You don’t have to be in the health field to appreciate the overwhelming evidence that supports the benefits of adding fluoride into public drinking water.
In 2011, Calgary’s city council decided to discontinue fluoridating Calgary’s drinking water. This act came in direct opposition to all prominent health bodies’ recommendations. There are over 70 years of research on fluoridating drinking water, and yet in Calgary, we still have an ongoing debate that is doing nothing but increasing the number of (very preventable) dental cavities in our population.
What does fluoride do? At appropriate levels, fluoride strengthens tooth enamel and prevents tooth decay. Fluoride is essential to protect and strengthen developing and aging teeth (i.e., children, teenagers, adults and seniors).
But are there any risks? Well, if too much fluoride is ingested while your teeth are developing, you could get fluorosis in your adult teeth. Fluorosis ranges from small white spots to generalized grey banding on the teeth, which is considered an aesthetic concern, not a health concern. Health Canada found that only 16 per cent of Canadian children may have very mild or mild dental fluorosis, while the number of children with moderate to severe fluorosis was too low to report.
On the other hand, the risk of vulnerable people (children, seniors, socially and economically vulnerable Calgarians) not having adequate exposure to fluoride is much greater. In children, these risks include dental cavities, and consequences in nutrition, sleeping, learning and social development.
In seniors, tooth decay and poor nutrition are common findings. Experts expect that Calgary water fluoridation would result in about three million fewer cases of dental cavities over 20 years. Since the fluoride removal in 2011, Calgary dentists have noticed a significant increase in children, adults and senior patients coming in with dental cavities. Current estimates suggest that dental infections have increased by 700 per cent since fluoride was removed from Calgary water in 2011.
Some people might ask why they should want fluoride in their drinking water, and why using fluoridated toothpaste and dental checkups as sources of fluoride are not enough. You can get fluoride from fluoridated toothpaste and from dental checkups, although this is dependent on the individual level of oral hygiene. But if drinking water is fluoridated, our teeth would be exposed on a more continuous basis (at a much lower fluoride concentration than is in toothpaste), which would be more beneficial than just using toothpaste or occasional dental visits.
We use water for everything — drinking, cooking, brushing our teeth — which means our teeth would be more consistently exposed to fluoride, providing more protective effects. Dental care is not covered by the provincial health care plan. Which means, to be able to afford dental services like a basic checkup, one either has private insurance, employment benefits or has to pay out-of-pocket. Having fluoridated water eliminates this particular barrier for better oral health for all Calgarians.
So, while using fluoridated toothpaste and visiting the dentist is a source of fluoride, there is a better solution that will benefit all Calgarians (not just those who can afford it).
An argument against fluoridating Calgary’s water contends that that public health policy goes against individual autonomy to make one’s own health-related decisions. Except that one of the population’s most affected (children) are not allowed to make this decision for themselves, and are reliant on adults to make appropriate decisions related to their health on their behalf.
Reintroducing fluoride at an appropriate concentration into Calgary’s drinking water would provide many health benefits, without the risk of dental fluorosis. Community water fluoridation is consistently cited as the most efficient and cost-effective public health measure to protect against dental cavities and is even considered by the CDC as one of the 10 greatest public health achievements of the 20th century.
Calgary needs to bring back the fluoridation of its water for the health of all its residents.
Rachel Cowitz is studying for a master’s degree in public health at Memorial University.