On the surface, it seems like a simple decision to make. Why add fluoride to drinking water supplies? It is a toxic chemical, dangerous to work with, costly to add, and widely available elsewhere, in toothpaste, mouthwashes and food and drink prepared with fluoridated water.

Add in the concerns of fluoride opponents that this addition to water can cause everything from arthritis, cancer, and low IQ, along with diseases of the gastrointestinal tract, kidney, pineal gland, and thyroid, and it seems even more simple – everyone, everywhere should remove fluoride from the water immediately.

The Town of St. Paul is surveying residents to get their take on fluoridation, with initial results from the town’s social media poll suggesting a majority of respondents favoured removing fluoride from drinking water.

While it is important to weigh public opinion in making decisions, sometimes other factors come into play as well, including cost benefits and health and safety risks – both from ingesting or not ingesting fluoridated water as well as risks to those that work with the toxic substance.

On the other side are arguments from proponents who say that water fluoridation is critical to preventing tooth decay. In 1999, the US Centers for Disease Control and Prevention listed water fluoridation as one of the ten great public health achievements of the 20th century, and it’s important to note that national and international health agencies endorse fluoridation, as does the Alberta Dental Association & College and Alberta Health Services.

These are agencies that support the practice of vaccination as well, a practice that faced – and still faces – criticism without a solid basis in fact. It’s hardly surprising that once eradicated diseases like measles are reappearing as people increasingly choose not to get jabbed.

Could the same thing happen with communities that are giving up fluoridation? It’s hard to say, but anecdotal evidence from dentists in cities like Calgary and from those in countries in Europe suggests that following the removal of fluoride, the incidence of tooth decay has increased.

Perhaps it’s not quite time to throw the fluoride out with the bathwater.