Fluoridation battle in Calgary cuts deep

[The City of Calgary has a protracted history with fluoridation of its tap water, an issue some councillors do not want to revisit. SHUTTERSTOCK]

It’s a tempest over teeth: the City of Calgary is embroiled in a debate over water fluoridation and the matter is getting heated again.

Councillors voted 9-5 against a motion Tuesday to get more information from local researchers about the issue.

Calgary removed fluoride from the city’s water in 2011, without a public vote or even recommendations from an expert panel.

“I think we have a duty of care,” Coun. Diana Colley-Urquhart told her colleagues. Colley-Urquhart, a registered nurse, had supported the motion, along with two others.

What’s causing the issue to pop up again is a recent study by the University of Calgary, which showed that rates of tooth decay in children in Calgary spiked after the removal of fluoride.

The motion was simply to ask for more information from the researchers, who partnered up with the University of Alberta and Alberta Health Services for the study involving 5,000 children.

Calgary has a protracted history with fluoridation: residents voted against it in 1957 and then again in 1961, 1966 and 1971. But in 1989, Calgarians narrowly voted to add the mineral.

‘Fluoridation is just part of the answer’

Dr. Bill Ghali, scientific director of the O’Brien Institute for Public Health at the University of Calgary was present at the council debate. His institute would have been tasked with the inquiry of looking into fluoridation — it’s also the institute under which the study on tooth decay in children was done.

“We were being asked to do it in a way that wasn’t about advocacy, just focusing on evidence,” Dr. Ghali told Yahoo Canada News. “So it wasn’t going to be about dental care but also on harms and safety concerns, as well as economic and ethical considerations.”

The motion put forward by three members of council was to get the institute to answer their questions. It wasn’t a proposal about reversing council’s 2011 decision.

“We wanted to be engaged in the community — this would have cost the city nothing — and not just to go over the study that was done [earlier this year],” explained Dr. Ghali. “Look, fluoridation is just part of the answer to better oral health.”

The World Health Organization says fluoride can reduce incidents of dental cavities as well as prevent tooth decay. It also cautions that excessive amounts of the mineral while teeth are developing can trigger enamel and skeletal fluorosis, which causes discolouration of teeth and accumulation of fluoride in the bones and joints — a painful condition.

“I understand people see it as a chemical,” noted Dr. Ghali. “At extremely high levels, it could have a toxic effect… but that is at doses a million times higher than the tiny amounts people are ingesting in their drinking water.”

Across the country 45 per cent of Canadians drink fluoridated water. Parts of the country with little or no fluoridation include Nunavut, the Yukon and Newfoundland and Labrador.

A study by the Canadian Institute for Health Information (CIHI) discovered that rates of day surgeries for cavities are highest in Nunavut, Northwest Territories, Saskatchewan and Newfoundland & Labrador.

Ethics of forced fluoridation

One of the factors, the O’Brien Institute would have investigated surrounds the ethical and legal debate.

“It’s a contentious issue here and in Calgary, it’s always about a 48 to 52 per cent split [for or against] whenever we voted on it,” pointed out Dr. Ghali. “So there is an ethical issue of forcing fluoride on a large portion of the population that doesn’t want it.”

Ghali is concerned the councillors were unable to even approve an inquiry which would have been far-reaching in its scope.

“There are political forces at play here because voting to get more information would look like the councillor was approving fluoridation. We need more evidence-informed public policy and that is what this would have been if we had [gotten the go-ahead].”

Dr. Ghali is also quick to point out that the study of children in Calgary and Edmonton came up with an overwhelming fact: oral health in the province was poor. Although Edmonton has fluoridated water, children in that city still have higher rates of cavities – which has been linked to factors such as lower income, which is known to affect dental health. Edmonton’s median income has always been lower than that of Calgary’s.

“It’s also about health literacy,” he said. “Besides having money and an employer-funded health plan, people need to know what they have to do day in and day out to have good oral health.”

“So, it can’t be just about fluoride.”