CALGARY — Depending on who you ask, and when, fluoride is either one of the top public health initiatives of the 20th century, or a poison artificially injected into the water supply.
Fluoridated water is endorsed by virtually every credible health organization in North America, including Health Canada, the Centre for Disease Control and numerous dental associations. Yet, in its 60-year history, no public health measure has stirred up as much controversy and fear as the addition of the ion into the public water supply.
There are some concerns about whether fluoride doses need to be as high as they are, given the widespread use of the ion in food and toothpaste. But the more serious health claims made by anti-fluoride activists — including an alleged link between fluoride and reduced IQ — have been found wanting after scientific scrutiny by Health Canada and other researchers.
And yet, as decades have passed — and ongoing studies continue to show the efficacy and safety of minute amounts of fluoride in preventing cavities — the controversy continues. Campaigns to de-fluoridate the water supply continue to succeed at an ever growing pace across the country and continent.
Waterloo, Calgary and Windsor are among the most recent major municipalities to stop adding fluoride; Windsor cut its supply only weeks ago. Smaller municipalities have done it too: Okotoks, Alta., Lasalle, Ont., and Moncton, N.B.
To flouride’s many supporters, the decision has led to utterly predictable results: Calgary dentists are already reporting an increase in tooth decay since fluoride was removed in 2011.
“On the private side of practice, it does seem to be to be getting worse. The waiting lists are longer and longer for specialists,” said Dr. Kuen Chow, a local dentist who volunteers his time to help children who have escaped domestic violence.
“For us, we’re advocating for fluoride even though it’s going to hurt our bottom line. We don’t really care. We don’t want to see kids suffering.”
Municipalities vote to eliminate fluoride often despite the objections of their own experts; in Calgary’s case, Alberta Health Service actively urged the city to continue fluoridation. Dr. Allen Heimann, the medical officer of health at the Windsor Essex County Health Unit, failed to convince his city to keep the additive.
“Certainly the removal of fluoride does concern us,’’ he said.
“We do have to recognize that fluoridation of the water supply is one step in a good dental health program and if one portion of that program is removed, we have to redouble our efforts to ensure other steps are more effective.’’
Calgary’s mayor, Naheed Nenshi, did not support removal but was out of town for the vote; he said this week through a spokesman that he was unlikely to re-open the issue.
Likewise, city councillor Druh Farrell, who spearheaded the city’s bid to remove fluoride, said cavities have increased across North America in both fluoridated and non-fluoridated areas.
“I think Alberta Health Services needs to look at other countries that have been very successful with this issue. They need to provide alternatives and start focusing on hygiene,” she said.
With the $750,000 saved by cutting fluoride, the city will purchase a mobile dental health unit to service people in disadvantaged communities, she added.
One of Calgary’s leading citizens behind the anti-fluoridation campaign, family doctor Robert C. Dickson, noted the Calgary dentists complaining about increased cavities are relying solely on anecdotal evidence.
“I guess, in a nutshell, it’s not safe, it’s not effective and it’s very unethical,” he said. Numerous studies support his position, he said; all of the major medical associations have sided in favour of fluoride because they’re “old boys clubs” unwilling to admit they’ve made a decades-long mistake.
He traces the campaign to fluoridate water to the Manhattan Project.
“Fluoride was a major component of manufacturing atomic weapons during the 1940s,” he said. The aftereffects of nuclear weapons manufacture — fluorine compounds — were causing animals and plants to fall ill, prompting a campaign to “whitewash fluoride,” by claiming it strengthened teeth. They then put it in the water supply, he said.
The more established history of fluoride begins at the turn of the century, when a dentist in Colorado found local children had mysterious dark stains on their teeth. Although unsightly, they found the teeth resisted decay.
The cause was eventually traced to naturally occurring fluoride; after several studies, scientists suggested a small dose would make the tooth enamel more resilient without causing the spots.
Grand Rapids, Mich., was the first to add fluoride to the water in the mid ’40s. The recommended dose was similar to what health agencies recommend cities add to the water today.
‘I think almost every disease that’s ever been a plague on our bodies, some subset of the anti-fluoridation group leaps on the bandwagon and say fluoride is causing it’
A 2010 guideline published by Health Canada suggested a maximum concentration of 1.5 mg/L. The report found no link between that level of fluoride and any adverse health effects, “including those related to cancer, immunotoxicity, reproductive/developmental toxicity, genotoxicity and/or neurotoxicity,” it reported. “It also does not support a link between fluoride exposure and intelligence quotient deficit, as there are significant concerns regarding the relevant studies, including quality, credibility, and methodological weaknesses.”
Numerous studies have found that children who have access to the ion record fewer cavities, although the disparity between fluoridated and non-fluoridated communities may be decreasing due to the use of fluoridated toothpastes, better hygiene and exposure through foods, said Allan Freeze, a groundwater scientist and retired University of British Columbia professor.
Mr. Freeze became fascinated by the fluoride debate about a decade ago, prompting him to write a book, The Fluoride Wars, in 2009.
“I wrote the book trying to be as objective as possible. I tried to lay out both sides,” he said. His conclusion was “fluoride did much more good than harm. It essentially stopped the epidemic of childhood and adult dental caries. There’s no question that dental caries and the number of cavities in kids went up and up and up until fluoride was introduced and then it went down and down and down to almost nothing.”
Mr. Freeze said the concerns about fluoride almost always mirror the prevailing health and political fears of the era.
“I think almost every disease that’s ever been a plague on our bodies, some subset of the anti-fluoridation group leaps on the bandwagon and say fluoride is causing it,” he said.
When it was first introduced, some anti-fluoride activists claimed it was a communist plot.
“They were worried about polio, then as cancer came on, it became about cancer. Then came AIDS,” he said, adding that the latest claims involve a link between fluoride and a depressed IQ. Whenever one connection is disproven, the movement focuses in on another. “Now I suppose the Taliban is putting it into the water supply.”
‘I guess, in a nutshell, it’s not safe, it’s not effective and it’s very unethical’
That’s not to say fluoride is harmless, Mr. Freeze added. At extremely high doses found naturally in some parts of the world, a lifetime of over-exposure can lead to major problems, including skeletal fluorosis, a crippling bone disease. However, the concentrations involved are many times higher than what Canadian and American municipalities put in their water. This disease, common to parts of China and India, is practically unheard of in developed nations, Mr. Freeze said.
In North America, the most common side effect of fluoride use is a slight cosmetic mottling of the teeth.
“Some of the more sophisticated ones will say we don’t need fluoride in the water any more because we have fluoride in the toothpaste and that’s enough. That has some merits,” he said. But when it comes to municipal water fluoridation, it’s local politics rather than science that tends to win the fight.
Longtime Montreal mayor Jean Drapeau’s anti-fluoride advocacy prevented the ion from ever being added to the water supply; a dental survey conducted in the late ’70s found children in Montreal had twice the number of cavities as those from nearby, fluoridated communities. Vancouver has always been free of fluoride.
Calgary’s recent decision is actually the latest round in political ping pong; plebiscites in 1956, 1961 and 1971 rejected fluoridation. Calgarians voted in favour in 1989, but the subject came under heated review and further votes regularly afterward.
Dr. Chow said the politics and the finances might make for a compelling case. But, he said, the savings are illusory.
“There’s not enough money saved to cover all the work we’re doing. It’s just so sad.”
*Original article online at http://nationalpost.com/news/canada/fluoride-increasingly-removed-from-water-supply-despite-lack-of-evidence-it-is-harmful