Green Bay scores touchdown for community water fluoridation

Green Bay, Wis. — Community water fluoridation can sometimes be a strictly local issue, but the nature of virtual meetings has allowed that issue to be debated — and fought for — from those who live thousands of miles away.

The Green Bay, Wisconsin, City Council, after several hours of virtual testimony and scores of letters over the past few months, voted 9-3 to reaffirm community water fluoridation on Dec. 1 after members of the dental and oral health community stepped up across the nation to share the best science about the practice.

image of fluoridation iconGreen Bay, the home of the Packers, is the third-largest city in the Badger State, with more than 100,000 people residing within city limits. The water utility also serves villages in the greater metropolitan area.

John Dane, D.D.S., Missouri state dental director, wrote a letter to the council before the vote. After the vote, Dr. Dane said he was glad he pitched in.

“Green Bay opened the discussions to people from outside their service area,” Dr. Dane said. “I was alerted to this and that anti-fluoridationists were planning on stacking the speakers list. While I wasn’t able to get on the speakers list, I could write a letter. I encouraged my staff to do the same and they all wrote letters. So we sent six.”

California State Dental Director Jayanth Kumar, D.D.S., member of the ADA’s National Fluoridation Advisory Committee, applauded the council’s vote.

 Dr. Russell Dunkel
Dr. Dunkel
“Oral health disparities are profound within the U.S. population, and advancing equity to eliminate these disparities is central to the overall goal of improving population health,” he said. “Community water fluoridation is one of the best population-based interventions that is safe, reaches a large proportion of the population and is cost-saving.”

Widespread support

On top of support from around the country was advocacy from those at home. The Wisconsin Dental Association, with support from the ADA, lobbied for the continuation of community water fluoridation in Green Bay.

“This is an issue that will directly impact the oral health in Green Bay,” said Mark S. Paget, executive director of the Wisconsin Dental Association, in a letter to the council.

Erika Valadez, dental practice and government relations associate with the Wisconsin Dental Association, credited an interprofessional response to turning the tide.

“The WDA is part of a Fluoride Response Team that works together to battle anti-fluoride efforts throughout Wisconsin. Members of this team include Department of Health Services/Oral Health Program staff, Wisconsin Oral Health Coalition, American Fluoridation Society, local health departments, the Department of Natural Resources, Oral Health Partnership and other local professionals who work together on educating council and committee members on the benefits of fluoridation for their community.”

The Wisconsin Oral Health Coalition urged the council to continue fluoridation, using not only public health benefits but also budgetary reasons to buttress their cause.

 “Green Bay spends $30,505.12, or 22 cents per resident, to provide this proven public health benefit to 140,000 individuals,” according to a letter sent to the council from the Wisconsin Oral Health Coalition. “Delta Dental of Wisconsin … compared claims data from Delta Dental of Wisconsin members residing in
 Dr. John Dane
Dr. Dane
communities with and without community water fluoridation. They estimate fluoridation saved Wisconsin residents more than $6.1 million in 2011 by reducing the need for fillings, crowns or other costly procedures.”

‘Low-cost, high-impact’

According to the Centers for Disease Control and Prevention, Mr. Paget said, communities of 1,000 or more see an average estimated return on investment of $20 for every $1 spent on water fluoridation. Communities served by fluoridated water save an average of $32 per person a year by avoiding treatment for carries, he added.

“Community water fluoridation is the best low-cost, high-impact way for [municipalities] to maintain optimal oral health in our communities,” Mr. Paget said.

Nearly 90% of the population in Wisconsin on public water supplies has access to the benefits of optimal levels of fluoride, said the Wisconsin Oral Health Coalition.

Russell Dunkel, D.D.S, Wisconsin state dental director, cautioned that while the vote was a win for pro-fluoridation advocates, it does not mean that at a later date a move to terminate fluoridation could possibly resurface.

“Even pre-COVID we were already dealing with a vast number of social and health inequities and with access to dental care being no exception,” he said. “Now post-COVID, dental offices have to change their way of practicing and scheduling and as a result the Medicaid and uninsured population will now suffer even greater barriers to accessing dental care. With all these barriers to health care, especially for the under-resourced and vulnerable populations, now is definitely not the time to remove a proven safe and cost-effective method for reducing decay. To emphasize the magnitude of this problem, community water fluoridation may be the only dental treatment many of these individuals receive for the near future.”

Science-based decision

Green Bay City Council Alder Lynn Gerlach said during the council meeting that she had received more than 140 emails from both sides prior to the vote and used studies presented to her by anti-fluoridation advocates and fluoridation advocates to make her decision.

“I’m trying to make a decision on the basis of science, not politics or philosophy,” she said.

She continued: “All of my grandparents wore full dentures — none had any teeth left. I was raised in Grand Chute [in Wisconsin] with a private well, with no fluoride — and by the end of my college years, I had a cavity in every tooth. My children were raised on military installations in the continental U.S. and in Green Bay, where we always had community water fluoridation. Each one had only one cavity by college graduation.”

As for the largely discredited studies presented by anti-fluoridation activists, Ms. Gerlach said, “I think perhaps we have been snookered.”

For more information on fluoride and ADA advocacy of community water fluoride, visit