Buffalo expected to restart water fluoridation this fall

Study investigates effects of years without mineral

After quietly halting its fluoridation program several years ago — allegedly without the public’s knowledge — the City of Buffalo, New York, is set to restart fluoridating its water supply this fall, according to the Buffalo Water Authority. 

City residents can expect the optimal amount of fluoride to be back in their water by the end of August or beginning of September.

Buffalo city officials allegedly decided to stop fluoridating the city’s water supply without properly informing residents in 2015. The public was not aware of this fact until the Buffalo News reported on it in 2023. Brendan Dowd, D.D.S., who testified multiple times before the Buffalo City Council in support of restarting fluoridation, said residents immediately banded together to urge city officials to reverse the decision upon learning about the discontinuation.  

“It’s a public health issue. It’s a health equity issue. You’ve got a generation of kids now who have not had fluoride in the water,” Dr. Dowd said. “What could be more even-keeled than having fluoride in the water for everybody here? There’s a lot of kids that can’t afford to go to the dentist.”

Fluoride is a naturally occurring mineral that is often added to drinking water to prevent tooth decay. Anti-fluoride activists claim water fluoridation poses ethical and safety concerns, while most dental professionals say the longstanding scientific research points to fluoride as a safe and efficient way to prevent cavities. 

According to the ADA, water fluoridation reduces tooth decay by at least 25% in children and adults and was dubbed “one of 10 great public health achievements of the 20th century” by the Centers for Disease Control and Prevention. 

“The scientific research behind it is irrefutable. [Fluoridation] helps, there’s no question about it. This is a case of a setback in a mid-major town, and it’s too bad. It’s frustrating that a generation of kids weren’t able to have the protective water that we all use daily because of some strange reactions from city officials,” Dr. Dowd said.  

The University at Buffalo School of Dental Medicine is in the early phase of a research project investigating the effects of halting Buffalo’s water fluoridation for nine years. Specifically, Marcelo Araujo, D.D.S., Ph.D., dean of the University at Buffalo School of Dental Medicine, said the retrospective study involves looking back at how the lack of water fluoridation has impacted children throughout Erie County, which includes Buffalo. 

Researchers have created a database of medical records for more than 150,000 children from 2013, before fluoridation stopped, to 2024. Dr. Araujo said the study’s aim is twofold: to understand the size of the problem in the city and to encourage good policymaking.

“Data can be used for advocacy and policymaking. We [want to] make sure that we prevent Buffalo from stopping water fluoridation in the future, but we’re hoping it’s a good example that can be used across the country,” Dr. Araujo said. “Scientific evidence needs to be developed to support policy, and the policy should be focused on prevention, equity in oral health and cost effectiveness. That way we can provide what the kids in the community need.” 

While the research is still in its nascent stages, clinicians have said the data shows many kids have more decay than normal. So far, it appears the past three years have seen an increase in the number of visits to pediatric clinics, according to Dr. Araujo.

“I cannot make a direct correlation yet. That’s all I know is that more kids are coming,” he said. 

With fluoridation slated to return to Buffalo in a few weeks, John Craig, Ph.D., executive director of the Eighth District Dental Society in New York, said he is hopeful things will go according to plan. Current operations and quality control access panels are in the process of being finalized, according to the Buffalo Water Authority, and training will begin in August for staff on these new systems. Then both county and state health departments will review the procedures and results of initial training and quality control efforts before the system is approved and certified by authorities. 

“We’re very hopeful that will happen and that Buffalo will once again be a fluoridated city like it has been for the last 60 or 70 years,” Dr. Craig said. 
 
Dr. Craig played a crucial role in galvanizing leaders and community members to advocate for the return of fluoride. They attended city council hearings, held meetings with state officials and wrote letters in an effort to spread awareness. 

Buffalo’s lack of water fluoridation has drawn the ire of residents — and a class action lawsuit by families against the City of Buffalo — but more than anything, many community members just want fluoride back in their water as soon as possible. 

“I think everybody at this point is a little bit more relieved,” Dr. Craig said. “It seems that [a plan] is in place. The Water Authority is taking a more proactive stance on letting people know what the current situation is and when [fluoride is] going to be reintroduced. So, I think we have a pretty good feeling that things will be back to normal.”