Though voters in Redding last week tried to block city attempts to provide fluoridated water, state health officials said residents will soon have no choice in the matter.
State law requires that communities with at least 10,000 water hookups add fluoride to their water systems, as long as start-up money is available from a source other than taxes.
California has not yet forced any city to fluoridate, but that day may have arrived.
"The state will ultimately enforce the law," said Dr. David F. Nelson, a fluoridation consultant with the state Department of Health Services. "It will have to. It has no choice."
As long as money to buy and install fluoridation equipment is offered to Redding, the city must add fluoride, Nelson said.
On Thursday, Redding was offered $1.6 million for the project, said Jon Roth, executive director of the California Dental Assn. Foundation. Roth's group is responsible for funneling portions of a $15-million grant from a private foundation, the California Endowment, to various communities for their fluoridation efforts.
Redding's Measure A prohibited the city from adding to its water any chemical not "approved" by the Food and Drug Administration -- even though the federal agency has no jurisdiction over water issues.
The fact that 56% of Redding voters approved Measure A is moot, Nelson said, adding that "state law trumps local initiative."
Money for fluoridation has also been offered and accepted by the city of Watsonville, which had a measure on Tuesday's ballot nearly identical to Redding's. The result of that election was still too close to call Friday.
Nevertheless, Watsonville will also be forced to fluoridate, Nelson said. Exemption from the law has already been retracted. "It's a fait accompli in that community," he said.
Once a city is notified that it is no longer exempt from the law, it has two years to begin fluoridation.
Michel Czehatowski, a Redding acupuncturist and leader of the anti-fluoride group there, said he believes it would be illegal for state officials to offer money to fluoridate Redding. "What that is called is a bribe. They're asking them to take money to circumvent the law."
Czehatowski's group, Redding Citizens for Safe Drinking Water, raised questions during the campaign about the safety of fluoride and the compound commonly used to fluoridate water, fluorosilicic acid. It called fluoridation "mass medication."
Opponents of the measure -- including the local hospitals, the Redding school district, the chamber of commerce, the child-care planning council and most local doctors and dentists -- dismissed the anti-fluoride group as "fear mongers" who set out to confuse the public.
Fluoride has been used in water systems since 1945 to help prevent dental decay. However, only about one-third of Californians have access to fluoridated water, compared with nearly two-thirds of all Americans.
Nationwide, tooth decay is the single most common chronic childhood disease, according to the U.S. surgeon general. Children in California have twice as much dental disease as children in other states, Nelson said. It was concern about dental disease that led the Legislature to pass AB 933, the fluoridation law, in 1995.
Other cities that have decided against fluoridation will not be penalized, Nelson said. Santa Barbara and Santa Cruz voted it down, but were not offered any grant money for fluoridation. Modesto voted against fluoridated water last year, but grant money it had been offered was diverted to other cities.
Los Angeles, Sacramento, Escondido and Santa Maria, among other cities, have accepted grant money and are in the process of fluoridating, Nelson said.
The city of San Diego has a law dating from the 1950s that specifically prohibits the addition of fluoride to the water. The state could force the issue there, Nelson said, but "we are negotiating with San Diego."