New York State In-depth

With no fluoride in Buffalo water, parents can take steps to protect their children’s dental health

Some of the area’s most high-profile dentists and academics at the University at Buffalo said they were caught off guard by the news that the Buffalo Water Board stopped adding fluoride to the city’s water more than 7½ years ago.

Leading dentists said while it’s good that Buffalo intends to fluoridate its water again later this year, parents shouldn’t wait and take matters into their own hands when it comes to their children’s dental health.

Her recommendations include using fluoride toothpaste at home and having children regularly fluoridated by a dentist.

“Nobody in organized dentistry knew that the water in Buffalo wasn’t fluoridated and that fluoridation stopped in 2015,” said Dr. Joseph E. Gambacorta, Associate Dean for Academic and Faculty Affairs at UB’s School of Dental Medicine. “It’s not like any kind of memo was sent out or any kind of consultation (like: ‘If we do this, what will the result be?’ There was never a dialogue between the university, organized dentistry or the dental community, to discuss this subject.”

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According to the Buffalo Water Board’s annual water quality report for this year, Buffalo stopped adding fluoride to its water system in June 2015. Fluoridation should be restored sometime after March 2016, the report said. The next year, that estimate was pushed back to December 2017 before being extended to 2018 and 2019.

Buffalo’s water system now contains far less fluoride, which promotes dental health and protects against tooth decay, than recommended by public health experts. This puts Buffalo in the minority both nationally and in upstate New York.

As of 2019, Buffalo Water no longer provided a time estimate in its annual reports. Instead, it stated that its water has had no added fluoride since 2015 and “we do not expect fluoride addition to be restored until various capital projects are completed.”

Buffalo Water Board Chairman Oluwole A. McFoy told The Buffalo News the city was in the process of upgrading an aging fluoride system when the 2016 lead water crisis in Flint, Michigan prompted the Water Board to take a break and investigate, whether the new type of fluoride system would have a corrosive effect on Buffalo’s many lead pipes. He said studies conducted in collaboration with the University of Buffalo showed the system is safe and the city will start adding fluoride to its water again sometime this year.

What steps parents can take

dr Sarah J. Ventre, an attending pediatrician at John R. Oishei Children’s Hospital in Buffalo, said she was unaware of the city’s fluoride decision, but agrees with what she and other dentists have seen.

“It was definitely a surprise to me, and I know other pediatricians I work with who weren’t aware of it either,” Ventre said. “I personally feel bad for not properly educating parents about the lack of fluoride in tap water.”

There are steps parents can take while waiting for the city to take action, Ventre said.

Fluoride toothpaste is now recommended as soon as a child’s teeth erupt, she said, adding that parents should give their children an amount the size of a grain of rice up to the age of 3.

Fluoride treatments — where dentists apply a fluoride varnish to the tooth — should also be done every 3 to 6 months, she said, depending on a child’s risk of tooth decay. Over-the-counter mouthwashes are an option, but not before age 6.

“Because they need to be able to whistle and spit,” she said.



Buffalo tap water fluoride

Because Buffalo has quietly stopped adding fluoride to its public water system, dentists and pediatricians recommend that Buffalo children brush their teeth with fluoridated toothpaste and get regular fluoride treatments from a dentist.


Derek Gee/Buffalo News

Another option is a dietary supplement that can be taken from 6 months to 16 years of age. A doctor’s prescription is required for the supplements, she said.

Gambacorta and Ventre said some of these options may be out of reach for low-income families. Ventre noted that fluoride varnish treatments are covered by Medicaid.

All are good options, doctors said, but none can match the effectiveness of a fluoridated water supply.

“We just want the fluoride back in the water,” Gambacorta said.

As of 2015, the CDC has recommended an optimal fluoride concentration of 0.7 parts per million in municipal 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 and effluent from fertilizer and aluminum plants as possible sources of fluoride in water.

Mayor Byron W. Brown on Friday took responsibility for the city’s failure to add fluoride to its water system over the past 7½ years.

Byron Brown on Fluoride:

“The buck ultimately stops with me,” Brown told reporters in his office at City Hall. “Like others, I wasn’t notified immediately, but I should have been, and we should have shared the information with the community. No apologies for that.”

“The buck ultimately stops with me,” Brown told reporters in his office at City Hall. “Like others, I wasn’t notified immediately, but I should have been, and we should have shared the information with the community. No apologies for that.”

McFoy said the water board mailed the city’s annual water quality report with the fluoride stop messages to residents until 2018, when it began sending out a mailer directing residents to read the water quality report online on its website. Fluoridation was not prominently featured in this online report either.

Buffalo Common Councilor Rasheed NC Wyatt said the disclosure is unlikely to draw the attention of city dwellers.

“I absolutely don’t think that’s enough,” Wyatt said. “Unfortunately, companies and organizations in our world think it’s okay just because I put it in writing. You write it down, but you don’t tell anyone. This should not have happened without community input. It’s just kind of ridiculous.”

Councilor David A. Rivera sent a letter to McFoy on Jan. 18 inviting him to speak at a meeting of the council’s community development committee at 1 p.m. Tuesday in the council chambers of City Hall.

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