Context
- In Canada, local governments decide on whether or not the drinking water is fluoridated.
- Fluoride reduces dental caries (cavities or tooth decay) by making tooth enamel more resistant to decay and by aiding the reparation of a tooth at its early stages of decay. (1)
- Fluoridation of drinking water at recommended concentrations is a safe and cost-effective public health measure proven to have positive effects on teeth and oral health. (2)
- Even with the widespread availability of fluoridated sources such as toothpastes and mouthwashes, water fluoridation still plays an important role in maintaining good oral health. (3)
- Removing water fluoridation will have an adverse effect on the general population; water fluoridation serves as a universal backup to inconsistent or inadequate tooth brushing and irregular or missed dental visits.
- Lower income and other health-disadvantaged populations face greater prevalence and impact of tooth decay and less equitable access to dental care including fluoride treatment.
- As a result, discontinuing water fluoridation will further worsen significant existing oral health inequities.
Fluoride promotes oral health in a variety of ways:
- Fluoride in saliva or plaque fluid decreases the rate of enamel (outer layer of the tooth) demineralization and increases remineralization in early cavities; (4)
- Fluoride inhibits the process that metabolizes sugar to produce acid; (5) and
- Ingesting small amounts of fluoride during early stages of tooth development strengthens tooth enamel, decreasing the likelihood of cavities later in life. (6, 7)
- Some research suggests that maintaining a constant, low-level of fluoride in the mouth is the most effective measure in cavity prevention, as opposed to infrequent high-concentration fluoride gels, foams, and varnishes administered by professionals. (5)
- Water fluoridation is a method that promotes continuous low-levels of fluoride in the mouth.
Cost-Effectiveness of Water Fluoridation
- Water fluoridation is an inexpensive method to promote good oral health.
- A 2004 Canadian study concluded that every dollar invested in water fluoridation saves approximately $38 in dental treatment costs. (8)
- The US Centers for Disease Control and Prevention found that the costs of restorative care to avert disease outweighed the cost of water fluoridation in towns of any size, even with the widespread availability of many forms of fluoride today. (9)
- Under typical conditions, the annual per person cost savings in fluoridated communities is $16 in communities of under 5,000 people and $19 dollars in communities over 20,000. (10) In Toronto, water fluoridation costs $0.77 annually per person,62 while in Peterborough, costs are $0.38. (11) The lifetime cost of water fluoridation for one person is less than the cost of one dental filling. (7)
- A 2007 report by the Institut National de Santé Publique shows that in Dorval, Québec, the discontinuation of water fluoridation in 2003 led to the doubling of the percentage of kindergarten children at high risk of developing cavities by 2005. (12)
References
- Fluoride: Nature’s Tooth Decay Fighter. Journal of the American Dental Association. 2009, 140(1):126.
- J. Fawell, K. Bailey, J. Chilton, E. Dahi, L. Fewtrell and Y. Magara, Fluoride in Drinking Water, World Health Organization, 2006.
- Marian McDonagh, Penny Whiting, Paul Wilson, Alex Sutton, Ivor Chestnutt, Jan Cooper, Kate Misso, Matthew Bradley, Elizabeth Treasure, Jos Kleijnen, Systematic Review of Water Fluoridation, BMJ. 2000, 321:855-859.
- Giuseppe Pizzo, Maria Piscopo, Ignazio Pizzo, Giovanna Giuliana, Community water fluoridation and caries prevention: a critical review, Clinical Oral invest. 2007, 11:189-193.
- World Health Organization, Fluoride and Oral Health: Report of a WHO Expert Committee on Oral Health Status and Fluoride Use, WHO Technical Report Series 846, Geneva, 1994.
- Ibid.
- Faculty of Dentistry, University of Toronto, Water Fluoridation Questions & Answers, April 2012
- Community Water Fluoridation, Cost Savings for Community Water Fluoridation, Department of Health and Human Services, Centers for Disease Control and Prevention. Updated webpage
- Susan Griffin, Kari Jones, Scott Tomar, An Economic Evaluation of Community Water Fluoridation, Journal of Public Health Dentistry. 2001, 61(2):79-86.
- Ibid.
- Rosana Pellizzari, Message to City Residents from the Medical Officer of Health, Peterborough County – City Health Unit.
- News Release: Drinking Water Flouridation, Statement from Dr. Arlene King, Chief Medical Officer of Health, April 4 2011. Accessed from http://www.mhp.gov.on.ca/en/healthy-communities/dental/CMOH-on-Fluoridation11.pdf
How come European countries that stopped fluoridating years ago have shown no increase in decay rates?
Where are your references?
The public has the right to informed consent prior to any treatment. This right is violated when water is fluoridated .
Interesting article references. I like how they say water fluoridation is safe, even when it causes harm. Sure, studies show it may not kill you directly, or cause certain types of cancer, but they show it can influence some cancers in higher doses, and in general has a negative impact on bone health.
These get dismissed due to the low dose in the water, but you cannot account for all factors involved in fluoride consumption. Nor does this take into account that people drink things like juice from a store that when being manufactured using fluoridated water can easily end up with over 10 ppm fl and they do not have to put this on the label as they are not adding it, just concentrating the fluoride through the manufacturing process.
I also like how no reference is made to the fact that new-borns are not to have formula made with fluoridated water. Yet that is what is happening as parents do not know, and parents of low economic status likely cannot afford to buy fluoride free water for their infants.
And 1/2 a cavity prevention per person through their lifetime, although considered statistically significant, is not really significant at all.
Stop water fluoridation and focus on diet and education. Get to the source of the problem.