History of Community Water Fluoridation in
California: Lessons Learned
Ernest Newbrun DMD, PhD.Professor Emeritus
University of California San Francisco
Presented to Division of Dental Public, UCSFJanuary 28, 2020
North American Clinical Trials to Test Efficacy of Controlled Water in Children Aged 12-14
San Francisco Water DistrictCommunal Water Fluoridation
1951 Spring SF Board of Supervisors unanimously requested water department to take steps to fluoridate. Appropriated $40,000.
1951 Fall communal water fluoridation referendum place on ballot to SF residents
56% favored fluoridation44% opposed fluoridation
1952 August SF commenced water fluoridation supplying fluoridated drinking water to 871,844 consumers in San Francisco & San Mateo Counties
10 years’ dental caries experience of children in Antioch, California 1952-1962
Stadt et al. California’s Health 1964 21: 24
California Water Systems Fluoridating in 1950s
Healdsburg, California Fluoridation Referenda 1952, 2014, 2016
Santa Rosa Fluoridation referendum
year pro fluoridation opposed fluoridation
1952 1241 43% 1662 57%
CWF was defeated by only 421 votes yet that community has been denied
the benefits ever since!
California Water Systems Fluoridating in 1960s
California Water Systems Fluoridating in 1970s
East Bay Municipal Utility District fluoridation referenda 1960 to 1980
Cartoon depicting
the cowardice of LA City
Councilmen with a yellow
stripe down their backs
The fight for fluoridation never endsSept. 5, 1984 SF Supervisor Wendy Nelder suddenly renewed the fight against fluoride in water claiming CWF might cause AIDS. By 1983 a causative retrovirus, later named HIV, had been isolated from an AIDS patient.Opponents of CWF, lead by Supervisor Wendy Nelder, attempted to pressure the city’s board of supervisors to stop San Francisco’s 34-year old practice of fluoridating its water supply. Mayor Dianne Feinstein denounced Nelder’scharges as “off the wall.” The board voted to continue to support CWF based on the city health department’s report on the benefits and safety of fluoridation.
Mayor Dianne Feinstein and Supervisor Wendy
Nelder (1983)
Percentage of Californians served by community water systems receiving fluoridated water
Note that the X axis/ years is not drawn to scale/linear
Assemblywoman Jackie Speiernow Congresswoman Speier
Author of Assembly Bill 733 passed by California Assembly, Senate and signed by Governor Pete Wilson Oct 9, 1995.Jackie Speier has been described as “a legislator known for her courage under fire and her penchant for hard-hitting bills.”
1995 Passage of AB 733Feb. 22 Introduced by author, Assemblywoman Jackie Speier
(D-Burlingame)April 18 Heard in Assembly Environmental, Safety & Toxic Materials
Committee (Passed 7-5)May 31 Heard in Assembly Appropriations Committee (Passed
10-5)June 2 Heard on Assembly Floor (Passed 48-18)July 5 Amended and re-referred to Senate Health an d Human
Services CommitteeJuly 13 Heard in Senate Health an d Human Services Committee
(Passed 8-3)Aug. 28 Heard in Senate Appropriations Committee (Passed 8-3)Sept. 14 Heard on Senate Floor (Passed 22-10)Sept. 14 Heard in Assembly for concurrence on amendmentsOct. 9 Governor's signature
Percentage of Los Angeles County population on public water supplies receiving fluoridated
water (88 cities, >10 million population)
Maritza CabezasDDS, MPH
Dental DirectorLA County
National Oral Health
Conference 2014
Metropolitan Water District of Southern California
MWD supplies water to 19 million consumers in
6 countiesA consortium of 26 cities and water districts, it is a
regional wholesaler
San Diego County Water AuthorityImports ~ 67% of its water by pipelines
from Northern
California & Colorado
River
1.36 million people receive fluoridated water treated by San Diego Water Authority.
Healdsburg, California Fluoridation Referenda 1952, 2014, 2016
Lack of CWF in most of Sonoma County
__________
Based on 2012 Water Fluoridation Statistics from CDC
Lessons Learned
Referenda vs Governing body decisions
• Administrative bodies such as the LA City Council, the board of the Metropolitan Water District of Southern California and the San Diego City Council decided to fluoridate or continue fluoridation in the case of San Francisco Board of Supervisors.
• In USA from 1980-89 when CWF was being decided: 78 % of governing body decisions were in favor of CWF37 % of referenda on CWF were successful
SummaryCommunal Water Fluoridation is the most effective measure in preventing caries. We have reviewed the history, and lessons learned, of water fluoridation in California tracing referenda and decisions by administrative bodies. Progress was slow until a breakthrough when Assembly Bill 733, thefluoridated drinking water act, became law in 1995, thanks to the courage and persistence of then Assemblymember Jackie Speier (D-Burlingame). Morerecently, administrative bodies have exerted their authority to direct water agencies to fluoridate, thereby avoiding expensive and divisive referenda.
CONGRESSWOMAN JACKIE SPEIERA heroine in the fight for Communal Water Fluoridation
