Water fluoridation debate dominates municipal race

Point: Water fluoridation benefits go beyond public health

Keith Marshall

When voters go to the polls on Oct. 25, they will be asked whether or not Waterloo should continue to add fluoride to its drinking water.

Adding fluoride to drinking water is an important, low-cost, public health initiative. As a public policy started in Ontario over 40 years ago, it is currently in place in 70 per cent of the municipalities in Ontario. Compared to the cost of dental treatment, fluoridation of drinking water is a cost-effective means of preventing future dental problems in children. In Canada, it typically costs less than 60 cents per person a year to fluoridate water.

Fluoridated water has been found to protect children’s teeth from bacterial penetration, a problem that can lead to serious conditions like pulpal necrosis.

Additional research has suggested that younger children, particularly those who are first forming teeth, gain more acid-resistant teeth by drinking tap water with added fluoride. This can prevent teeth wear later in life caused by acidic foods and drinks. Drinking water with added fluoride is a preferred alternative for children under the age of three, who shouldn’t be using toothpaste when brushing their teeth.

Fluoridation is also an important means of reducing the number of cavities found in children, particularly those in lower-class families.

A 2007 study in the Journal of Public Health Dentistry revealed that children in Dublin, Ireland, who used fluoridated water, were less likely to develop cavities than their counterparts in Freiburg, Germany, who instead relied on fluoridated salts to protect children’s teeth.

It was also discovered that the difference in the number of cavities between lower and middle-class children was much less in Dublin than in Freiburg. This is because proper dental care is not as accessible for lower-income families, whereas fluoridated water is more widely accessible.

Having a healthy, clean, complete set of teeth has a number of documented social benefits. Sherry Güed and Matthew Neidell of Columbia University found in a study examining the economic value of teeth that people with access to water fluoridation during childhood earn on average two per cent a year more than those that don’t and are less likely to experience employer discrimination based on their appearance.

They also found that women were more likely than men to earn less as a result of having poor teeth appearance. As with any measure of hygiene, proper dental care is essential for success and fluoridated water has shown to do its part.

Current research suggests that keeping fluoride at levels between 0.5 and 0.8 ppm (parts per million) has no negative health effects. This is the level used for drinking water in the City of Waterloo.

In Canada, fluoride levels in water can naturally occur at levels up to 1.1 ppm, and Health Canada recommends municipalities maintain a level less than 1.5 ppm. In comparison, the Environmental Protection Agency in the United States considers any source of water with fluoride levels less than 4 ppm to be safe.

The use of hydrofluorosilic acid, the principle concern of area residents supporting the referendum, is a cost-effective means of obtaining the fluoride that is vitally needed in the drinking water of this community.
While efforts must be taken to ensure lead, arsenic and mercury levels are monitored and minimized, there is insufficient evidence to suggest that amounts of these materials, presently at quantities far below safety standards, pose any risk to public health.

Decades of safe use of fluoride in toothpaste and in drinking water, combined with regular brushing and flossing, has led to remarkable achievements in improving dental health in Canada. As a community, the people of Waterloo need to act responsibly when voting on this important health issue. Take the time to read further about the importance of fluoride for your health.

Counter-point: Fluoride is a health risk with few benefits

Andrew Chai

The topic of fluoridation is nothing new to Ontario. Starting with Brantford as the initial test city in 1945, now almost 75 per cent of the population of Ontario receive fluoridated drinking water.
Following its introduction we have seen cases of dental problems, such as cavities, decrease significantly.

Due to these results it has received much praise in North America and has even been named one of the ten most successful public health measures in the 20th century by the U.S. Centers for Disease Control and Prevention. 
Has the fluoridation of water been the sole reason for such success? In most European countries substantial declines in tooth decay occurred without its use, primarily from the introduction of fluoride toothpaste in the 1970s. 
Furthermore, the most recent study comparing cavity rates in Ontario and Quebec, which has the highest and lowest fluoridation rate respectively, found no clinically significant difference in the amount of tooth decay in children aged six to 19. 

Health Canada, which officially endorses the fluoridation of water, tried to downplay the results of the study by pointing out that it failed to assess individual fluoride intake and correlate that with cavity rates. They nevertheless admitted that the data collected by the study was accurate. 
The study suggests that if fluoridation is the only difference between the two provinces then its effectiveness has been strongly exaggerated. Mere correlation has been confused with causation. 

It is more probable that other developments such as advances in dental hygiene, lower sugar consumption, widespread use of antibiotics and increased exposure to Vitamin D have been the cause of decreased tooth decay and other dental maladies. 

A worldwide reduction in cavity rates, regardless of the use the chemical, provides further evidence that factors other than fluoride are at work. 

“The parallel reduction in caries [cavities] incidents in countries with a lot of fluoridation and countries with not much fluoridation is quite dramatic,” said Warren Bell, former head of the Canadian Association of Physicians for the Environment, a group that questions the practice. 

It seems that fluoridation may not be as useful as it was once thought to be, and that should be reason enough not to continue doing it.

Along with questions of water fluoridation’s effectiveness, some studies have shown that its consumption may come with adverse health risks. 
Recent studies have linked altered thyroid function, and reduced IQ levels in children to the ingestion of fluoride from municipal water.

An even more troubling 2006 study conducted by Harvard researchers found that boys aged seven exposed to high levels of fluoridated water were about four times more likely to develop osteosarcoma, a rare bone cancer that killed Canadian hero, Terry Fox, back in 1981.

The disturbing results from these studies also bring up another point: fluoridation is not something you can opt out of. If your city chooses to fluoridate its water, then you have no choice but to use that water. 
“It’s a clear violation of informed consent,” said Paul Connett, a retired chemistry professor from New York’s St. Lawrence University, in an interview with the Waterloo Chronicle.

Presently, the City of Waterloo, portions of Woolwich and a small part of Kitchener all add fluoride to their water supplies. But, this may all change in the coming weeks. Citizens of Waterloo will get to vote on a referendum on whether the city should continue to fluoridate its water. Based on the evidence, fluoride is at best unnecessary and at worst a serious health risk. Stop this practice by voting NO on Oct. 25.