For Don Saylor, it's just common sense: Adding fluoride to drinking water in Davis and Woodland would improve dental health for 130,000 people, particularly low-income residents who can't afford regular health visits.
"This is a social justice as well as a public health issue," said Saylor, a Yolo County supervisor. "It's well past time to address this."
But a fight is brewing, particularly in Davis, where opponents say fluoridation amounts to a widespread medication of residents that harms people and the environment. While the county's health and education establishment has endorsed fluoridation, grass-roots activists are organizing the opposition effort.
As Davis and Woodland begin construction on their massive Surface Water Project, which will draw from the Sacramento River and include a joint treatment facility, both cities are considering whether to add fluoride to their drinking water for the first time.
Nearly three-quarters of Americans live in communities with fluoridated water, according to the Centers for Disease Control and Prevention, and fluoridation has been endorsed by U.S. surgeons general for a half-century.
Sacramento and, more recently, West Sacramento are among local cities that add fluoride.
Saylor wrote a nonbinding resolution in May supporting the movement to add fluoride to drinking water in Davis and Woodland once the Surface Water Project is completed. The resolution sailed through the Board of Supervisors on a 4-1 vote, with only board Chairman Duane Chamberlain voting against.
Sixteen local agencies and health care providers, including Yolo County's Health Department, Davis' and Woodland's school boards and hospitals support fluoridation.
"Dental care is out of reach for many," Saylor said. "There are still children who don't have access to care. Topical (fluoride) applications are expensive and require dental insurance."
Alan Pryor leads a Davis-based group, Davis Citizens Against Fluoridation, which has taken to the streets and to social media to oppose fluoride efforts.
"Fluoride is not a benign chemical. It would go down drains, into our parks and wetlands," Pryor told the city's Water Advisory Committee in May. "It's an extremely inefficient way to deliver medication to the public. We can do better than fluoridating water."
Pryor derisively calls fluoridation a "drug therapy" that contaminates water supplies and can lead to fluorosis – damage done to tooth enamel and bones by overexposure to fluoride.
The American Dental Association, which supports fluoridation, advises that fluorosis is typically mild and "does not affect the health of your child or the health of your child's teeth."
The battle lines were clearly drawn at a Davis water advisory committee meeting in late May.
Many in the near-capacity crowd wore decals that bore a "no" slash across a capital "F" for fluoride, their cause emboldened by the well-publicized defeat of a fluoridation initiative in Portland, Ore., earlier in the week.
They queued in long lines at the lectern. They came armed with handwritten notes and published research to describe fluoride's hazards. And they brought their voices.
"It's completely unnecessary to fluoridate water – it's not necessary to treat the whole water supply," said Joannie Siegler, a Davis nutritionist, at the water committee meeting. "We need to be more creative from a public health standpoint. This is a huge waste of time, money and infrastructure."
Though the costs of adding fluoride to Davis' water supply have yet to be determined – a cost analysis is expected at the end of the month – Pryor said money would be better spent providing dental care to communities that need it.
He proposes a 1 percent excise tax on Davis water bills, with money going to the Yolo County nonprofit CommuniCare network of community clinics and outreach. The health network provides medical, dental and other services in Yolo County.
"That would do a better job of serving the needs of disadvantaged communities," Pryor said. "No doubt we have a dental health crisis in Yolo County. The real problem is a lack of dental health care in disadvantaged communities."
Fluoridating drinking water has been named one of the 10 great public health achievements of the last century in the United States by the federal CDC and is credited with vastly improving oral health for millions around the world.
Saylor and other local fluoride proponents say decades of science and public health gains, near-universal support from the nation's health community and fluoridation's wide reach should be enough to compel residents to support it.
"When you have the entire public health, medical and dental communities saying it's a no-brainer, this isn't something that's recently come along," said Dr. Michael Wilkes, a UC Davis medicine professor and chairman of the Yolo County Health Council.
"Fluoride, at the end of the day, is a public health issue," Wilkes said. "At its core, it's a social health issue. Those who benefit most are people with the least access to dental health."
Fluoridation has gone before Davis and Woodland voters in the past – 1956 in Woodland and 1960 in Davis, according to news reports – but both efforts were defeated.
Both cities continue to rely on networks of wells for their water supplies. Proponents say the more centralized Surface Water Project will make it easier to add fluoride to the cities' water.
In Woodland, reaction to fluoridation appears to be more muted. But Woodland Mayor Skip Davies at a May 7 City Council meeting said any decision to add fluoride "will not only be a health decision, but an economic decision that fits our community."
"Each community is going to have to decide whether the costs of fluoridation are worth it to the community," Woodland councilman and dentist William Marble, a staunch advocate of fluoridation, told The Bee.
"From a public health standpoint, I've studied this for a lot of years. I've read reams of research and I'm convinced the benefits are real," Marble said, adding dentists "know the good it can do."
But Pryor said fluoride opponents have rallied around Portlanders' recent rejection of fluoridated water in that city and predicts a similar result in Davis if residents get to decide.
"This is far from a fait accompli. All you have to do is look at Portland," Pryor said. "We're going to see the same outcome if it comes to a vote."
Call The Bee's Darrell Smith, (916) 321-1040.