Canada - Water fluoridation offers many health benefits (he/she says)

August 24, 2009
News from the United States this summer has been filled with debates over health care reform. They have been characterized by misinformation and fear. They have also reminded me that good public decisions on health must be made using accurate and complete information.

In November 2010, citizens in the city of Waterloo will be asked to vote on whether we wish to continue to receive fluoride in our municipal drinking water, in response to concerns from a number of very vocal residents. As a resident who has received the benefits of fluoridated water in Waterloo for my entire life, I want each of our citizens to make an informed decision on water fluoridation.

First, the U.S. Centres for Disease Control has identified water fluoridation as one of the 10 great public health achievements of the 20 century. Studies have estimated that fluoridated water can be expected to reduce the rates of dental caries, also known as cavities, by 30 to 50 per cent in children and approximately 27 per cent in adults. Caries can cause pain and structural problems, and, if left untreated, can lead to infection, loss of function, and the need for tooth extraction. While we often see cavities as a treatable problem, they can have serious health effects, particularly for those who cannot afford regular dental visits or treatment.

Second, adding fluoride is a tremendously cost-effective public health intervention, at approximately 60 cents per person per year. This means that providing me with fluoridated water to this point in my life has cost our government less than $15. Treatment of a cavity is enormously more expensive.

So fluoridated water is effective and inexpensive for its benefits, but is it safe? As of 2007, 70 per cent of Ontario’s population received fluoridated drinking water. In the right small amounts, as we have in Waterloo, there is no reason to believe that water fluoridation is unhealthy. Fluoridation is supported by the Canadian Dental Association, the Ontario Dental Association, the American Dental Association and the World Health Organization, among others.

Some have expressed concern about dental fluorosis, which most often is mild and causes white flecks to appear on teeth as a result of too much fluoride up to the age of six. Children do not get too much fluoride from appropriately fluoridated drinking water. The most common cause of excess fluoride in children is swallowing toothpaste.

We like to think that our society is equitable, and that how healthy we are isn’t related to how much money we have. Unfortunately, these difficult times have reminded us that far too many people in our community do not get their prescriptions, do not eat healthy food, and do not get preventive dental care, all because they cannot afford them.

Water fluoridation is an important step in levelling the playing field. Research from England indicates that those who are poor receive the most benefit from water fluoridation. Removing fluoride from our drinking water would be most damaging for those in our community who have the least.

Unjustly, when decisions are made based on fear and misinformation, the results often most injure those who are most vulnerable. This may well be the ultimate result of the U.S. health care reform debate. Do not let it become the result of our 2010 referendum. I encourage everyone to use the next year to become informed about this issue, using reliable and relevant information.

And for those who do not receive fluoride in your municipal drinking water, this may be a good time to figure out if you think that should change.

I hope the good citizens will hear from those opposed to fluoridation and not just this propaganda.