Canada - New debate on controversial tap water fluoridation for new city council

Windsor’s newly elected council will grapple on Monday night with the contentious and emotional issue of fluoridating the municipal water supply.

It’s the new council’s first substantive meeting after a ceremonial swearing-in on Dec. 3. The fluoridation debate is rearing its head again after a deferral in the spring headed off a long list of delegations arguing both sides of the issue. Flouride was removed as an additive in city drinking water in 2013 after a council vote following another lengthy city hall debate.

The Windsor-Essex County Health Unit is urging its re-introduction, citing an oral health study reporting on the rise in cavities among children and other signs of declining dental health. Based on school screenings between 2011/12 and 2016/17, it says there’s been a dramatic 51-per-cent rise in the number of children with tooth decay requiring urgent treatment, as well as a decline in the percentage of cavity-free kids. Comparing Windsor-Essex, where no municipalities fluoridate, with the rest of Ontario, where 70 per cent do, the percentage of children with urgent dental needs was double.

The health unit has the backing of multiple dental and public health organizations urging the return of fluoridation.

“We need to accept as a community we have a problem with oral health and we need to take action,” said acting medical officer of health Dr. Wajid Ahmed. “And we know from an evidence-based perspective that fluoridation of water is regarded as a success story of the last century by many of the world (health) agencies.”

When you look at the local percentages of children, the decline in their oral health is pretty significant since fluoride was removed, said Ahmed.

“It’s my obligation and my duty to provide the best advice to the community and this is based on the evidence.”

When council debated the issue in 2013, voting 8-3 to end 51 years of fluoridation, there was a five-hour debate which included 27 delegations, 16 of whom wanted it removed. There were 81 submitted reports and letters. And while most of the dental and health organizations pleaded for fluoridation to be kept, there was a groundswell of citizens — armed with their own studies — questioning the safety of adding a chemical into the water system.

Mayor Drew Dilkens was a city councillor when he made the motion to get rid of fluoride. Today, he has the same opinion, he said Wednesday.

“There are many opportunities available to people to take care of their oral health, the best being the use of fluoride toothpaste, which is really inexpensive. It can be bought at the dollar store and I don’t see the need to medicate the entire population when there are plenty of options to ensure that kids and adults get proper fluoride on their teeth.”

The mayor said groups of dentists on both sides of the issue have tried to convince him one way or the other. “And so I have to use my own judgment.” There’s an $850,000 initial capital cost for the equipment required for Windsor Utilities Commission to restart fluoridation.

It’s not an issue that should be left up to a municipal council, said Dilkens. If it’s such an important public health issue, the province should be deciding whether all municipalities should fluoridate.

“Why would they leave it up to non-science people like myself and the rest of city council to make that decision?”

Windsor is one of 23 municipalities in Ontario to discontinue fluoridation since 2000, while two have decided to reintroduce it. Windsor also provides drinking water to LaSalle and Tecumseh.

Part of the reason for council’s deferral earlier this year was to find out if the government would make a provincewide decision on fluoridation. Letters from the current ministers of health and the environment responded that it was a municipal responsibility.

Ontario’s chief medical officer of health Dr. David Williams, however, wrote to council in May urging the reintroduction of fluoride. Citing the “concerning decline” in oral health of local residents, particularly among children, he said: “The health benefits of drinking water fluoridation extend to all residents of the community, regardless of age, socioeconomic status, education or employment.”

The health unit’s Dr. Ahmed stressed that fluoridation is only one of the recommendations in the Oral Health Report. Others involve educating the public about the importance of good oral health and finding ways for people who can’t afford dentists. When council got rid of fluoridation, it directed that the money saved — $478,750 over five years — should be directed into programs that promote oral health. About $338,750 has been spent, leaving $140,000.