Are your kids getting more cavities? Buffalo's water system may be the reason why

Sep 07, 2023

Jonas Reed, 7, brushes his teeth at his family's home in North Tonawanda.

When Philip Reed's son visited the dentist this fall, Reed and his wife were surprised to learn that Jonas, 7, had five cavities in his teeth.

"He was brushing everyday," Reed said, "but he wasn't getting any fluoride."

That's because unbeknownst to Reed and probably most of the more than 200,000 other customers of Buffalo's water system, the Buffalo Water Board stopped adding fluoride to the water in 2015, citing a need for upgrades and "ongoing capital improvements" to its system.

The change was mentioned briefly on the last page of a government water quality report, printed in small type.

Buffalo's water system now contains far lower measurements of fluoride, which boosts dental health and guards against tooth decay, than what public health experts recommend. That puts Buffalo in the minority both nationally and in New York State. Experts say the change could have serious implications for dental health, particularly in children.

Buffalo Water Board officials say they were in the process of upgrading an outdated fluoride system when the lead water crisis in Flint, Mich., caused them to pause in 2016 and study whether the new type of fluoride system would have a corrosive effect on Buffalo's many lead pipes. They say studies showed the system is safe and city will begin adding fluoride to its water again sometime in 2023.

Buffalo Water Board Chairman Oluwole A. McFoy said the Water Board mailed the city's annual water quality report containing the fluoride stoppage news to residents until 2018, when it began sending a mailer directing residents to read the water quality report online on its website. The fluoridation change was not listed prominently in that online report, either.

Mayor Byron W. Brown's administration does not appear to have issued a news release about the city's fluoride situation. The city's website does not include any news releases on water fluoridation.

Asked whether the Brown administration took any steps – such as sending out a news release – to notify the public about the change, a spokesman for the mayor, Michael J. DeGeorge, just reiterated that the city mailed out the annual water quality report to all residential customers. Brown declined to comment.

The News could find no mention of a change in Buffalo's water fluoridation in media reports during the last seven years.

"My wife and I were just completely shocked," Reed said. "We just assumed that he was getting fluoride from the water. That was what surprised us."

Dr. Courtney Peterson, a pediatric dentist on Elmwood Avenue, said she was caught off guard, too.

"It's something that we weren't aware of," Peterson said. "We just assumed that Buffalo was like most other towns and cities that did fluoridate the water."

Jonas Reed, 7, is embraced by his mother, Annie Reed, after brushing his teeth in the upstairs bathroom of his family's home in North Tonawanda on Dec. 22, 2022.

Public health benefits

Community water fluoridation began in 1945 and "is a major factor responsible for the decline in occurrence and severity of tooth decay during the second half of the 20th century," according to a 2015 report from the U.S. Public Health Service.

In adolescents, tooth decay in at least one permanent tooth decreased from 90% in the 1960s to 60% in the early 2000s, the report stated, adding that fluoridation also contained benefits for adults.

The Centers for Disease Control and Prevention lists community water fluoridation as one of the 10 great public health achievements of the 20th century, along with vaccines and the recognition of tobacco as a health hazard.

Nearly 70% of American water systems contain added fluoride, according to the CDC.

Local governments, though, have the ultimate say on whether to fluoridate water. Those in Western New York and across the state have overwhelmingly said yes.

Of New York State's 10 most populous cities, only Buffalo and Albany do not add fluoride to their water systems.

In Erie County, 21 of the 48 community water systems, or 43%, don't add fluoride to the water they provide their customers. But the City of Buffalo, which supplies water to more than 228,000 residents, is an outlier.

Most of those 21 water systems that don't add fluoride are servicing a single apartment complex or mobile home park, and affect fewer than 100 residents. The villages of Akron and Alden and the towns of North Collins and Holland are among the few municipal water providers in Erie County that don't add fluoride.

According to the CDC, all 24 community water systems in Niagara County, including the City of Niagara Falls, add fluoride to their water.

Buffalo stopped in 2015

Buffalo Water officials stopped adding fluoride to their system in June 2015, according to the agency's annual water quality report for that year.

Fluoridation was expected to be restored sometime after March 2016, the report stated. The next year, that estimate was pushed back to December 2017, before being extended to 2018 and 2019.

Starting in 2019, Buffalo Water stopped giving a time estimate in its annual reports. Instead it stated that its water has not contained added fluoride since 2015 and "we do not expect fluoride addition to be restored until completion of various capital projects."

Water Board Chairman McFoy said the city in 2015 began replacing its "archaic" dry sodium fluoride system – which required city workers to physically dump bags of chemicals into the water – to a more effective wet fluoride system.

The agency received a $300,000 grant in 2015 to make the conversion but put the project on hold after the water crisis in Flint, Mich., led to greater awareness nationwide about the dangers of making sudden changes to public water systems.

Buffalo's water system is managed by the same private company, Veolia, that was involved in the Flint water crisis. Families in Flint are still suing Veolia, which has denied any wrongdoing.

"Out of an abundance of caution, we placed this project on hold, while we further studied this treatment change," McFoy said. "We're very methodical. We don't want to screw anything up. We wanted to make sure nothing like that happened in Buffalo."

McFoy, who has chaired the Buffalo Water Board since 2007, said the city partnered with the University at Buffalo to develop a "state-of-the-art" pipe laboratory to test the new fluoride system. He said the wet fluoride system has proven safe and should be installed next year.

Since 2015, the CDC has recommended an optimal fluoride concentration of 0.7 parts per million in community water systems. Buffalo's fluoride concentration in its 2021 water quality report was 0.13 parts per million, more than five times lower than the recommended level. The report lists natural deposits, discharge from fertilizer and aluminum factories as possible sources of fluoride in the water.

"Since June 22, 2015, fluoride has not been added to your drinking water, and we do not expect fluoride addition to be restored until completion of various capital projects," Buffalo's water quality report states. "You may want to discuss this with your family dentist to see if some other form of fluoride supplement should be considered for your dental protection."

Peterson, who has an office in Getzville and another in Buffalo, said she "definitely" thinks Buffalo's lack of water fluoridation has played a role in the uptick in cavities.

"The past five years or so, there has been a huge epidemic, especially with kids," Peterson said. "We’ve seen a rise in everything. Not having fluoride in the water I think is a true disservice to the people of Buffalo, especially the children of Buffalo."

Peterson recommended city parents buy fluoride toothpaste and mouthwash as an alternative way to strengthen their children's teeth.

Jonas Reed was not using fluoride toothpaste because the 7-year-old had trouble spitting after he brushed, his father said.

"I find it kind of frustrating that they would do this, apparently indefinitely, and it seems like something the public should know," Philip Reed said.

Reed said he could not recall any mailers or other notification sent out by the city or the Buffalo Water Board warning parents about the change.

"We did not get anything like that, or we would have taken steps," Reed said. "Certainly we would have been switching the younger son to fluoride toothpaste earlier. It's expensive to treat cavities. We had to pay a significant amount out of pocket for this."

The Reed family has since moved to North Tonawanda. Reed said he made a phone call soon after purchasing a home.

"I called North Tonawanda water and confirmed we were getting fluoride," he said.

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Charlie Specht is a member of the Watchdog Team. A Buffalo native, he has won state, regional and national awards for investigative reporting.

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