Juliet Guichon and Ian Mitchell are faculty members in the Cumming School of Medicine at the University of Calgary, and helped lead Calgary’s return to water fluoridation.
On an ordinary cold and dark winter morning in Calgary, parents and their children wait for the dental clinic to open. The children are all in need of dental surgery requiring general anesthetic, a need that grew dramatically after water fluoridation ended in Calgary in 2011, as did the need for urgent intravenous-antibiotic therapy for treating infections originating in a tooth.
Calgary City Council’s foolish 2011 decision to cease water fluoridation is a lesson for all Canadians. Fluoridation works and it is safe. Fluoridation reduces dental decay by approximately 25 per cent.
The Liberal and New Democratic Parties are planning to spend over $13-billion on a national dental treatment plan, but they have not included a prevention plan: to fluoridate municipalities that don’t currently benefit from this service. From a cost perspective, this is a critical misstep.
Both Prime Minister Justin Trudeau’s electoral riding of Papineau in Montreal, and NDP Leader Jagmeet Singh’s electoral riding of Burnaby South in Metro Vancouver, do not benefit from water fluoridation.
Mr. Trudeau and Mr. Singh would be much more appreciated by the children of Montreal and Vancouver if their work enabled children to continue playing with their friends at recess with a healthy mouth – like many children in, for example, Ottawa, Toronto, Halifax, Winnipeg, and Edmonton, which are all fluoridated. Children generally don’t enjoy undergoing dental treatment, despite the kindness and skill of the dentist. Prevention is always better than treatment.
Most of Canada is not fluoridated, unlike the United States and Australia. Canadian federal, provincial, and municipal elected officials could work together to save billions of dollars over time by adjusting the naturally occurring levels of fluoride in the water to 0.7 parts per million – less than one part of fluoride in a million parts of water.
The first reason federally elected officials might offer for not taking this initiative is that water treatment is not their jurisdiction. But the federal government can provide fluoridation infrastructure grants to reduce the costs of its new dental treatment plan. Fluoridation ought to be promoted by the federal Conservatives, who are typically focused on capping big spending – this policy will save money in the long run.
Provincial governments also have good reasons to encourage fluoridation. They oversee and pay for hospital care and for dental treatment for low-income residents. People with infections and pain often appear in emergency departments and must be admitted for treatment, sometimes to prevent death. The provinces could reduce costs by incentivizing municipalities to implement water fluoridation.
Municipalities are on the front line of water treatment, but some municipal officials refuse to assume another burden that does not reduce their budgets because health care is not a municipal jurisdiction. Municipal cost without municipal benefit is why incentives should be considered.
More problematic is the trend in recent years of municipal elected officials being susceptible to false, hostile and sometimes physically threatening opposition to water fluoridation by a small but highly vocal minority who oppose it.
Water fluoridation is a scientifically proven public-health measure, but some opponents, fuelled by misinformation, falsely claim that fluoridation harms the brains of infants. As has been demonstrated by the U.S. National Academies of Sciences, Engineering and Medicine, and numerous well-designed studies, there is nothing to the “fluoridation harms the brain” claim. Regarding this and other false claims, elected officials should accept the advice of public-health experts.
Although fluoridation opponents must be answered to kindly and respectfully, their arguments do not have merit and ought to be resisted by elected officials. To be sure, it is unpleasant to be threatened by these individuals, but elected officials must make hard decisions in the public interest despite the opposition of some residents. Their police forces must ensure that they can do so safely.
And fluoridation opponents should work to alleviate their own concerns. They can read the plain-language explanations about water fluoridation efficacy and safety offered by Health Canada and the United States Centers for Disease Control and Prevention. Or they could consider the careful, technical reviews provided by the Australian Health and Medical Research Council, the Irish Food Safety Authority, or the German Senate Commission on Food Safety.
Canada has decided to pay billions for a national dental care plan. We should pay millions for prevention. All Canadians should benefit from the more than 75 years of evidence that water fluoridation is effective, safe and cost-effective. Prevention is always better than treatment – and less expensive, too.