I read the Oct. 5 opinion letter by a group of local doctors trying to convince Parry Sounders to vote in favour of fluoridation in the upcoming plebiscite. As one of the persons derogatorily labelled as a ‘so-called expert’, I’d like to offer some corrections and facts in response based on science, not politics or endorsements.
Claim 1: “As health professionals we serve as first-hand witnesses to the impact that poor dental hygiene has on the overall health of the community”
This is an odd statement, since physicians do not practice dentistry and are not familiar with dental science.
Fact: poor dietary choices (frequent sugar intake) cause cavities. “Poor dental hygiene” is a not a major factor in the prevalence and severity of dental decay.
Claim 2. Cavities cost Canadians over a billion dollars a year.
Sounds impressive, but that’s only $27/person/yr.
Fact: Other dental costs, including cosmetic dentistry to treat the dental fluorosis side effects of fluoridation, are 12 times higher.
Claim 3. The truth is, fluoride in drinking water has been scientifically studied for over 70 years without ever finding evidence that the low levels recommended in municipal drinking water have any negative health effects.
Fact: While fluoridation has been in place for 70 years, studies have not been conducted to show safety. Our expert review panel (the National Academies of Sciences Committee on Fluoride in Drinking Water) reviewed over hundreds of studies on fluoride toxicity. See https://www.nap.edu/catalog/11571/fluoride-in-drinking-water-a-scientific-review-of-epas-standards We found several problems with fluoride in drinking water because fluoride accumulates in the body, primarily the skeletal system.
Our own study (Chachra et al, 2010) published after our NAS Review of 2006 comparing the bones of fluoridated Torontonians with the bones of the non-fluoridated Montrealers showed that the people in Toronto had more fluoride in their bones and the physical properties of their bones had changed. Fluoride accumulation in bones weakens them.
But if you don’t look for problems you won’t find them. There has never been a randomized, double-blinded clinical trial to see if fluoridation actually works. This kind of study is required for every drug that seeks approval from Health Canada or the U.S. FDA.
Claim 4. In recent years, when communities have voted to remove fluoride from drinking water, cavity rates have risen.
Fact. This is incorrect. Nearly all studies, including in Canada, showed that where fluoridation was halted, dental decay continued to drop. The increased dental decay claimed was anecdotal and could not be backed up with good science. We published a critique of the findings in Calgary after it stopped fluoridating in 2011 https://www.ncbi.nlm.nih.gov/pubmed/28994462.
Claim 5. It is true that swallowing too much fluoride toothpaste can cause your teeth to stain (known as fluorosis); an uncommon finding even in those who brush regularly and have fluoride in their town water.
Fact. Dental fluorosis occurs when too much fluoride is ingested from birth to age six years. It is the total fluoride that is ingested that is important. By far, fluoridated water is the largest contributor, especially when a baby is given infant formula made with fluoridated tap water. Unfortunately dental fluorosis, a permanent scarring of the teeth, is now a very common side effect of fluoridation. Some estimates are that one in 10 children have unsightly dental fluorosis in fluoridated areas.
Claim 6. The point is, there are no known negative health effects from the amounts of fluoride added to municipal drinking water, despite decades of study on the topic.
Fact: The good doctors are obviously not up on their science. There are four studies published in the last two years that linked prenatal exposure to fluoride to lowered IQ in the children later in life. One study showed that dental fluorosis was associated with lowered IQ. This is not ‘misinformation’ as the doctors suggest. These are peer-reviewed studies from highly respected international researchers.
Claim 7. Will updating our fluoridation system cost money? Yes, but not as much as it will to deal with all the cavities we will face if we don’t.
Upgrading Parry Sound’s fluoridation system to current standards will cost taxpayers at least $350,000. Add to that $150,000 over the next 15 years to maintain and run the system. The total cost is at least $500,000.
What are the dental cost savings Parry Sound families can expect after 15 years of fluoridation?
Fact: The most up-to-date peer-reviewed study (Slade et al, 2018) shows that 0.5 teeth might be saved per teenager exposed to fluoridated water since birth.
There are about 850 teens in Parry Sound. Saving 0.5 tooth/teen from decay will save families in Parry Sound about $85,000. Spending $500,000 to save $85,000 in dental costs is not wise way to spend taxpayers’ money. I was told that the cost to fluoridate will be recovered from increases in Parry Sound water bills.
Claim 8. It’s worth noting that no Canadian town has ever removed fluoride from water because of actual health concerns related to these low levels of fluoride.
This is another unsupported claim. When Canadian towns have the opportunity to weigh the risks vs. the benefits and look at all the health concerns, they usually vote to discontinue the practice.
Fluoridation is medication, as ruled by Supreme Court of Canada. You cannot control the dose. Everyone is obliged to take it whether they need it or not. It will harm the most susceptible even if they do not provide consent to this ‘medical treatment’.
In most medical schools graduates are asked to uphold the oath “primum non nocere” which is “first do no harm”.
But then those advising you to vote for fluoridation, including your medical officer of health and the group of doctors who wrote the OpEd letter, are not liable for any harm that fluoridation will cause your family.
Because of the Fluoridation Act of Ontario, if the answer to the referendum is in the affirmative, a majority of 51 per cent of the community can tell the other 49 per cent they have to contribute to the cost of fluoridation, pay for fixing dental fluorosis their children will get, pay for a home filtration system that removes unwanted fluoride and try and avoid foods made with fluoridated drinking water including foods served in the restaurants and coffee shops of Parry Sound.
This time Parry Sounders have a say whether or not they want fluoridation. It’s not up to the council, whether for or against.
Dr. Hardy Limeback BSc, PhD (Biochem), DDS
Professor Emeritus and former Head of Preventive Dentistry
Faculty of Dentistry, University of Toronto
Past member of the US NRC Committee on Fluoride in Drinking Water
Note from FAN: Some of the letters published in the paper
• Oct 17, 2018, Parry Sounders have a say whether or not they want fluoridation this time, by Hardy Limeback, DDS, PhD
• Oct 5, 2018: Parry Sound doctors support water fluoridation for health of community, signed by 22 doctors.
• Sept 27, 2018: Parry Sound health officer James Chirico says fluoride vote will be important, by James Chirico, MD