Model Brief Supporting the Fluoridation of Water
Brief as RTF for editing
This model reply brief catalogues by issue the existing case law to serve as a quick reference guide for government entities seeking support for public water fluoridation implementation ordinances. Because there is not a lot of case law from any particular jurisdiction, available case law from jurisdictions that have considered water fluoridation plans across the country is relied upon. The model brief is formatted so that an attorney from a government entity facing a challenge to its fluoridation plan may insert the specific statute or ordinance currently being challenged, as well as pertinent local case law. Additionally, a government attorney may choose to edit the model brief to include responses only to those challenges to water fluoridation being raised by the opponent in his case. Finally, several websites are cited throughout the brief, intended to help attorneys in one of two ways. The sites listed before the body of the brief begins are links to policy opinions of professional organizations promoting water fluoridation, as a starting point to locating expert witnesses. The websites cited in the body of the paper are provided to lead attorneys to relevant scientific evidence proving the merits of fluoridation.
I.	FLUORIDATION OF THE PUBLIC WATER SUPPLY IS A PROPER EXERCISE OF A STATE’S POLICE POWER.
The court’s power to review state legislative action taken pursuant to the police power is limited by the doctrine of separation of powers enunciated in the United States Constitution.
The United States Constitution does not grant any general police power to the federal government. Thus, that power – the power to make laws providing for the protection of the health, welfare, and morals of the public – is inherently reserved to the states. The following are among those actions that have been held to be valid exercises of state police power: prohibiting cigarette smoking in confined areas, see State v. Heidenhain, 7 So. 61 (La. 1890); requiring all citizens to receive vaccinations against contagious illness, see Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (U.S. 1905); requiring infected or impure goods to be quarantined, see Train v. Boston Disinfecting Co., 11 N.E. 929 (Mass. 1887). 16A Am.Jur.2d Constitutional Law §§ 363–365.
As governed by the doctrine of separation of powers, the ability of the courts to review legislative action taken by states pursuant to their police power is limited. Several state courts have been faced with the question of whether the addition of fluorides to the water is a proper exercise of police power. These courts have almost uniformly held that such action is proper. Chapman v. City of Shreveport, 74 So.2d 142 (La. 1954); Attaya v. Town of Gonzales, 192 So.2d 188 (La.App. 1st Cir. 1966); De Aryan v. Butler, Mayor, et al., 260 P.2d 98 (Cal.App. 4th Dis. 1953); Kaul v. City of Chehalis, 277 P.2d 352 (Wash. 1954); Rogowski v. City of Detroit, 132 N.W. 2d 16 (Mich. 1965); Kraus v. City of Cleveland, 121 N.E.2d 311 (Ohio 1954); Dowell v. City of Tulsa, 273 P.2d 859 (Ok. 1954).
For example, in De Aryan v. Butler, Mayor, et al., 260 P.2d 98, 101 (Cal.App. 4th Dis. 1953), the court held that the decision to fluoridate the public water supply was well within the province of the state legislature, explaining “The legislature is possessed of the entire police power of the State, except as its power is limited by the provisions of the Constitution and other laws applicable thereto. Such police power is an indispensable prerogative of sovereignty and may not be legally limited even though at times its operation may seem harsh, so long as it is not unreasonable and arbitrarily invoked and applied.”  Other state courts considering this issue have essentially resolved it in the same way.
Though the United States Supreme Court has never specifically considered whether the addition of fluorides to water is a proper exercise of police power, it has recognized that broad deference must be accorded to the state legislature in determining what actions are necessary to protect the public welfare. In Jacobson v. Commonwealth of Massachusetts, 195 U.S. 11 (1905), the United States Supreme Court considered the argument that compelling citizens to receive a smallpox vaccination was an unconstitutional and improper exercise of the police power. In rejecting this argument the Supreme Court stated:
 “If there is any such power in the judiciary to review legislative action in respect of a matter affecting the general welfare, it can only be when that which the legislature has done comes within the rule that, if a statute purporting to have been enacted to protect the public health, the public morals, or the public safety, has no real or substantial relation to those objects, or is, beyond all question, a plain, palpable invasion of rights secured by the fundamental law, it is the duty of the courts to so adjudge, and thereby give effect to the Constitution.” Jacobson at 31.
Thus, a court cannot strike down an ordinance authorizing the fluoridation of water promulgated pursuant to the state’s police power without first determining that the action bears no reasonable relation to protecting the public health, is unreasonable and arbitrary, or is an invasion of the fundamental rights granted to individuals by the Constitution. 
The wide latitude that courts must grant determinations made by state legislatures pursuant to their police power means that courts will have little opportunity to examine those substantive issues central to the fluoridation debate. Several courts faced with attacks against fluoridation statutes have clearly stated that when reviewing a decision made by the legislature based on careful evaluation of scientific evidence, the court must defer to the legislature’s decision as it is not within the power of the judiciary to make an evaluation of its own when there is evidence in the record sufficient to support the legislature’s conclusion. Attaya v. Town of Gonzales, 192 So. 2d 188, 192 (La.App. 1st. Cir. 1966); Froncek v. City of  Milwaukee, 69 N.W.2d 242, 248 (Wis. 1955); Rogowski v. City of  Detroit, 132 N.W.2d 16, 23 (Mich. 1965). 
For instance, in Froncek v. City of Milwaukee, 69 N.W.2d 242, 248 (Wisc. 1955), the court determined it was unnecessary to engage in a thorough review of the scientific evidence in the record. In so holding, the court noted the extensive evaluation undertaken by the city council and determined that this evaluation was more than sufficient to support the city council’s conclusion. Similarly, in Attaya v. Town of Gonzales, 192 So.2d 188, 192 (La.App. 1st Cir. 1966), the plaintiffs alleged that the trial court had erred in failing to permit them to introduce evidence as to the potentially harmful effects of fluoride. The court rejected the plaintiff’s argument, explaining that courts must grant great latitude to legislative decisions upon review. “That fluoridation may be a controversial subject does not in itself justify the court substituting their judgment for that of the legislative body. The merits or demerits of the subject, in the absence of a clear showing of abuse of discretion, unreasonableness or capriciousness on the part of the legislative body, is solely within the province of the Governing Authority.” Id. at 193. 
The court in Rogowski v. City of Detroit, 132 N.W.2d 16, 23 (Mich. 1965), likewise refused to reconsider the scientific determination made by the city council. The Rogowski court went further than have most courts in stating that a court may take judicial notice of the benefits provided by the addition of fluorides to the water based on extensive scientific evidence and other support found in the record. In Rogowski, the City of Detroit introduced into the record a significant number of affidavits and professional opinions supporting fluoridation. The court found it unnecessary to engage in its own evaluation of the evidence presented by both sides, and concluded it could “…take judicial notice of the common knowledge or belief, as evidenced by the above listed public statements, affidavits, and official actions, that fluoridation is beneficial to prevent dental caries and so improve public health.” Id.
Courts across the country have recognized the fluoridation of public water as a permissible exercise of police power. Judicial review of such legislative action is accordingly limited. When a municipality acts pursuant to a delegation of authority properly granted by the legislature, the court is without power to interfere unless it is determined that the municipal action is arbitrary or unreasonable.
Fluoridation measures (specify ordinance or resolution) bear a reasonable relation to protecting the public health.
While the prevalence of dental caries is disturbing, it may be efficiently controlled through the process of water fluoridation. Statistics show that the occurrence of the disease in populations drinking fluoridated water is significantly lower than in populations without the benefit of similar water treatment systems. (La. DHHS). Furthermore, water fluoridation is the most cost-effective method for preventing tooth decay at a fraction of the cost required to treat the disease when it is allowed to develop freely without proper preventive measures. Considering the foregoing facts, [specify fluoridation measure at issue] satisfies the “reasonable relation” test, as its stated purpose of is to control and prevent the spread of tooth decay.
The Louisiana Supreme Court found that a city ordinance mandating the fluoridation of public water systems was reasonably related to protecting the public health in Chapman v. City of Shreveport, 74 So.2d 142 (La. 1954). The court began its deliberation as to the validity of the fluoridation measure with a detailed analysis of the provisions of Louisiana law relevant to the power to protect the public health. Id. at 145. In concluding that there was in fact a valid delegation of power, the Chapman court explained fluoridation was within the power granted to the city by charter as long as it was reasonably related to the public health. Id. The court further explained that the health of a community’s children is vital to the protection of the welfare of that community as a whole. Id. Thus, fluoridation of water, the purpose of which is to prevent the incidence of dental caries in children, does bear a reasonable relation to the public health. Id.
In Froncek v. City of  Milwaukee, 69 N.W.2d 242 (Wis. 1955), the Supreme Court of Wisconsin considered a similar challenge by residents and water users of the city of Milwaukee alleging that an ordinance mandating water fluoridation was not reasonably related to protecting the public health. Particularly, the Froncek plaintiffs claimed that because the ordinance’s stated purpose was to provide benefits only to young children by preventing the occurrence of dental caries, a non-contagious disease, it resulted in an unreasonable compulsion upon all citizens to drink the treated water. Id. at 246. The court, citing Chapman, explained the wide latitude afforded to the legislature, and to the city by delegation, to make these determinations, and concluded that fluoridation did bear a reasonable relation to the public health and therefore was a valid exercise of police power. Id. at 247.
	The Missouri Supreme Court has also addressed this issue. In Readey v. St. Louis County Water Co., 352 S.W.2d 622, 626 (Mo. 1961), when considering whether a fluoridation statute bore a reasonable relation to protecting public health, the court first noted the significant amount of evidence on the record supporting each party in the litigation. After acknowledging the extremely controversial nature of the subject, the court explained that as long as the resulting ordinance was reasonably related to protecting the public health, it was the legislature’s function to resolve the debate. Id. At 627.
In conclusion, fluoridation measures are intended to prevent a severely deteriorative condition from spreading throughout a community. The measures are proven to be very effective at accomplishing this purpose, with little or no known adverse effects when fluoride levels are properly monitored. Clearly [specify fluoridation measure at issue] is reasonably related to protecting the oral health of the citizens of [specify city or town]. It would be unreasonable to prevent the government from affording its citizens this protection.
II.	THE FLUORIDATION PLAN [specify ordinance currently at issue] IS NOT IN CONFLICT WITH THE FEDERAL OR STATE CONSTITUTIONS, NOR IS IT IN CONFLICT WITH [applicable state or federal laws].
[Specify fluoridation measure at issue] can be applied in conjunction with the state and federal constitutions, and/or is not in conflict with [alleged conflicting statute]. Several courts have considered attacks of this nature; most have rejected them.
In Chapman v. Louisiana, 74 So.2d 142, 146 (La. 1954), the Supreme Court of Louisiana considered the allegation made by the plaintiff that a fluoridation ordinance violated the Fourteenth Amendment of the United States Constitution. In rejecting this argument, the Court stated:
The Fourteenth Amendment does not deprive a state or its subdivisions of the right to preserve order or to protect the health of the people under its police power, and in the exercise of its power the legislative branch may interfere with and impair the individual liberty of the citizens in a manner and to an extent reasonably necessary for the public interest, and the courts will not interfere except where the measures invade fundamental rights or are arbitrary, oppressive, or unreasonable. Id.
The plaintiffs in Chapman also alleged that the city of Shreveport did not have the authority to enact a fluoridation measure under the state constitution. The district judge in Chapman had concluded that the city lacked the power to take this action under its police power. The Supreme Court of Louisiana reversed the decision, finding that the power to add fluorides to the public water could be found within the charter of the city of Shreveport, which was enacted pursuant to Article 14, § 37 of the Louisiana Constitution. Id. at 145. 
Other arguments advanced by opponents of water fluoridation have also focused on the particular grant of authority the measure was enacted pursuant to. In DeAryan v. Butler 260 P.2d 98 (Cal.App. 4th Dist. 1953), the court considered the assertion by a taxpayer of the affected county that in requiring the fluoridation of city water the municipality had exceeded the powers granted to it by charter. In making its decision, the court discussed the state statutes governing the required quality of water, as well as the legislature’s grant of authority to the city council to “regulate the purity, potability and wholesomeness of public waters”. Id. at 101. The court explained that the State Board of Health had concluded, after due consideration, that the fluoridation requirements did not conflict with the required standards of water. Therefore, the city council had not exceeded its authority as it had acted in conjunction with state water standards. Id. at 102. 
Kaul v. City of Chehalis, 277 P.2d 352, 354 (Wash. 1954), involved a similar attack by the plaintiff, a taxpayer and registered voter of the city, that the City Council had exceeded its authority in adopting an ordinance providing for the fluoridation of city water. The Supreme Court of Washington pointed out that the state Constitution authorized cities to make sanitary and other regulations as long as they did not conflict with other laws of the state. Id. The court also pointed out that a state statute, which could be read in conjunction with the Constitution, gave the city the authority “to prevent the introduction and spread of disease.” Id. The City of Chehalis’ ordinance was upheld, and the city was allowed to proceed with its plans to add fluorides to the public water supply. Id. at 356.
Recently, however, the Washington Supreme Court did strike down a resolution mandating the fluoridation of certain water systems adopted by a county board of health, finding that it irreconcilably conflicted with other statutes. Parkland Light & Water Co. v. Tacoma-Pierce County Board of Health, 90 P.3d 37 (Wash. 2004). A state statute in existence prior to the adoption of the resolution gave water districts in the county the authority to decide whether to fluoridate their systems. Id. at 40. The court held that the Board of Health resolution conflicted with the state statute and was thus invalid. Id. “Essentially, the Board's resolution is a local regulation that prohibits what state law permits: the ability of water districts to regulate the content and supply of their water systems expressly granted to them by statute. The resolution ordering fluoridation takes away any decision-making power from water districts with respect to the content of their water systems, and the express statutory authority granted to water districts pursuant to RCW 57.08.012 (the state statute) would be rendered meaningless.” Id. 
The dissent in Parkland Light refers to the Kaul decision, noting that it is still good law, and that the majority in the Parkland Light case came to the wrong conclusion. “The majority incorrectly concludes that the legislature’s grant of permissive authority to decide on fluoridation of their water systems….However, the court should conclude that there is no conflict between the Board’s resolution and RCW 57.08.012 having regard to the context and legislative history.” Id. at 41. 
Although the majority in the Parkland Light case did strike down the fluoridation measure, that holding has no bearing on the present case. Here, [government entity/agency] acted according to a valid delegation of legislative authority and did not infringe any other agency’s authority in so acting.
Attaya v. Town of Gonzales, 192 So.2d 188 (La.App. 1st. Cir. 1966), involved a different kind of attack against the municipality’s authority to fluoridate the water.  In this case, citizens of the town alleged that defects in the form and procedure followed in adopting the fluoridation ordinance should render the ordinance invalid. Id. at 189. The city subsequently adopted a new ordinance in full compliance with the required procedure. The court refused to consider plaintiffs attacks regarding defects in procedure, citing as its reason that a later valid ordinance existed on the record and would be considered as controlling for purposes of the matter. Id. at 190.
Still other arguments center on alleged conflicts between fluoridation measures and specific statutes other than the state and federal constitutions. Like the allegations that fluoridation measurers are unconstitutional, these arguments have not fared well. 
For example, in Dowell v. City of Tulsa, 273 P.2d 859, 864 (Okla. 1954), the opponents alleged that a fluoridation measure violated a state statute prohibiting the sale of food which contained fluorine compounds. In rejecting the argument, the court explained that the fluoridation measure had set forth specific regulations regarding the amount of fluoride to be added to the water and was thus not unreasonable or a violation of the statute. Id.
In Froncek v. City of Milwaukee, 69 N.W.2d 242, 251 (Wis. 1955), opponents of a water fluoridation measure alleged that it violated the Federal Food, Drug, and Cosmetic Act. The Froncek court rejected the argument, citing an opinion of the U.S. Attorney General that the Act did not prevent the addition of fluorides to municipal water supplies. Id. 
These cases are important because they reiterate the judiciary’s position that actions taken by state legislatures pursuant to the broad powers granted to them via the United States Constitution should not be disturbed by the courts unless they can be found to be arbitrary or unreasonable.
III.	THE PROPOSITION THAT A STATE’S POWER TO PROTECT THE PUBLIC HEALTH SHOULD BE LIMITED TO ACTING ONLY IN RESPONSE TO CONTAGIOUS DISEASES HAS NEVER BEEN ACCEPTED AND SHOULD NOT NOW BE ACCEPTED.
Several attempts have been made to convince courts that a state’s power to protect the health of its citizens should be limited to those diseases that are contagious or infectious to other human beings. Currently, no court has accepted this argument and there is no such limit on any state’s police power.
An example of this argument can be found in Kaul v. City of Chehalis, 277 P.2d 352, 356 (Wash. 1955). Here, the plaintiffs argued that because dental caries was a non-contagious disease, it did not present an imminent threat to the public and therefore was not rightfully within the reach of the state’s police power. The court stated its unwillingness to refine Washington’s existing public health law to include a distinction between contagious and non-contagious diseases, explaining its belief that both were within reach of the state’s police power. Id.
Likewise, in Rogowski v. City of Detroit, 132 N.W.2d 16 (Mich. 1965), the plaintiffs advanced an argument attempting to limit the police power. The Rogowski court concluded that there was no support for the proposition that a disease’s status as contagious (as opposed to non-contagious) was an essential element to the state’s power to protect the public health. Id. at 25.
This issue was also raised in Dowell v. City of Tulsa, 273 P.2d 859, 860 (Ok. 1954), where the plaintiffs alleged that the legislature had never before attempted regulation of a non-infectious disease, and that to do so was unconstitutional. The Dowell court concluded that the legislature’s broad grant of authority to Oklahoma cities to act in protection of their citizens in no way evinced an intention by the legislature to exclude non-contagious diseases from regulation. Id. at 861.
Similarly, in Chapman v. City of Shreveport, 74 So.2d 142, 146 (La. 1954), the court rejected the argument that “fluoridation of the water to prevent tooth decay is not a matter of public health, but a matter of private health and hygiene.” In doing so, the court noted the seriousness of dental caries, and its prevalence in Shreveport and around the nation, concluding that the fact that a disease is not infectious does not in anyway lessen its detrimental effect on the public. Id. (See also Froncek v. City of  Milwaukee, 69 N.W.2d 242, 244 (Wis. 1955)).
Another case, Readey v. St. Louis County Water Co., 352 S.W.2d 622 (Mo. 1961), also discussed whether the status of dental caries as a non-contagious disease should justify an argument that it was as such not subject to the reaches of police power. Citing the U.S. Supreme Court case Jacobson v. Massachusetts, 197 U.S. 11 (U.S. 1905), the Readey court stated that it did not think the holding in Jacobson meant to imply that the legislature could only act pursuant to its power to protect the public health if it was attempting to regulate a contagious disease. Readey at 629-30.
That dental caries is not a contagious disease does not lessen the gravity of this problem in communities nationwide.  Failure to takes steps to prevent further increases in the occurrence of dental caries will result in this disease becoming of epidemic severity.  While several courts have considered the argument from opponents to fluoridation that state police power should be limited to taking action associated with contagious diseases only, these courts have consistently found this argument to be without merit.
IV.	FLUORIDATION IS NOT THE PRACTICE OF MEDICINE, AND AS SUCH THE ADDITION OF FLUORIDES TO WATER DOES NOT CONSITUTE COMPELLED MEDICATION IN VIOLATION OF INDIVIDUAL FUNDAMENTAL RIGHTS.
Opponents of fluoridation measures assert that allowing fluoridation of the public water supply amounts to compelling citizens to drink or ingest medication against their will, thereby resulting in a violation of their freedoms of religion and choice. Additionally, some opponents have claimed that fluoridation of water should be condemned as the unauthorized practice of medicine.
First of all, an overwhelming majority of courts have found that fluoridation is not the practice of medicine. In Chapman v. City of Shreveport, 74 So.2d 142, 146 (La. 1954), the court relied largely on the testimony of dental professionals in holding that the fluoridation of public water supplies would not be considered the practice of medicine.  Several other courts have come to the same conclusion. Attaya v. Town of Gonzales, 192 So. 2d 188, 192 (La.App. 1st. Cir. 1966); Dowell v. City Of Tulsa, 273 P.2d 859, 863 (Okla. 1954); Kaul v. City of Chehalis, 277 P.2d 352, 625 (Wash. 1955); Rogowski v. City of Detroit, 132 N.W.2d 16, 24 (Mich. 1965); Readey v. St. Louis County Water Co., 352 S.W.2d 622, 628 (Mo. 1961).
Other arguments have stemmed from the unfounded claim that fluoridation is the unauthorized practice of medicine. For example, in Dowell v. City of Tulsa, 273 P.2d 859, 863 (Okla. 1954), it was alleged that fluoridation violated the freedom of religion, presumably because it required certain citizens to submit to medication against their religious beliefs. In rejecting the argument, the court adopted the decision made in the DeAryan case that fluoridation was not the practice of medicine. Id. 
Additionally, courts considering these arguments have stated that adding fluorides to the public water supply is not technically compulsion. “The United States Supreme Court, in establishing and clarifying the Constitutional right of religious and other freedoms, has distinguished between the direct compulsions imposed upon individuals, with penalties for violations, and those which are indirect or reasonably incidental to furnished service or facility.” De Aryan v. Butler, 260 P.2d 98, 102 (Cal. Ct. App. 4th Dist. 1953). In other words, because fluoridation of public water is reasonably related to the state’s interest in protecting the public health, the resulting burden on citizens to drink the fluoridated water is considered “reasonably incidental” to the state’s justified action.
To date, no court has accepted the proposition that fluoridation of water should be considered medication. In rejecting this proposition, most courts have recognized the opinions of medical and dental professions that the addition of fluorides to public water should be viewed as a preventative mechanism, and not as medication. Because water fluoridation is not the practice of medicine, it follows that all arguments based on this suggestion should not succeed. 
V.	THE ADDITION OF FLUORIDES TO THE PUBLIC WATER SUPPLY BENEFITS NOT ONLY CHILDREN, BUT SOCIETY AS A WHOLE. 
While it may be true that the majority of the benefits water fluoridation provides fall to children, it is equally true that all members of a community enjoy the benefits of water fluoridation. Even so, opponents of fluoridation allege that plans to add fluoride to the public water supply are arbitrary and unreasonable because their stated purpose is to reduce the instance of dental caries in a limited class of citizens – more specifically, individuals under approximately twelve to fourteen years of age. Cases such as Chapman v. City of Shreveport, 74 So.2d 142 (La. 1954), and Dowell v. City of Tulsa, 273 P.2d 859 (Ok. 1954), have found that a statute directed at a particular class of citizens is not to be automatically rendered arbitrary and unreasonable.
In Chapman v. City of Shreveport, 74 So.2d 142 (La. 1954), the court stated that a statute directed at a limited class of citizens may nevertheless be beneficial to the public as a whole. Id. at 146. The court further explained that the addition of fluorides to the water would eventually directly benefit the entire population, as today’s children will mature to become the adult population. Id. The court in Froncek v. City of  Milwaukee, 69 N.W.2d 242, 247 (Wis. 1955), cited its approval of Chapman’s conclusion that the fact that the purpose of fluoridation is to prevent the occurrence of tooth decay in a limited class of citizens does not preclude it from being within the reaches of the state’s police power.
The plaintiffs in Dowell advanced a similar argument, claiming that fluoridating the water could not be justified as a public health measure because of the lack of evidence proving the treatments would benefit anyone over the age of sixteen. Dowell v. City of Tulsa, 273 P.2d 859, 863 (Ok. 1954). The Dowell court responded to this claim much like the Chapman court, finding it without merit. “When it is borne in mind that the children and youth of today are the adult citizens of tomorrow, and that this one segment of the population unquestionably benefited by the drinking of fluoridated water now, will in a few years comprise all or a very large percentage of Tulsa’s population; and it is further realized that reducing the incidence of dental caries in children will also benefit their parents, the fallacy of plaintiffs’ argument is manifest.” Dowell at 863.
The limited class argument was also raised in Readey v. St. Louis County Water Co., 352 S.W.2d 622, 631 (Mo. 1961). The Readey court determined the fluoridation measure to be beneficial to the public as a whole, citing testimony in the record that because children will become adults the benefits are actually bestowed upon all citizens.
The consensus among courts seems to be that although the addition of fluorides to water provides direct benefits mainly to young children, it also indirectly benefits the parents of those children. And as children will inevitably grow up and comprise a large portion of the adult population in a particular area, fluoridation will eventually directly affect all citizens.
VI.	COMMUNITY FLUORIDATION PLANS HAVE BEEN WIDELY IMPLEMENTED ACROSS THE U.S. IN THE LAST HALF CENTURY, AND CONSISTENT MONITORING OF THESE PROGRAMS HAS PROVEN THAT THERE ARE NO UNIFORM ADVERSE AFFECTS.
Arguments related to the “limited class” arguments against fluoridation are those asserting that fluoridation may in fact hurt those it does not help. These arguments are without merit, as scientific evidence has proven not only that fluoridation administered at closely monitored levels causes no uniform adverse effects, but also that it is tremendously successful at reducing the incidence of tooth decay. (CDC). Courts considering this argument have noted the science evidence supporting fluoridation programs, and have recognized that it is the duty of the legislature to determine the best course of action for the public health.
For example, in Chapman v. City of Shreveport, 74 So.2d 142 (La. 1954), the plaintiffs alleged that fluorides in the water may adversely affect adults, and therefore to implement fluoridation measures without conclusive proof that no adverse effects would occur was arbitrary and unreasonable. In responding to this assertion, the court cited the existence of ample evidence in the record supporting the legislature’s decision to require fluoridation. Examples of the evidence include the opinions of professional medical and dental societies that fluoridation was not harmful and was in fact beneficial to citizens. Focusing on the fact that the plaintiff’s argument merely alleged that adverse effects may be possible, and in no way provided conclusive proof that they would result, the court rejected this argument.
Further, in Attaya v. Town of Gonzales, 192 So. 2d 188 (La.App. 1st. Cir. 1966), the appeals court affirmed the trial court decision not to allow the plaintiffs to submit evidence in an attempt to prove that fluoridation may have adverse effects on some individuals. 
In the present case, [Specify government entity] held extensive hearings on the advantages and disadvantages of water fluoridation. After thorough consideration of the issues, the conclusion was reached that it was in the best interest of [city of town] to implement a water fluoridation plan. The evidence on the record is more than sufficient to support this conclusion, thus, the court is not permitted to disturb it upon review.
NOTE: There is a case, Smith v. State of Alaska, 921 P.2d 632 (Alaska 1996), that involves a citizen who died as a result to excessive fluoride levels in this water. The substantive merits of water fluoridation are not before the court; rather, the issue is the scope of the state’s liability for the death. Still, the case is worth noting and distinguishing. Prior to the occurrence of the death, the state was aware of excessive fluoride levels in the water and did make repairs to the system. Id. at 633. The state also had plans to completely replace the water system, as it was old and not functioning properly. Id. [Specify government entity enacting fluoridation measure] does not dispute that fluoridation is a dangerous substance when extreme amounts are ingested. However, [specify fluoridation measure] includes detailed provisions for monitoring fluoride levels in the water and ensuring that it never approaches even remotely dangerous levels. Accordingly, the Smith case should have no bearing on the present case.
VII.  OTHER ARGUMENTS HAVE BEEN ADVANCED IN AN ATTEMPT TO STRIKE DOWN FLUORIDATION STATUTES. THESE ARGUMENTS HAVE ALSO BEEN REJECTED BY COURTS.
Courts have rejected a few additional arguments opposing fluoridation without engaging in a detailed analysis. Examples of such arguments are as follows:
In Kraus v. City of Cleveland, 121 N.E.2d 311, 313 (Ohio 1954), the plaintiffs asserted, among other reasons, that a fluoridation ordinance was unconstitutional because it did not set forth the exact chemical to be used. In rejecting all of plaintiff’s assertions, the Ohio Supreme Court focused on the facts that the city council had acted properly within the power delegated to it by the legislature, and that there was sufficient evidence on the record to support the council’s decision.
In Rogowski v. City of Detroit, 132 N.W.2d 16 (Mich. 1965), the plaintiffs also claimed that the fluoridation ordinance at issue should be struck down because water fluoridation was wasteful and uneconomic. Here the Michigan Supreme Court was considering an appeal by plaintiffs from a summary judgment granted in favor of the defendants. Thus, the standard of review was whether all of plaintiffs’ claims taken together as true set forth a valid claim for relief. The Court held that they did not and affirmed summary judgment in favor of the City of Detroit.
Opponents of fluoridation alleged that it subjected citizens to mass medical or scientific experimentation in both the Rogowski and Kraus cases. Both courts resolved the cases and upheld the validity of the fluoridation measures on other grounds without getting to the experimentation arguments. Rogowski v. City of Detroit, 132 N.W.2d 16 (Mich. 1965); Kraus v. City of Cleveland, 121 N.E.2d 311 (Ohio 1954).
The plaintiffs in both Rogowski v. City of Detroit, 132 N.W.2d 16 (Mich. 1965) and Readey v. St. Louis County Water Co., 352 S.W.2d 622 (Mo. 1961) both made allegations that fluoridation measures were invalid because they were not the least intrusive means of controlling dental caries. Both the Michigan Supreme Court and the Missouri Supreme Court rejected these arguments.
CONCLUSION
The benefits provided by water fluoridation systems are scientifically proven and have been extensively documented. City councils and other government entities across the country have considered allegations that these systems cause adverse effects, and have concluded that the allegations are unfounded. Further, statutes or ordinances enacting water fluoridation plans have survived virtually every type of constitutional attack. [Specify government entity] acted squarely within the powers granted to state legislatures by the United States Constitution, and has not acted arbitrarily or unreasonably in any manner. In view of these facts, the attacks against [specify fluoridation measure] should be rejected, and [city or town] should be allowed to proceed with its duties to protect the health and welfare of its citizens.
TABLE OF AUTHORITIES
Cases
Attaya v. Town of Gonzales, 192 So.2d 188 (La.App. 1st Cir. 1966)
Chapman v. City of Shreveport, 74 So.2d 142 (La. 1954)
De Aryan v. Butler, Mayor, et al., 260 P.2d 98 (Cal.App. 4th Dis. 1953)
Dowell v. City of Tulsa, 273 P.2d 859 (Okla. 1954)
Froncek v. City of Milwaukee, 69 N.W.2d 242 (Wis. 1955)
Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (U.S. 1905)
Kaul v. City of Chehalis, 277 P.2d 352 (Wash. 1954)
Kraus v. City of Cleveland, 121 N.E.2d 311 (Ohio 1954)
Parkland Light & Water Co. v. Tacoma-Pierce County Board of Health, 90 P.3d 37 (Wash. 2004)
Readey v. St. Louis County Water Co., 352 S.W.2d 622 (Mo. 1961)
Rogowski v. City of Detroit, 132 N.W.2d 16 (Mich. 1965)
Smith v. State, 921 P.2d 632 (Alaska 1996)
Secondary Sources
16A Am.Jur.2d Constitutional Law §§ 363–365	
R.D. Hursh, Validity, Construction, and Effect of Statute, Ordinance, or Other Measure Involving Chemical Treatment of Public Water Supply, 43 A.L.R.2d 453 (2004)
STATEMENTS FROM PROFESSIONAL ORGANIZATIONS SUPPORTING PUBLIC WATER FLUORIDATION
American Academy of Pediatric Dentistry
http://www.aapd.org/members/referencemanual/pdfs/02-03/P_FluorideUse.pdf
American Dental Association
http://www.ada.org/prof/resources/positions/statements/fluoride3.asp
American Medical Association
http://www.ama-assn.org/apps/pf_new/pf_online?f_n=browse&doc=policyfiles/HnE/H-440.923.HTM
Centers for Disease Control and Prevention
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm
Department of Health and Human Services, Office of the Surgeon General
http://fluoride.oralhealth.org/papers/pdf/SGstatement2001.pdf
International Association for Dental Research & American Association for Dental Research
http://www.iadr.com/about/iadr/policy.html
National Institute of Dental and Craniofacial Research
http://www.nidcr.nih.gov/HealthInformation/OralHealthInformationIndex/Fluoride/WaterFluoridation.htm
World Health Organization
http://www.who.int/water_sanitation_health/oralhealth/en/ index2.html