Text under photo: All Ontarians need access to flouridated [sic] drinking water, says Dr. Arlene King, Ontario’s Medical Officer of Health.
The chief medical officer for the province wants all Ontarians to be proud of their smile.
Dr. Arlene King said people need to be better informed about the links between oral health and whole-body health. In a report released Friday, she argues more action on access to oral healthcare.
Calling tooth decay one of “the most prevalent chronic diseases,” King highlighted several recommendations, including fluoridation of drinking water across the province, at a time when the issue has been hotly debated across the GTA.
The Star spoke with King about why putting fluoride in our drinking water is so misunderstood and the implications for accessible preventative care.
Q: Over the years there’s been some objection to fluoridated drinking water, with academics and other professionals claiming we already get enough through toothpaste or other dental applications, and that fluoride in excess could be harmful. What you would say to those arguments?
A: Seventy per cent of the population of Ontario benefits from fluoridated drinking water. And this has been cited both in Canada and in the United States as one of the top 10 achievements in the last century in terms of public health.
The adding of fluoride to drinking water is safe, it works and it is effective.
We have very, very strict regulations governing the optimal amount of fluoride that exists in our community water supplies.
The most common side effect of excess fluoride is a condition called dental fluorosis. That is a condition where there’s a change in the appearance of the teeth that is caused by a change in enamel formation, which occurs during tooth development. Mild and even moderate fluorosis has no effect on tooth functioning. That being said, the prevalence of serious fluorosis in Canada is very low.
Q: Earlier this year, Halton Region was poised as the first GTA community to potentially ban fluoride in their water. But after a close vote they maintained the status quo. I’m wondering why you think there’s such heated debate over the topic.
A: I think it’s related to a lot of the challenges we’re having with some of the most significant public health achievements of the last century — and that is a proliferation of information available, largely online, that needs to be vetted thoroughly by health professionals in order to enable interpretation by the public and by decision makers.
Q: In Toronto, there was a recommendation that city council cut fluoridation and they could save $1.9 million. What are the economic implications of having fluoridation for drinking water across Ontario?
A: It is probably one of the most cost-effective health interventions that exist. The cost to fluoridate a community is less than the cost of one dental filling —and that’s the average lifetime cost per person.
Q: You mentioned in your report this patchwork of services related to oral health for low-income families. So I’m wondering if you think programs like Healthy Smiles Ontario are doing enough to improve health through preventative care.
A: I’m concerned that by reducing the number of communities in the province of Ontario that don’t have access to fluoridated drinking water, that we actually make an impact on some of these important public health programs that have been put in place. That being said, there is a need to review our publicly funded programs and expenditures to basically try to get as much bang as possible for our buck.
The solution is a real shift, to try to do as much prevention in as many people as humanly possible, to prevent that downstream load of dental disease later on in life.
This interview has been edited and condensed.