visits, which summarizes 2023 dental-related emergency department visits and expected payers for emergency department visits by California counties.
    • There is data regarding how much money per person can be saved through community water fluoridation. An economic analysis found that CWF can save an average of $32 per person a year by avoiding treatment for cavities (this number can be adjusted for inflation for current numbers). These are clear savings to the community once CWF is in place; it doesn’t include the initial investment in fluoridating the system. One opportunity among LOHPs currently without access to appropriately fluoridated water is to consider some of the other ways to implement fluoride interventions. Over the years, you can build on getting people more comfortable with the concept of fluoride and its benefits, and richen the soil to plant the seed about water fluoridation. That may be a softer approach than going straight to CWF. 
  2. Was there a change in IQ after Calgary stopped fluoridating? Multiple studies have found no evidence of CWF being negatively associated with IQ/cognition: