In this Share & Learn session, you heard more about best practices in working with communities on water fluoridation, drawing from the California Fluoridation Manual, published in 2022 and available on the COHTAC website. Marjorie Stocks and Howard Pollick shared their many years of experience with several different communities in initiating and maintaining fluoridation in California. They were joined by Mark Bartson, who has many years of experience with the California State Water Resources Control Board, and representatives from a few local oral health programs (LOHPs) who spoke about their experiences with community water fluoridation efforts.

Learning objectives:

1. Recognize how community water fluoridation can prevent tooth decay and improve oral health.
2. Understand how to access and use the California Fluoridation Manual.
3. Use effective communication techniques to educate their community about water fluoridation.
4. Develop an advocacy plan in support of fluoridation.
5. Understand best practices when creating partnerships with water professionals/districts.

Speaker bios

Slides

Recording (1:31:08)

Q & A: 

1. Questions from Bureau Chief, "are any grants available to the cities for converting to fluoride additions to the public tap water and for ongoing maintenance? Any public education available about this topic? Is Howard Pollick available to counties to get his 1:1 help if they are mounting a campaign to get water fluoridation in a city?" Howard and his colleagues are available to assist communities in mounting a campaign. Email [email protected] to get connected to Howard, Marjorie, and Mark. 
2. What is it exactly that goes into the water supplies to achieve the optimum levels? I was told it is a chemical and that's not good, didn't know how to answer. Thank you. I have heard your concern before about chemicals. Of course there are so many different kinds of chemicals. Table salt, sodium chloride, is a chemical. Sodium fluoride is a chemical that is used in fluoride toothpaste. There are three different fluoride additives that are used for water fluoridation, depending on the type of equipment that the water district uses. Each additive releases fluoride ions that are exactly the same as what there is in toothpaste. Another consideration to add: it is a form of a mineral.
3. To fluoridate water systems, who foots the costs for implementing and maintaining fluoridation? What are initial start-up costs like and what is needed to maintain? First the community has to agree that they want fluoridation. Start-up costs should not be considered initially because they can seem unsurmountable. But when the community has agreed that CWF is the best option to address the oral health problems, then funding agencies can be approached.
4. Have water systems with over 10,000 service connections that are not fluoridated been identified across California? Those systems were identified in the 1995 legislation. We are working on getting an update where there is population growth.
5. Many of these fluoridation areas are in urban settings. It seems the Ag industry is a major opponent to fluoridation in rural and agricultural counties. What efforts have been done to address the industry's concerns? There are some counties where the water suffers from agricultural runoff and people don’t drink that water. We are not considering trying to fluoridate those contaminated water systems. Opposition to fluoridation comes from various entities. We may not be able to overcome opposition in all circumstances.
6. Are there any studies about impact of fluoride on agriculture? Howard published some time ago on this topic: https://www.tandfonline.com/doi/abs/10.1179/oeh.2004.10.3.343. Also available at https://americanfluoridationsociety.org/wp-content/uploads/2017/05/e-Water-Fluoridation-and-the-Environment-Pollick-Int-J-Env-Health-2004.pdf. 
7. Can you share any updates on the pilots with the new fluoridation tablet system for smaller water systems? KC Industries that started the F tablet system have withdrawn their involvement due to lack of funding. The three pilots in other states ran into administrative and technical problems. There may be opportunities to adjust the tablet system in the future.
8. Does the filter in our fridges filter out fluoride? Almost all refrigerator filters use carbon/charcoal or kinetic degradation fluxion, so they do not take out fluoride. Reverse osmosis filters do, but they are much more expensive.