Canadians’ growing penchant for bottled water may help explain what some dentists are calling a steep jump in the rate of cavities among children.

As families increasingly opt for spring water, most of which contains only trace amounts of naturally occurring fluoride, they are avoiding tap water that in many cities is supplemented with the decay-fighting chemical.

“It’s not just drinking the bottled water. It’s the parents thinking the tap water is no good, whereas, in fact, there is fluoride in it,” said Franklin Pulver, a pediatric dentist in Toronto.

“If they don’t get it through prepared food and what-not, the kids are missing out on the fluoride.”

Other experts suggest the reasons have more to do with lifestyle and diet: Parents too busy to instill good dental hygiene, immigrants from developing countries not versed in cavity prevention and a sense that drinking fluoridated water is all that is necessary.

“I have so much decay, I can’t keep up with it,” Dr. Pulver said.

Problems are particularly pronounced among certain pockets of low-income children, with Montreal and Winnipeg, for instance, facing near-crisis levels of young people who need so much work they must be put under general anesthetic.

Manitoba is seeing an increase in decay among aboriginal and other disadvantaged groups, with about a quarter of the province’s children suffering tooth problems as bad as in the developing world, said Charles Lekic, head of pediatric dentistry at the University of Manitoba.

More than 1,000 young children, with as many as 20 cavities each, are languishing on a waiting list of six to 12 months for an operating room to have their teeth fixed.

“Hundreds of children are crying throughout the day because of tooth decay,” Dr. Lekic said. “You can imagine how these children feel — experiencing pain from the beginning of their lives.”

He blames the phenomenon on lots of cheap pop and candy and a lack of public education on cavity prevention. Practices such as giving babies a bottle to suck on in bed have led to widespread early-childhood carries: cavities in the baby teeth of pre-schoolers.

In Montreal, 600 children younger than four are waiting for dental work so extensive, it must be done under general anesthetic, said Stephane Schwartz, a pediatric dental specialist at Montreal General Hospital. She and her colleagues are planning a major lobby effort to convince the city to add fluoride to the water.

Dentists across the country report seeing more cavities over the last five years in children from all social strata, said Michael Sigal, head of one of Canada’s two graduate programs in pediatric dentistry, located at the University of Toronto.

“If you were to take a poll of pediatric dentists 10 or 15 years ago, they’d all be lamenting that they weren’t seeing that many children, their practices weren’t that busy, they were branching out into other aspects of dentistry to fill the void,” he said. “Now, if you talk to them, they are so busy just trying to keep up with fixing the teeth due to cavities, that they do not have to branch out into any other areas…. That’s right across North America. It’s not a regional thing.”

No one collects national statistics tracking the rate of tooth decay in the Canadian population. However, studies showing dentists are spending more time treating children and anecdotal reports of long waits for service would appear to confirm the trend, Dr. Sigal said.

Elizabeth Griswold, a spokeswoman for the Canadian Bottled Water Association, said she would be surprised if an increase in the consumption of bottled water was contributing to the jump in childhood cavities.

She said there is controversy over the effectiveness of fluoride, but some bottlers nonetheless add the substance to their product.

Canada produced 920 million litres of bottled water in 2001, and Canadians drank an average of 29 litres per person, according to figures from the International Council of Bottled Water.

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National Post

September 12, 2003

Letter to the Editor: Cause of cavities

In spite of Ontario dentists’ claim that bottled water is to blame for cavities, it is well known that the poor have more cavities than the rich and it is not for drinking bottled water which, unlike the rich, they cannot afford while fluoridated tap water is free by comparison.

Ontario is one of the most fluoridated provinces in Canada. People are preparing meals, tea coffee and other beverages with fluoridated water. Virtually all packaged foods and soft drinks processed in Ontario are processed with fluoridated water. Toothpastes and several drugs contain fluoride.

University of Toronto Dental Professor Dr. Hardy Limeback says Ontario citizens are actually getting too much fluoride because of the high rate of dental fluorosis (fluoride mottled teeth) seen in his dental practice.

To suggest people are missing out on fluoride by drinking bottled water when there are so many other sources of fluoride exposure is truly one for Gullible’s Travels.

Croft Woodruff, Vancouver.

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