n 2007, when I served as Chairman of the First 5 Commission (Commission), I directed staff to explore the potential of investing in community water fluoridation as a way to improve oral health of local children. On November 5, 2007, after several months of research and community input, the Commission voted unanimously to allocate $5,670,137 for community water fluoridation. This action designated funds to water districts in San Diego County to construct and equip facilities, and for related costs to operate and maintain the equipment for the purpose of fluoridation.
The Commission designated the City of San Diego to be the first water district to receive funds to implement community water fluoridation, as it is the municipality that serves the largest number of children ages 0-5 in San Diego County. The Commission offered the City of San Diego full funding for the purpose of fluoridating its public water supply. These funds will support the costs of the capital equipment required, and up to two (2) years of operations and maintenance expense.
Shortly after we began this mission to fluoridate the city's water, the Commission found a new partner, The California Endowment, to help implement community water fluoridation in San Diego County. On February 14, 2008, The California Endowment awarded the Commission a grant in the amount of $1,000,000 for this purpose, increasing the total amount of funds available for this project to $6,670,137.
The Commission and The California Endowment are making this large investment in fluoridation because tooth decay is one of the most common and preventable diseases in infants and young children. Yet many children in San Diego County, and throughout California, suffer from this chronic infectious disease. A recent study conducted by the Dental Health Foundation found that by the time California children enter kindergarten, more than half have already experienced dental decay, 28 percent have untreated decay and 19 percent have rampant decay. Only 55 percent of two to five year olds in San Diego County have ever had a dental visit and 28 percent do not have dental insurance. Data from Rady Children’s Hospital suggest that approximately 150,000 pre-school children in San Diego County suffer from early childhood dental disease.
The U.S. Surgeon General reports that community water fluoridation remains one of the great public health achievements of the 20th Century. Community water fluoridation is the most cost-effective dental disease prevention program available, especially for large, multiethnic populations with disparities in health conditions. Decades of studies demonstrate that fluoridation contributes to the lasting protection of the tooth, and that water fluoridated at the optimum level is safe and effective in reducing cavities, especially among young children.
Legal Considerations
California Health and Safety code section 116410 requires all water districts to fluoridate its water supply where funds are offered to cover the capital costs and one year of operations and maintenance. This State legislation is preemptive of any local ordinances, regulations or initiatives. It is the intent of the First 5 Commission of San Diego County to provide the City of San Diego Water Department with sufficient funds to trigger the provisions in this law.
Status of Community Water Fluoridation in San Diego County
Several water districts serving the San Diego County region purchase treated water from the Metropolitan Water District of Southern California (MWD); most of the residents served by these water districts already receive water with optimal levels of fluoridate.
The City of San Diego is the largest municipality in the country without fluoridated water. Some of the City’s water has natural fluoride elements and/or fluoride added by a water supplier prior to its distribution to the City’s water treatment plants. This creates a situation where the City’s water has varying, suboptimal levels of fluoride throughout its water supply. As a result of this irregularity, parents are not able to determine the amount of fluoride their children are ingesting on a day-to-day basis. Parents who use fluoride supplements to safeguard their children’s teeth run the risk of administering too much fluoride to their children, which can contribute to a condition called dental fluorosis that may affect the appearance of children’s teeth.
Dental health professionals and community stakeholders recommend that the water supply throughout San Diego County be treated with optimal levels of fluoride. This is the best way to minimize the risk of fluorosis and ensure consistent, optimal levels of fluoridation throughout the region, maximizing the benefit for children.
What is the First 5 Commission?
The First 5 Commission of San Diego County was established by the California Children and Families Act (Proposition 10), passed by California voters in November 1998. This statewide ballot initiative imposed an additional tax on all tobacco products. The revenue generated from this tax is used to fund programs and activities that promote early childhood development from the prenatal stage to age five. The Commission is responsible for implementing the Act in San Diego County. The Commission’s vision is that every child in San Diego County will enter school ready to learn.
