We are perplexed that Montreal aims to stop fluoridating West Island water in 2025.
Fluoridation is best practice in North American water treatment, and has almost 80 years of proven public health efficacy and safety, reducing dental decay by approximately 25 per cent.
We find that the arguments offered by city councillor Maja Vodanovic for ceasing fluoridation are poor.
For one, she cites the safety of water-treatment operators. It seems to us that if water-treatment personnel cannot safely handle fluoride, then they cannot safely handle chlorine and should be redeployed.
Vodanovic further claims she “does not want to use water as a vehicle for pharmaceuticals.” Fluoride is not a pharmaceutical. It is a mineral.
In some municipalities, fluoride occurs naturally at a sufficient level to help protect teeth. If not, fluoridation tops the concentration to a minuscule amount of less than one part per million of water.
The projected West Island fluoridation costs are insignificant because of fluoridation’s excellent cost-effectiveness and low cost per resident. A study in the Journal of Public Health found that $1 invested in fluoridation saved between $71.05 and $82.83 per Quebec inhabitant in dental costs in 2010 — or more than $560 million for the province and taxpayers.
The projected capital costs of keeping the fluoridation program — $19 million — amount to $6.60 per resident per year over 20 years. The annual operating costs — $330,000 — amount to $2.30 per resident annually. Thus, for about $9 per year, residents of Pointe-Claire, Beaconsfield, Kirkland, Baie-D’Urfé, Dollard-des-Ormeaux and Dorval can enjoy at least a 25 per cent reduction in dental decay.
Moreover, fluoridation is much less expensive than dental treatment. Why would Montreal’s elected officials even think about taking it away? There is no good financial reason.
Nor is there a health reason. A Montreal study reported that children in fluoridated Dorval and Châteauguay had three times fewer caries than children in eight other Montreal districts, including N.D.G. and Pierrefonds.
The claim that fluoridation has uncertain health effects is based on the false claim that fluoridation is associated with harm to babies’ brains. The false claim comes from flawed evidence from studies that failed to use valid measures of assessing fluoride exposure and IQ, and used flawed analyses and reporting.
Seeing through the poor–quality studies, public health officials in North America, the U.K., Australia and New Zealand, among other countries, have not changed their recommendations that fluoridation is effective and safe.
Fluoridation has other benefits. It is helping the West Island reduce unnecessary dental waste by reducing the need for dental treatment. On average, dental procedures generate 21 items of single–use plastic items.
Water fluoridation ought to be maintained in the West Island and advanced elsewhere because dental decay is the most common chronic disease of childhood and a leading cause of chronic disease in adults.
Fluoridation eliminates much of the disparities in access to oral care by benefiting everyone, especially children whose parents don’t know or cannot afford to take other preventive steps (toothbrushing, a diet low in simple sugars, and visits to dental health-care providers) and people with physical illnesses or substance-use disorders who find preventive steps difficult.
In short, fluoridation helps everyone and is most valuable for the disadvantaged.
The trend is for municipalities to favour fluoridation. Regina adopted it in 2021. That year, Calgary electors denounced elected officials who had removedfluoridation, voting 62 per cent in favour of restoring it. Windsor restored fluoridation in 2018. The Kingston Board of Health recently asked the city council to fluoridate.
City councillors should exercise fiscal responsibility by co-operating with the federal government, which budgeted $13 billion over five years on dental treatment. Municipalities should fluoridate the drinking water where possible to reduce dental decay and thus federal expenses.
Prevention is always better than treatment. The agglomeration council ought to make good decisions for all residents. For almost 80 years, the evidence has demonstrated that water fluoridation is a good decision for all North American municipal councillors to take.
Paul Allison and Belinda Nicolau are professors in the faculty of dental medicine and oral health sciences at McGill University. Eduardo Franco is a distinguished James McGill professor in the departments of oncology and epidemiology and biostatistics. Juliet Guichon is a professor at the Cumming School of Medicine at the University of Calgary.
Original article online at: https://montrealgazette.com/opinion/opinion-the-case-for-maintaining-water-fluoridation-in-the-west-island