Cal Communities Rejecting Fluoridation: A to Z

California Water Districts and Communities Rejecting Fluoridation: A to Z

Crescent City Harbor - Photo by Robert Campbell, US Army Corps of Engineers Digital Library
Crescent City Harbor – Photo by Robert Campbell

The names of water districts on the CDPH Water System Priority Funding Schedule  are colored blue. Communities and water systems that rejected fluoridation at some time in the past, but are now fluoridated, are marked with a red X.

Santa Cruz (12 on the priority funding schedule), San Diego (18 on the priority funding schedule), and Sunnyvale (81 on the priority funding schedule), are communities whose local regulations on water fluoridation (all in place since 1999) are in conflict with State fluoridation regulations.

California Communities Rejecting Fluoridation [1952-2015]: An annotated list in alphabetic order

Bertsch Ocean View Community Services District, Del Norte County: Fluoridation ended through a decision by Bertsch District’s water supplier (2013). All Bertsch District water is provided by Crescent City, therefore when Crescent City stopped adding fluoridation chemicals to its water, per ballot measure A (11/6/2012),  Bertsch District no longer received fluoridated water (11/8/2012). SOURCE: California Department of Public Health Drinking Water Program 2013 Annual Fluoridation Report [PDF].

Cotati, City of, Sonoma County: Rejected fluoridation (11/12/2013) in a unanimous vote of the City Council, after watching and discussing presentations on both sides. The Council followed its decision with a letter to  the Sonoma County Board of Supervisors, advising the Board of its decision. Reasons: there are more cost effective ways to provide dental care; fluoride works topically, no need to ingest; inappropriate to prescribe a medication by approving fluoridation; individuals deserve to decide for themselves. SOURCES: ;

Crescent City, Del Norte County: Placed a moritorium on water fluoridation (11/6/2012). Ballot measure A, passed with 56% of the vote, mandated “a moratorium on water fluoridation…until conditions are met by the fluoridation chemical manufacturer.” These conditions are: “to provide to the public toxicological reports,” “a list of contaminants and amounts,” and “a written claim for safety.”

Davis, City of, Yolo County: 136 on the CDPH fluoridation priority funding schedule. Rejected fluoridation (10/01/2013) in a 4 to 1 City Council vote. Davis has rejected fluoridation attempts before. Its 5th rejection of fluoridation was on 12/14/1990.

X – El Cajon, City of, San Diego County: City Council resolution (4/27/1999) to support the safe drinking water position taken by Helix Water District, which services their community. Helix is now fluoridated.

X – Escondido, City of, San Diego County: 4 on the CDPH fluoridation priority funding schedule. Rejected fluoridation (03/1999) when the City Council passed an ordinance  prohibiting the addition of any substance to the water, including fluoride, that is intended to treat humans, rather than improve the drinkability of water. In spite of an unresolved lawsuit, the City of Escondido water began water fluoridation in 8/2004. “About 75 percent of Escondido will receive the fluoride-treated water. Residents who receive water from a supplier other than the city – such as the Rincon Municipal Water District, Valley Center Municipal Water District and Vallecitos Water District – may not.” SOURCE:

XHelix Water District, San Diego CountyNumber one on the CDPH fluoridation priority funding schedule (1998). Helix rejected fluoridation (4/7/1999), but Helix water has been fluoridated since 12/2007. Helix Water District supplies approximately 250,000 customers in the east San Diego county cities of La Mesa, El Cajon, Lemon Grove, and parts of Spring Valley. Other water districts, Otay Lakes and Padre Dam Municipal Water District (15 on the fluoridation priority funding schedule), are affected, because they receive water from Helix, and they, in turn, supply water to the Riverview Water District and Lakeside Water District (see Lakeside below). HISTORY: By unanimous vote (4/7/1999), the Board of Directors of Helix Water District directed its staff to advise the California Department of Health and Human Services, a fluoridation task force coalition, and the other water agencies and communities that Helix serves, that Helix will reject any grant offered them that would require that fluoride be added to Helix water. Helix Water District Directors gave their individual reasons for  rejecting water fluoridation, including “that the mission of the District is to remove impurities by treating the water, not to add to impurities, or to medicate people.” the Helix fluoridation program began in 12/2007, in conjunction with the start of fluoridation in Metropolitan Water District (MWD). In 5/2009, the Helix board “authorized staff to continue fluoridation as long as San Diego County Water Authority (SDCWA) and MWD continue fluoridation.” /   SOURCES: Helix Fluoride FAQ, ; California Department of Public Health Drinking Water Program 2013 Annual Fluoridation Report [PDF].

Hoopa Indian Reservation (Humboldt County) / (11/21/2013) Fluoridation stopped by unanimous vote of the Hoopa Tribal Council, just weeks into their new terms. Murphy Lott, senior water treatment operator for the local Public Utilities District, said, “…I agree with that decision.” SOURCE:

Humboldt Bay Municipal Water District, Humboldt County: In 2009, HBMWD “scrapped looking into whether or not it would be the regional provider for fluoridated water.” DETAILS: “During a packed regular meeting of its board of directors…the board voted 4-1 to cease consideration of adding fluoride to the drinking water of its customers, which include several community service districts interested in adding fluoride. Although the board had previously considered holding a public hearing…HBMWD General Manager Carol Rische said …that hearing is moot, and won’t be scheduled because there wouldn’t be enough votes to approve the fluoridation anyway. According to a report released several weeks [before,] from the district’s consultant hired to estimate the costs, fluoridating the drinking water is projected to cost HBMWD $325,000 for construction and another $46,000 per year in ongoing costs. HBMWD’s board of directors was asked to look into the matter at the request of at least one of it customers, the McKinleyville Community Services District, whose elected board express interest into adding fluoride. While the Fieldbrook Community Service District and Humboldt Community Services District have also expressed interest in providing fluoride, the Manila Community Service District put the matter to voters last year and the measure was overwhelmingly defeated.” SOURCE:

X – Lakeside Water District, San Diego County / Rejected fluoridation (4/6/1999), but as of 2013, CDPH reports Lakeside as fluoridated. SOURCE: California Department of Public Health Drinking Water Program 2013 Annual Fluoridation Report [PDF].

X La Mesa, City of, San Diego County / City Council rejected water fluoridation (3/9/1999) in a unanimous resolution stating that it opposes the fluoridation of its citizens, and requesting that Helix Water District ensure “…that every means available and necessary is used to vigorously oppose putting fluoride in the water supply.” La Mesa receives its water from Helix, which CDPH reports as fluoridated. SOURCE: California Department of Public Health Drinking Water Program 2013 Annual Fluoridation Report [PDF].

X – Los Altos Hills, Town of (Purissima Hills Water District)Santa Clara County: Rejected fluoridation in 1993, but receives its water from now fluoridated San Francisco (SFPUC). “Purissima Hills Water District receives 100% of its water supply…from the San Francisco Public Utilities Commission which delivers it to Los Altos Hills…” SOURCES: California Department of Public Health Drinking Water Program 2013 Annual Fluoridation Report [PDF] ;

Mammoth Lakes, Town of, Mono County: Rejected fluoridation (11/8/2005),  passing Mammoth Lakes’ Safe Drinking Water Initiative in a landslide vote of 72%. The Safe Drinking Water Initiative is a water quality criteria ordinance that prohibits any substance intended to treat people to be added to the public drinking water, unless it has been specifically approved by US FDA, for safety and effectiveness for the full range of human consumption, including approval for all adverse and cosmetic effects. In addition, contaminants of health treatment additives are now restricted to concentrations not to exceed California Public Health Goals, and U.S. Maximum Contaminant Level Goals (MCLG), the scientifically derived points of safety for lifetime ingestion. SOURCE:

Manila, Humboldt County: Rejected fluoridation (02/2008), defeating a proposal to fluoridate water provided by Humboldt Bay Municipal Water District (Advisory Measure A), in a landslide vote of 164 to 60 . Apart from Arcata and Eureka, where water is already fluoridated, Measure A would have fluoridated drinking water in Manila, Blue Lake, McKinleyville, Fieldbrook-Glendale, and Cutten. SOURCES: ;

Modesto, City of, Stanislaus County (Charter City): Rejected fluoridationin the defeat of Measure M, and in a vote of the Modesto City Council (11/7/2001)”to drop the idea of fluoridating tap water.” DETAILS: A majority of council members personally favored fluoridation for dental health, but acknowledged “convincing voter disapproval” in the voter defeat of Measure M by more than 60 percent of of the vote. If the measure had passed, the council would have been forced to fluoridate, but Measure M’s failure did not guarantee that the council would not fluoridate, which is the reason the council revisited the issue. The Modesto City Council formally rescinded its May 2000 order to fluoridate, rejecting $1 million in grants that would have paid for fluoridating equipment, and declined to raise water rates to pay for maintenance and supplies. BACKGROUND: In 2001, the City of Modesto was able to secure funding for capital equipment from the Fluoridation 2010 Workgroup. However, because Modesto did not have funding for the operation and maintenance of a fluoridation system, it was decided to bring the decision to a public vote on a 2% water rate increase to pay for ongoing maintenance and operation costs of fluoridating of Modesto’s tap water. The ordinance specified that unless operation and maintenance costs were secured, the city would not have funds to move forward capital equipment installation. Fluoridated water would have gone to an estimated 200,000 people, including about 35,000 outside the city limit who were barred from voting on Measure M. Residential water rates would have increased $7 or $8 a year. When Measure M failed, the Fluoridation 2010 Workgroup responded by withdrawing its funding offer to Modesto. SOURCES: ; OHCD_June_Board_Report [pdf]

Morgan Hill, City of, Santa Clara County: Rejected fluoridation (03/07/1990) on the independent initiative of City of Morgan Hill water department employees, who stopped ordering fluoridation chemicals for the seventeen groundwater wells that are the City’s exclusive source of water. SOURCES: 2011 Morgan Hill Water Quality Report (pdf) ; CDPH 2013 Annual Fluoridation Report (pdf) ;

Napa (City of), Napa County (Charter City): 17 on the CDPH fluoridation priority funding schedule. The Napa City Council unanimously rejected the Civil Grand Jury’s  recommendation that the city apply for grants to install fluoridation equipment in its three water treatment plants within six months (8/17/2010). DETAILS: Staff response was that the water department had projects of higher priority. In a staff report, Assistant Public Works Director Phil Brun noted that it would cost more than $1 million to adapt the water system for fluoride, yet the investment would benefit only a few, because less than 1 percent of city drinking water is actually consumed. Brun wrote, “Of this 1 percent, only a small percentage includes children that get the most benefit from fluoride in the water. Of that small percentage, an even smaller percentage is children that don’t get fluoride from other sources such as toothpaste and mouthwash. It would be more cost-effective to reach children who might benefit from fluoride through health and dental clinics.” As for the state mandating that the city fluoridate, the law imposes this requirement only if an outside source of funding can be found for a fluoridation system and operating costs, according to the city. “Water Division General Manager Joy Eldredge said, “We have plenty of things we need to invest in. If we’re pursuing grants, we would pursue them to fund some of our higher priorities,” such as treating the water supply with ozone, which breaks down pharmaceuticals and other contaminants that can end up in the water. The city’s water system is also deteriorating, with several major water mains breaking in 2011, Eldredge said. Last September, the city of Napa raised water rates for the next five years so it could invest $3 million annually in its aging water system. Eldredge said updating Napa’s water system to deliver fluoride would cost more than $1 million, according to a 2003 estimate, the latest available. She estimated maintenance and testing of the fluoridated water would cost $150,000 per year after that. SOURCES: ;

Olivehurst Public Utility (OPUD), Yuba County:  Rejected fluoridation (2/22/2013). OPUD Board of Directors voted 3-2 to stop adding fluoridation chemicals to District water, citing potential health concerns. The vote came four years after OPUD approved fluoridation based on a local grant  to improve children’s dental health. SOURCE:

Plumas Lake, City of, Yuba County: Water fluoridation ended in Plumas Lake because its water provider OPUD voted to stop. The OPUD rejection was supported by dozens of Plumas Lake residents, who asked OPUD to remove fluoride, citing shared health concerns” (2/22/2013). SOURCE:

Redding, City of, Shasta County: 76 on the fluoridation priority funding schedule. Rejected fluoridation (11/5/2002) in a vote of the people. HISTORY: Citizens for Safe Drinking Water circulated a ballot initiative petition to reject adding fluoridation chemicals to Redding tapwater, gathering 4,270 valid signatures supporting the measure, qualifying the proposal for council adoption or a general election. CITY GOVERNMENT RESPONSE TO THE BALLOT INITIATIVE:  An election “will provide a good opportunity for the community to have a dialogue/debate on the pros and cons of fluoridation,” Redding City Manager Mike Warren said in his report to the council, adding that “the discussion can now include costs.” COSTS: The report shows start-up costs about twice earlier estimates, including costs for hydrofluosilicic acid injectors for the city’s two treatment plants and 14 wells ($1.4 million), concrete buildings or additions to house the tanks and pumps at the plants and the wells ($246,302), a truck to haul the chemical ($38,000) and improved communication systems at the wells and plants ($155,000). GRANTS: If the voters rejected water fluoridation at the polls, CDA Foundation had a funding contingency plan for funding Redding  fluoridation, a grant to cover $1.6 million of fluoridation equipment costs, plus grants to cover first-year operating costs (c.$261,797), which would include $128,095 for technicians to handle the hydrofluosilicic acid, $118,702 for the chemicals, and $15,000 for monitoring, sampling and reporting the fluoridation chemicals concentration in the water.

Assistant City Manager and Acting Public Works Director Phil Perry reported that the city must commit to fluoridation for at least 10 years or forfeit the grant fundsavailable for the first year’s operation, and repay the $1.6 million. Perry noted that the city staff objects to those provisions because they would obligate future city councils.

The California Endowment would bankroll this grant. The $3 billion foundation formed in 1996 when insurance giant Blue Cross became a for-profit corporation, following a state requirement that proceeds from such conversions benefit the public. The Sacramento-based Sierra Health Foundation would chip in $225,000 for equipment. That organization formed in 1984, after the Foundation Health Plan went corporate. Finally, the Shasta County Public Health Department has pledged $100,000 toward equipment. The report does not include $173,776 for equipment recently approved by the county Children and Families First Commission, which decides spending for cigarette tax money.

The county Public Health Department commissioned PSOMAS, a Santa Monica-based engineering firm, to do the fluoride study out of its Sacramento office for $25,000. The report recommends the Public Health Department hire Lucy & Company, a Sacramento public relations firm, to promote the city’s fluoridation program should voters reject the Safe Drinking Water initiative. Lucy & Company would keep a database of people and organizations interested in fluoridation, create fliers, hold public meetings, draft press releases and advertisements, produce a video and develop an emergency response program to help the city reassure the public in case of a chemical spill.

The report pegs these services at $49,750 for one year.

PSOMAS recommends the city’s fluoridation program achieve 10 parts per hundred million (pphm) concentration, based on annual average air temperatures between 61 and 65 degrees. Concentrations even 2 pphm lower “can reduce dental benefits significantly,” the report said. Fluoridation could push arsenic levels at one city well over the new federal standards, Perry said in his council report. The city could wind up spending $126,000 a year blending water to dilute the arsenic or removing it from the well, Perry said, noting that water utility staffers are still investigating this issue.

The city also must plan to spend $336,740 on fluoridation equipment at four new wells scheduled for drilling in the coming decade and $162,229 on upkeep through 2012, the report said.

A November election could be moot if the state Department of Health Service orders fluoridation under a 1995 law requiring the chemical as a hedge against tooth decay in cities with more than 10,000 water connections, Warren said in his report. Under that law, cities need not fluoridate unless they can line up money outside local taxes, fees and rates. Foundation grants fit that bill.

First 5 Shasta

First 5 Shasta County allocated approximately $173,000 for the period of 2003-2005 for water fluoridation specifically targeting the city of Redding. This funding was contingent on the passage of a November 2002 local ballot initiative entitled Measure A. Measure A proposed to restrict the City’s ability to add compounds to the drinking water not approved by the Federal Drug Administration (FDA).15 In November 2002, Measure A passed and resulted in the First 5 Shasta Commission removing the commitment of funds for potential water fluoridation. The Fluoridation 2010 Workgroup also removed their offer of $1 million to Redding. Instead, the Commission funding will be directed to other oral health activities such as primary prevention, early intervention, and treatment services. SOURCES: ; OHCD_June_Board_Report [pdf]

Redwood Valley County Water District, Mendocino County: Rejected fluoridation (2/6/1993).

X – Riverview Water District, San Diego County: Rejected fluoridation (3/24/1999) , but has been fluoridated since 2007, when its supplier Helix Water District began water fluoridation. SOURCE:

X – San Diego, City of, San Diego County (Charter City): 18 on the fluoridation priority funding schedule.  San Diego Municipal Code Section 67.0101 prohibits the city from adding fluoridation chemicals to municipal water. Without changing the Municipal Code, San Diego began water fluoridation 2/2011 DETAILS: The Municipal Code was preempted by California law requiring fluoridation in any water district with at least 10,000 active connections, when an outside funding source is available. In 2008, First 5 Commission of San Diego County provided almost $4 million to cover fluoridation equipment and operating costs for the first two years of fluoridation. San Diego dentist Dr. David C. Kennedy, a Past President of the International Academy of Oral Medicine and Toxicology, has filed a suit against the City of San Diego (5/20/2014) for non-compliance with the  Public Records Act concerning the current payment source for the City’s fluoridation..

Santa Barbara, City of, Santa Barbara County (Charter City):  9 on the CDPH fluoridation priority funding schedule. Rejected fluoridation (11/23/1999) by a 5 to 2 vote of the City Council, passing a resolution that “… disagrees with and rejects the State’s recommendation to fluoridate the city’s public water system.” DETAILS: City Council framed the resolution in response to the local Citizens for Safe Drinking Water request for a protective ordinance. Santa Barbara provides water to neighboring Montecito, Carpinteria, and Goleta. Residents testified before the water boards of all affected districts , and a joint water board forum was held to facilitate public discussion. In all of the public sessions combined, fewer than ten citizens of the communities involved spoke in support of water fluoridation. SOURCES: ;

Santa Cruz, City of, Santa Cruz County (Charter City) 12 on the CDPH fluoridation priority funding schedule. Rejected fluoridation (3/2/1999) when Santa Cruz voters affirmed a 1998 City Council ordinance prohibiting fluoridation without a vote of the people, passing a ballot measure prohibiting the addition of any substance, including fluoride, that is intended to effect humans physically or mentally rather than treat the water. Marion Standish of the California Endowment, a non-profit charitable offshoot of Blue Cross, reported (3/1999) that the California Endowment has granted $10 million for the purpose of implementing Santa Cruz fluoridation, but is “not intent on forcing the funds on unwilling communities.” Whether the grant triggers the AB733 fluoridation mandate has yet to be tested. SOURCE:

Santa Rosa, City of, Sonoma County (Charter City): 152 on the CDPH fluoridation priority funding schedule. Rejected fluoridation (1952).

Sebastopol, City of, Sonoma County: Rejected fluoridation (2/4/2014). In a unanimous vote the City Council, Sebastopol joined Cotati in opposing the proposed fluoridation of water provided by the Sonoma County Water Agency (SCWA). Sebastopol is not an SCWA customer, so its potable water supply is not threatened by fluoridation through SCWA. Nonetheless, City officials raised concerns about fluoride leaching into local waterways. In addition, they are opposed to paying for treatment of fluoride-tainted wastewater through their partnership in the regional wastewater treatment system, and took issue with consumers of fluoridated water being given no choice in the matter. SOURCES: ;

Sonoma, City of, Sonoma County: Rejected flouridation (2015), when the  City Council voted 3 to 2 against the proposed fluoridation of water supplied by Sonoma County Water Agency (SCWA).

Suisun City, Solano County: Rejected fluoridation (05/01/1997).

X – Sunnyvale, City of, Santa Clara County (Charter City): 81 on the CDPH fluoridation priority funding schedule. Rejected fluoridation in 1954, and in 1965, both times at the ballot box. Years later, Sunnyvale began to reconsider fluoridation because of planned changes by SFPUC, which provides 40 to 60 percent of Sunnyvale potable water. Those changes would require Sunnyvale to accept fluoridated water, or seek other water sources. Sunnyvale has 3 sources of potable water, including 8 operating municipal wells, SFPUC, and the Santa Clara Valley Water District (SCVWD). 2015 UPDATE, from the Sunnyvale municipal website: “The San Francisco Public Utilities Commission (SFPUC) will start fluoridating the water it provides to the City of Sunnyvale in response to the California’s Fluoridated Drinking Water Act, Assembly Bill 733, which became law in 1995 and required water systems with 10,000 or more service connections to fluoridate once funding was available. The majority of communities served by SFPUC already receive optimally fluoridated water. San Francisco and northern Peninsula communities have received fluoridated water for about 50 years. The City’s other wholesale water provider, the Santa Clara Valley Water District (SCVWD), has no plans to fluoridate its water at this time. This will result in some areas of Sunnyvale to receive fluoridated water, other areas to receive non-fluoridated water, and some areas to receive a mixture of fluoridated and non-fluoridated water. Therefore, only the northern part of the City (approximately north of El Camino Real) will receive fluoridated water.” SOURCES: ; ;;

Valley of the Moon Water District, Sonoma County: Rejected fluoridation (04/07/2015). VOM Board of Directors unanimous approval of  Agenda Consent Calendar Item 3.F: Fluoride Letter to Sonoma County Board of Supervisors. Staff Recommendation: Authorize the President to sign and send the fluoride opposition letter to the Sonoma County Board of Supervisors.

Watsonville, City of, Santa Cruz County (Charter City): 98 on the CDPH fluoridation priority funding schedule. Effectively rejected fluoridation (2002),  passing Measure S, prohibiting introduction of any substance into the city’s water that is not approved for safety and effectiveness by the federal Food and Drug Administration (FDA does not certify water fluoridation additives). HISTORY: The Watsonville City Council accepted a $946,000 grant to fund installation of fluoridation equipment. Its citizens responded with Measure S. LEGAL ACTION: When Measure S passed, Watsonville sued the State to acknowledge that a vote of the people supercedes the state’s fluoridation requirement. The trial court and the intermediate appellate court ruled in favor of the state and its fluoridation mandate. The California Supreme Court declined to hear the case (02/2006), finding that, if the California fluoridation mandate applies to a community, a vote of the people has no standing. In 2010 Watsonville was cited for violating a California state law that requires fluoridating the water in a town over 10,000 active water connections when outside money becomes available. In response, in a 4-3 vote (9/28/2010), the Watsonville City Council approved a contract  for a $1.6 million grant from the California Dental Association Foundation, to design and build a fluoridation system, and to operate it for two years. As late as 11/16/2011, Watsonville remained under a court order to treat its water. At some point after that, the CDA Foundation withdrew its initial funding offer, notifying the City that between 2002 and 2012 costs had become too high for the CDA Foundation grant to cover the proposed Watsonville water fluoridation infrastructure. Without funding from an outside source, there is no state requirement to fluoridate. According to sources at the Watsonville Public Works & Utilities Department (12/2012), Watsonville has no plans to pursue fluoridation funding. Currently Watsonville is in compliance with state law because no further fluoridation funding has been offered. SOURCES: ; / ; ; ; ; ;,_California ;

X – Woodside, Town of, San Mateo County: Rejected fluoridation (09/14/2000). The Woodside Town Council voted 6-1 to tell its water supplier, the San Francisco Public Utilities Commission, that Woodside does not want fluoride added to its water. Woodside’s water remains fluoridated because SF PUC continues to fluoridated the water it provides (fluoridation adopted in 1952). SOURCE:


Water Fluoridation in the United States / Wikipedia

California’s mandatory fluoridation program is rejected by key cities / No

Chronological list of California cities rejecting fluoridation / Fluoride Action Network

United States and Canada: Communities Rejecting Fluoridation [1990-2012] / Fluoride Free Kansas 2012 /

Water Fluoridation:  a thing of the past in Watsonville:  Fluoride Action Network

Watsonville, California / Wikipedia