A San Francisco courthouse which survived devastating earthquakes in 1905 and 1989 will soon be the epicentre of a water fluoridation trial that may shake up perceptions of a practice long deemed to ensure good health.

One side in the dispute is essentially at odds with itself while recently published Canadian studies promise to be a primary focus of legal arguments. But the proceeding’s true groundbreaking potential lies in the stakes.

Likely hanging in the balance is the future of artificial water fluoridation in the U.S. with shock waves possibly to be felt in countries which still add synthetic fluoride agents to their drinking water.

The plaintiffs comprise a coalition of citizens’ groups, while the defendant is the U.S. Environmental Protection Agency (EPA). At issue is the potential health risks posed by artificial water fluoridation (AWF).

The EPA regulates maximum contamination level (MCL) of fluoride in drinking water by its known risk of causing dental fluorosis — the scarring of enamel from excessive fluoride exposure during tooth formation.

Although fluorosis rates are on the rise and afflicting the majority of U.S. teens, the EPA deems mild fluorosis a minimal and therefore acceptable risk.

But an independent organization of scientists, some of whom work for the EPA, has sought to intervene in the California case with its own court brief. The document warns the EPA’s logic “may overlook aggregate and cumulative risks” associated with AWF.

The coalition of plaintiffs includes Food & Water Watch, the American Academy of Environmental Medicine, the International Academy of Oral Medicine and Toxicology and the Organic Consumers Association.

Four Canadian studies outlined in the coalition’s (plaintiffs’) Proposed Findings of Fact contribute to mounting evidence of neurotoxic harm from fluoride at exposure levels common in fluoridated communities.

Evidence from these studies suggests the practice may result in lower childhood IQs and higher rates of ADHD.

Since its conclusions were so alarming, one of these studies was subjected to additional scrutiny before it was published in JAMA Pediatrics. The publication’s editor then joined the author in stating pregnant women would be prudent to avoid drinking artificially fluoridated water.

Similar advisories were not unknown in 2018, yet they were absent from that year’s oral health report compiled by the Windsor-Essex County Health Unit — a document that some believe relied on targeted and biased public-opinion surveys to promote a return to AWF.

Further, the report fails to establish that declines in oral health were caused by the 2013 cessation of AWF in Windsor. Its own data showed the greatest rate of decline actually occurred prior to 2013, when our community was also reeling from a dramatic plunge in average household income — a significant barrier to dental-care access.

Science is, as it should be, the primary yardstick for establishing public health policy. But science does not stand still. (It took decades for researchers to provide decision-makers with compelling evidence of tobacco’s destructive potential).

Nevertheless, proponents of AWF have consistently dismissed new research that has raised questions of safety. Our Medical Officer of Health told city council he had proof of safety, but an Access to Information Act request sent to the health unit revealed it had no studies which demonstrate artificially fluoridated water is safe for pregnant women.

There are now 65 studies that show a potential link between elevated fluoride exposure and cognitive impairment in developing children, which certainly outweighs dental fluorosis on the scale of acceptable risks.

The California trial is scheduled to begin June 8. Should the plaintiffs win their case, the EPA could be forced into a rule-making process that would ban AWF delivery agents under the U.S. Toxic Substances Control Act.

The roughly 30 per cent of Canadian municipalities that still practice AWF would then be hard-pressed to justify the status quo, particularly in the wake of Health Canada’s response to a 2014 Access to Information Act request for “reports, studies, toxicology and clinical tests relating to hydrofluorosilicic acid in Canadian tap water.”

Said the agency: “After a thorough search of the requested information, no records were located which respond to your request.”

Windsor area politicians and public health officials were aware of this gap in the AWF safety narrative in 2018.

I wonder if they hear the rumblings from California.

Cheryl Burr, Fluoride Free Windsor Essex

*Original article online at https://windsorstar.com/opinion/letters/guest-column-california-trial-may-determine-fate-of-fluoridated-water