KINGSTON — After decades of trying to raise an alarm about the negative effects of water fluoridation, Kingston activist Eric Walton said the discussion has reached a turning point.
A court ruling from a judge in San Francisco could change how municipalities look at fluoridation.
The court ruling could have an impact here in Kingston as the city considers adding fluoride to the municipal water supply as a way to address tooth decay, particularly among children.
After spending much of his life opposing water fluoridation, Walton said there are signs that attitudes are changing.
“I think the tide has turned,” Walton said.
There were only a couple of city projects that were shelved early in the COVID-19 pandemic.
The development of a deep water dock where cruise ships could tie up was put on hold.
So too was the study of fluoridation of the municipal drinking water system.
Fluoride occurs naturally in Lake Ontario, where Kingston draws its drinking water, at a rate of about 0.1 milligrams per litre. A community fluoridation program would increase the amount of fluoride in drinking water to 0.7 milligrams per litre.
A city council meeting had been scheduled for mid November was cancelled and Kingston, Frontenac, Lennox and Addington Public Health said in a statement to The Whig-Standard that the postponement was so the agency “could review new and emerging evidence regarding the overall benefits of community water fluoridation.”
Public health said there is no timetable for bringing the proposal back to council but added that the delay was not a response to events in the US and that it would continues to support the process.
“In our Canadian context, Health Canada continues to endorse community water fluoridation as a safe and effective initiative,” the agency stated.
When council voted to restart the fluoride project in March, Piotr Oglaza, medical officer of health with Kingston, Frontenac and Lennox and Addington Public Health, spoke to council and described community water fluoridation reduces tooth decay in children by 25 per cent and should be considered as one of several layers of tooth defence.”
More than 100 provincial, national and international health, medical and dental organizations support fluoridation but the practice is being reviewed, including by Health Canada.
“There is no evidence that fluoride at the low levels of 0.7 parts per million in community water leads to adverse health outcomes and rest assured that there is an ongoing review of research in this field,” Oglaza said.
But what has been called a landmark court decision in the United States, the future of fluoride in municipal drinking water is a little more muddy.
In a ruling three years in the making, U.S. District Court Judge Edward Chen wrote that the US Environmental Protection Agency must strengthen regulation of fluoride’s use after linking the compound to lowered IQ in children.
Fluoride at rates of 0.7 milligrams per litre pose “an unreasonable risk of reduced IQ in children,” Chen wrote.
“There is substantial and scientifically credible evidence establishing that fluoride poses a risk to human health; it is associated with a reduction in the IQ of children and is hazardous at dosages that are far too close to fluoride levels in the drinking water of the United States,” Chen’s ruling stated. “Reduced IQ poses serious harm. Studies have linked IQ decrements of even one or two points to, e.g., reduced educational attainment, employment status, productivity, and earned wages.”
Community water fluoridation was widely viewed as one of the great public health success stories.
“Fluoride in the drinking water is one of the best examples of a population-level approach to improving health,” Angela Ma, a resident in the Public Health and Preventative Medicine program at Queen’s University said in an interview in the summer.
“When we’re talking about dental cavities, dental caries, there are lots of different ways that we can tell people to prevent cavities. We can say brush with a fluoridated toothpaste. We can say go to your dentist regularly get checkups. But all of those, one, require individual action and, two, require access to resources.”
Backed by support from dental, medical and public health agencies, supporters of fluoride were optimistic that Kingston would join the cities that add fluoride to their drinking water.
More than 10 million people in Ontario, almost three-quarters of the province’s population, live in communities that have access to fluoridated municipal water supplies, including in Belleville, Brockville, Smith Falls, Perth, Carton Place, Ottawa, Sudbury, London, Hamilton, Peterborough, Toronto and the GTA.
In Windsor, fluoride was removed from the water supply in 2013 and reintroduced five years later after the rates of tooth decay increased.
“When we talk about active versus passive interventions from a public health perspective, we do tend to really advocate for passive interventions because people don’t have to think about it,” explained assistant professor Samantha Buttemer, director of the Master of Public Health program at Queen’s University.
“You don’t have to make mental space to think about protecting your teeth or making it to the dentist. We know a lot of people for a variety of reasons, maybe struggle to make it to the dentist chair as often as they’re supposed to,” Buttemer added. “This is one intervention where people just don’t have to use their mental energy to think about protecting their teeth, which is really helpful.”
But the popularity of fluoride may be ebbing.
There has always been suspicion of water fluoridation — surveys in Kingston showed close to 20 per cent of respondents were opposed — and that opposition has been buoyed by the California court decision.
That ruling came after a review of research by the U.S. National Toxicology Program, published in August, that indicated that exposure to levels of fluoride higher that the World Health Organization’s recommended amount of 1.5 mg per litre is linked to lower IQ among children.
A similar review by Cochrane, a United Kingston-based healthcare non-profit, that showed the introduction of fluoride in toothpaste and mouth rinses in the mid-1970s reduced the effectiveness of community water fluoridation.
Earlier this month, Montreal city council voted to end fluoridation on the West Island.
That decision was based on concerns about cost, children’s health and the environmental impacts.
The latest push to add fluoride to the water came after a startling report in March about dental decay in Kingston-area schools.
Kingston has looked at adding fluoride four times in the past 66 years.
In 1958, a proposal was narrowly approved by city voters in a referendum but it took until the mid 1960s for the process of adding fluoride to the municipal drinking water was completed.
The early 1960s was the era when many larger Ontario cities, including Toronto and Ottawa, began fluorinating their water supplies.
Fluoride was in Kingston’s water for about a year when, in 1966, another referendum rejected the measure and Kingston became one of the first municipalities to remove fluoride from its water supply.
The question was put to the voters twice more, in 1973 and 1978, and voted down both times.
Up until 2008, the federal government put fluoride in the water supply on Canadian Forces Base Kingston.
Walton said rather than adding fluoride to the city’s water, Kingston could instead invest in more mobile clinics to greatly expand dental screening in local schools.
And the new Canadian Dental Care Plan funds dental care for children, seniors and adults with disabilities who qualify for the program, Walton said.
Even with an apparent shift in the discussion around fluoridation, Walton said there remains an expansive system built up during the last 70 years that is in place to advocate for and expand the use of fluoride.
Walton called it “paradigm inertia,” a resistance to changing the understanding and approaches to long-followed policies.
“Municipal water fluoridation is one of the 10 best public health interventions in this century, right?” Walton said. “I personally think, this is just my opinion, it will be studied as an example of the dangers of paradigm inertia on the progress of science and it will be lumped in with lead and CFCs.”
“Kingston doesn’t need to have this debate,” Walton added. “Just wait, I’m saying. Wait a year and the water will clear. I think we will feel we dodged a bullet.”
Original article online at: https://www.thewhig.com/feature/public-health-pauses-effort-to-add-fluoride-to-kingston-water