Epidemiological researchers with the Windsor-Essex County Health Unit have descended on Kingsville and Leamington to stare into the mouths of locals and figure out whether their teeth are fouler than those found in Windsor.
The study, started last year, aims to measure the touted benefits of fighting cavities by adding fluoride into the municipal water supply, something the Windsor Utilities Commission has been doing in the city for 60 years, but something the Union Water System serving those county towns has never done.
It’s also an effort by local authorities to counter a recent surge in public opposition to the long-practised public health measure.
“We’ll try to see if we can get enough information on dental caries (tooth decay) … to accurately look at a comparison between fluoridation and nonfluoridation,” said local medical officer of health Dr. Allen Heimann.
Depending on the outcome, the study will no doubt be added to the arsenal of one or the other side in the renewed local debate over whether adding the chemical to our drinking water is beneficial.
Federal health regulators have left the decision on fluoridation to each municipality, and WUC staff have been conducting their own fact-finding review. Chief operating officer John Stuart said a report being prepared for the board will rely heavily on the input of health officials. For his part, Heimann said he remains convinced that fluoridation is the way to go.
But with a growing local campaign against fluoridation, Windsor politicians will soon be asked to play doctor and decide whether to join other North American municipalities that have decided to end the practice.
A special meeting of WUC is being hosted at 6 p.m. Feb. 29 at city hall. The commission will forward its recommendation to city council, but a decision won’t come easily.
“There are counter-arguments for every argument that one side or the other brings forward – that’s what’s going to make it so difficult,” said Coun. Bill Marra, who chairs the WUC board.
“Interest from the community is growing … it’s a good time for the facts.”
Formed last summer, Fluoride Free Windsor boasts about 200 supporters, and Marra said he and other city decision makers are being lobbied to pull the plug on fluoridation, viewed historically as a relatively cheap method of strengthening teeth and reducing the incidence of cavities in children.
In recent months, the group was successful in getting Lakeshore and Amherstburg councils to vote to end fluoridation, and politicians in both Tecumseh and LaSalle expressed concerns but decided to defer any decisions pending more information. The Windsor-Essex County Environment Committee is recommending Windsor consider ending fluoridation of its tap water.
“We are not the gullible people in the 1950s when they introduced this,” said Fluoride Free Windsor founding member Donna Mayne, a Windsor mother of three. While health officials point to the incidence of cavities going down in communities that fluoridate their water, Mayne and other opponents point to the same results of declining rates of tooth decay in places that don’t have municipal water fluoridation, including most of Quebec, B.C. and Europe. Fluoride in toothpastes, nylon toothbrushes, better nutrition and increased public awareness leading to better oral hygiene have all made a difference, they argue.
Kim DeYong, a Windsor mother of two and original member of the group, doesn’t like the municipal water system being used as a delivery vehicle for a chemical that is not required to treat the water. She said the dosage of this “medicine” is random and unmonitored, whether the recipient is a child, athlete, senior or diabetic. “When my daughter is thirstier … she gets more medication,” said DeYong. Because of its fluoride content, users of toothpaste are told not to swallow, “but we swallow the water,” she added.
Heimann said that, while “there have been a lot of claims on the dangers of fluoridation,” the list of proponents who can cite studies and reviews pointing to the benefits is lengthy, including the Canadian and American governments and professional health and dental organizations and the World Health Organization. The U.S. Centers for Disease Control and Prevention ranked tap water fluoridation as one of the top 10 public health achievements of the 20th century.
Asked whether he harbours any concerns about its continued use, Heimann responded: “Not at this time.”
The medical officer of health’s opinion holds sway.
“I’m not an epidemiologist, I’m not a doctor – I sort of rely on the health professionals,” said Stuart, who is leading WUC’s review effort.
But Lakeshore and Amherstburg decisions to stop fluoridation came over Heimann’s protests, and both towns join a growing number of Canadian municipalities, including, most recently, Waterloo, Moncton and Calgary, which have sided with the critics and ended the practice. Heimann points to cities like London, Hamilton and Toronto, which also recently reviewed the matter before choosing to stay with fluoridation.
Marra isn’t alone in finding the issue complicated and the advice conflicting. Consider some examples:
• The Canadian and Ontario dental associations are big supporters, but the head of preventive dentistry at the University of Toronto, Dr. Hardy Limeback, is one of the prominent dissenters and says adding fluoride to drinking water is “more harmful than beneficial.” He claims the early studies still cited by authorities were “not done very well,” and the more recent studies show little difference when comparing systems that use fluoridation to those that don’t.
• Proponents like the local health unit cite Health Canada claims of substantially higher cavity rates among children in Quebec, where there is almost no fluoridation, compared to Ontario, where the majority of the population drinks fluoridated tap water. Opponents, however, can point to Statistics Canada figures from the same two jurisdictions indicating there was only a slight difference, amounting to about half a cavity per child.
• Health Canada says infant formula prepared with fluoridated water “maximizes the protective role of fluoride” on future permanent teeth, while the CDCP and the American Dental Association, both strong proponents of fluoridation, caution against giving fluoridated water to infants.
• The U.S. CDCP [sic: CDC] may herald municipal fluoridation as one of the top public health achievements of the past century, but one of its own studies in 2010 concluded that more than 40 per cent of adolescents aged 12 to 15 studied had suffered dental fluorosis, which causes spotting on teeth and is a sign the individual is getting too much fluoride. Health Canada, citing data released that same year by the Canadian Health Measures Survey, claims the prevalence of fluorosis in Canada is too low to even be worth reporting.
“That’s ridiculous … we should not expect the 49th parallel to protect Canada from dental fluorosis,” said Dr. James Beck, professor emeritus of medical biophysics at the University of Calgary. A doctor of medicine, he helped convince Calgary council to vote a little over a year ago to stop fluoridation for a million residents.
DeYong said the public was never informed when the pharmaceutical-grade sodium fluoride originally used in the 1950s – and which was used in the health and safety tests – was replaced a decade later by cheaper industrial-grade hydrofluorosilicic acid, which is sourced from the smokestack scrubbers of phosphate fertilizer manufacturing plants.
Mayne accuses Health Canada of “doublespeak” when it says hydrofluorosilicic acid is safe when used in drinking and bathing water, while other government regulations make it illegal for factories to release the same material into the environment as a byproduct of the fertilizer manufacturing process. “Why can’t these industries dump their scrubber waste into our lakes?” asks Mayne, who has also learned the hydrofluorosilicic acid sourced from factory scrubbers contains such trace contaminants as lead and mercury.
“Even pharmaceutical grade has trace contaminants,” said WUC’s Stuart. “We follow all the regulations,” he added.
“The very few who really look into this are horrified. It’s all endorsements and propaganda – there’s no science,” said Heather Gingerich, a medical geologist who studies fluoride toxicity.
At a recent presentation to Amherstburg, Heimann advised that there is “no credible evidence of toxicity” when fluorosilicic acid is dissolved in water. But fluorosilicic acid, the industrial-grade fluoride put into Windsor’s tap water, has never been put to the test by being made the subject of toxicological studies involving either animals or humans, said Gingerich, who is the Canadian director of the International Medical Geology Association.
“There is no question that fluoride damages human health. The weight of evidence is tilting more and more against fluoridation,” said Paul Connett, director of the Fluoride Action Network and a retired professor of environmental chemistry and toxicology at New York’s St. Lawrence University.
The protective action of fluoride comes from its direct contact with the surfaces of the teeth (a chemical, not biological process), and yet it’s being swallowed and ingested through our drinking water and absorbed through the skin while bathing or showering, Connett and other critics say. The same chemical reaction that hardens tooth enamel is hardening bones, leading to increased brittleness and greater susceptibility to bone fractures later in life. Thyroid function can be affected and some studies show an impact on child IQ levels at higher dosages.
“It doesn’t make sense to expose every tissue in the body,” said Connett, co-author of the 2010 book The Case Against Fluoride.
Heimann said the fluoride added to drinking water is not a medicine, but Connett said the reason for its introduction is “to combat tooth decay – that’s the definition of a medicine.”
Health Canada was asked to provide an expert for an interview but its media office told The Star it would only respond to written questions.
“Health Canada’s review of the scientific literature on fluoride has found no adverse health effects from water containing fluoride at, or below, (the) maximum acceptable concentration,” it replied to a question on potential human health risks. The agency’s suggested “optimal” concentration in drinking water is 0.7 milligrams per litre. Stuart said WUC’s target level is 0.65 mg/L.
“Currently available studies indicates (sic) there is no link between any adverse health effects and exposure to fluoride in drinking water at levels that are below the maximum acceptable concentration of 1.5 mg/L,” Health Canada told The Star in its email response.
Still, earlier this month, Peel Regional Council, representing 1.3 million GTA residents, petitioned Ontario’s health minister to push Health Canada to begin regulating industry-sourced fluorosilicates as drugs under the Food and Drugs Act. It also wants Health Canada to “reassure the citizens of Peel” that what’s being added to drinking water is safe.
Alberta’s Beck said it took a decade-long effort to convince Calgary to end its fluoridation. In the end, he said, it wasn’t the scientific arguments about the effectiveness of putting fluoride in the drinking system to prevent cavities or about its toxicity and the potential dangers to human health that won the day. Rather it was the ethical issue over using something as essential as drinking water as a means to deliver a chemical with only an “extremely slight benefit” in preventing cavities.
“One councillor told me later that council felt itself overwhelmed by the scientific questions – but they were convinced by the ethical question,” said Beck. He said fluoride is the only medicine administered without the informed consent of the recipient, there’s no initial or ongoing monitoring by a physician, and the only way you can stop taking it is by not using the municipal water system.
The Essex County Dental Society has warned that tooth decay will increase if fluoride is taken out of the water. Gingerich, who lives in Ingersoll and is providing her support to the local anti-fluoride group, said fluoride can be found in the air, water, food and pharmaceuticals. “We’re now exposed to five times more in our environment than in 1971,” she said.
On an operating budget of about $50 million, WUC’s annual fluoridation costs are between $100,000 and $150,000. Agreements with Windsor’s neighbours see just over a fifth of WUC’s drinking water volume going to LaSalle and Tecumseh, so “it’s not just Windsor … they’d also need to pass bylaws,” Stuart said.
The issue will ultimately be decided by city council. “People today are more and more aware of the things they ingest and where they come from – I’m open-minded,” said Mayor Eddie Francis.
As with mercury in dental fillings and lead in gasoline, the Fluoride Action Network’s Connett predicts fluoridation of municipal drinking water will eventually cease.
“Yes, eventually good science prevails,” he said.
Windsor Utilities Commission is hosting a special meeting on fluoridation, 6 p.m. Feb. 29 at city hall. Anyone wanting to speak can email info@enwin. com (write “fluoride” on the subject line). Each delegate will have five minutes at the microphone.
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