The debate on whether fluoride in drinking water is poison or panacea started about four decades ago and in the years since, rather than going away the controversy around the issue has only intensified.
For much of those 40 years, several municipalities in Ontario who share the same water system have been debating whether to continue adding fluoride to the water. As far as one mayor is concerned it’s time the practice was ended once and for all.
“If you look at my grand children’s teeth, they’ve got fluorosis (mottling of the teeth) from too much fluoride,” says Lambton Shores Mayor Gord Minielly.
Minielly explains that after reading the book The Fluoride Deception he learned that fluoride was a component in the atomic bomb and that when the war ended, “they figured a way to use up the surplus and make more money by putting it in people’s drinking water.”
“Quebec voted it out a year or two ago. We seem to be one of the last few with it in,” he says.
But Sarnia Mayor Mike Bradley says fluouridation of the Lambton Area Water Supply System was initially decided on by public plebiscite and “if any politician wants to take it out” then the public has a right to again vote on the issue.
“It’s been in our water system since the 60s. In Sarnia it was brought in because there were terrible problems here with the dental health of children. It was brought in on the advice of dentists, and the dentists still support it,” he says.
Health agencies and dental associations in many countries have endorsed water fluoridation's safety and effectiveness, and the practice has been touted as one of the great public health achievements of the 20th century.
But the international scientific community remains sharply divided on the issue, particularly the potential for harm to babies, those with kidney disease, and elderly people who drink water containing the controversial additive.
Studies have linked water fluoridation with a number of serious conditions, including hypothyroidism, reduced IQ levels, and osteosarcoma, a rare bone cancer that strikes mostly young boys and the type that killed Canadian icon Terry Fox.
Dr. Hardy Limeback, Canada’s leading authority on fluoride, is an associate professor of dentistry and head of the preventive dentistry program at the University of Toronto. He says the lower rates of dental decay seen in recent years can’t be attributed to fluoridation, as regions that were never fluoridated also have fewer cavities.
“There are many reasons for it such as improved diets, better hygiene, possibly even antibiotics—there are all kinds of reasons why dental decay has declined, and we don’t really need the multiple sources of fluoride that kids are exposed to nowadays.”
These sources include baby formulas, soda pop, mouthwash, toothpaste and processed foods.
According to recent research, applying fluoride directly to the teeth, such as using fluoridated toothpaste, is more effective than ingesting the chemical.
“If you use it topically it builds up resistance in the tooth; if you ingest it, it causes defects in the enamel which makes [the tooth] more susceptible,” says Limeback, adding that in his dental practice he sees a high rate of dental fluorosis.
Fluoridation critics, who have long decried what they see as mass medication with a protected pollutant, say the practice is based on outdated research from the 1940s and wouldn’t pass today’s risk assessment methods.
A 2007 report published in the British Medical Journal indicates that fluoridation was never proven safe or effective, may be unethical, and that cavity rates declined equally in fluoridated and non-fluoridated European countries. The majority of Western Europe has either discontinued or never practised fluoridation.
Limeback says most of the fluoride used in water in North America comes untreated from smokestack scrubbers at plants that produce phosphate fertilizer and is contaminated with traces of heavy metals such as lead, radium, and arsenic.
In Hampshire, England, a battle is currently being waged with city officials who are pushing ahead with plans to fluoridate water to 200,000 homes although 72 per cent of residents oppose it.
A 15,300-name petition has been submitted to Downing Street, urging Prime Minister Gordon Brown to intervene.
Between 14 and 32 countries fluoridate their tap water to some extent, according to the New York-based Flouride Action Network. In Canada, aside from British Columbia and Quebec where there is almost no tap water fluoridation, about 43 percent of the population lives in communities that fluoridate.
While Health Canada recommended a decrease in fluoride levels in 2008, it still endorses fluoridation, as do the Canadian Cancer Society and the Canadian Dental Association (CDA).
“People who are not in favour of water fluoridation will come out and make reference to fluoridation causing general disease issues. But the CDA, based on our understanding of the literature and the reports, believes that water fluoridation is a safe and effective mechanism to reduce tooth decay,” says Euan Swan, CDA’s manager of dental programs.
Swan says the advantage to swallowing fluoride as opposed to topical applications is that it becomes incorporated into the saliva which in turn “is constantly bathing your teeth with fluoride.”
“So while one can achieve reductions in tooth decay with fluoride toothpaste and think of the action as being topical, there are studies that support the benefit of water fluoridation throughout ones lifetime.”
In regions that have naturally high fluoride levels such as parts of India and China, crippling and deformity from skeletal fluorosis is common. Indian researchers have found that the early stages of skeletal fluorisis are often misdiagnosed as arthritis.
In the U.S., Fluoride Action Network is running an online petition calling for a Congressional hearing on fluoridation. The network is also distributing a statement signed by over 2,000 professionals calling for an end to water fluoridation worldwide.
Limeback, who was once an advocate of fluoridation, says there should at least be another review that takes the latest research into account.
“The reviews that have been done in the past have not settled the issue, so of course they’re saying that since it’s not settled then it’s still safe,” he says.
“They don’t believe in the risks—it comes down to belief rather than the science.”
Meanwhile, Mayor Minielly hopes that after a presentation by two experts—one for and one against fluoridation—in September, the board will vote on the issue and the matter will be resolved.
Bradley, however, wants a plebiscite in 2010 when the next municipal elections are held in Ontario.
“[Minielly] represents about ten or 12,000 people. I’m representing 75,000, and unfortunately they seem to think they’re equal; they’re not. The majority of people should decide the issue,” he says.