7 Oct 2011    Fluoride Controversy   THE FLUORIDE CONTROVERSY The fluoride issue can be confusing at the best of times as it is multi-dimensional. To try to simplify the issue one needs to understand that there are two different types of fluoride. ‘Systemic fluoride’is one that you ingest into your body internally, like fluoridated water and prescription fluoridesupplements. ‘Topical fluoride’ is one that only goes into your mouth and is rinsed out, like toothpaste, mouthwashes, and fluoride treatments at your dental hygiene visit. The fluoride controversy currently before us in Smiths Falls is regarding the systemic fluoride in our water supply. The intended benefit of adding fluoride to the public water supply was to reduce tooth decay on a mass scale in a cost effective manner. The decision whether to fluoridate lies with local governments, with guidelines set by provincial, territorial, and federal governments. Brantford, Ontario became the first city in Canada to fluoridate its water supplies in 1945. In 1955, Toronto approved water fluoridation, but delayed implementation of the program until 1963 due to a campaign against fluoridation. Ontario, Alberta, and Manitoba have the highest rates of fluoridation, about 70–75%. The lowest rates are in Quebec (about 6%), British Columbia (about 4%), and Newfoundland and Labrador (1.5%), with Nunavut and the Yukon having no fluoridation at all Overall, about 45% of the Canadianpopulation had access to fluoridated water supplies in 2007.  In 2008 the recommended fluoride levels in Canada were reduced from 0.8–1.0 mg/L to 0.7 mg/L to minimize the risk of dental fluorosis. Dental fluorosisis a health condition caused by a person receiving too much fluorideduring tooth development. The critical period of exposure is between 1 and 4 years old; although fluorosis can affect people of any age despite claims that it only affects children. In its mild form, which is the most common, fluorosis appears as tiny white streaks or specks that are often unnoticeable. The spots and stains left by fluorosis are permanent and may darken over time. In its most severe form, which is also called mottling of dental enamel; it is characterized by black and brown stains, as well as cracking and pitting of the teeth. The severity of dental fluorosis depends on the amount of fluoride exposure from water and other sources, the age of the child, individual response, as well as other factors including nutrition. For any drug, chemical, or procedure that is recommended (be it conventional or alternative), the patient should ask two questions before consenting to its use. How effective is it, and what potential or known side effects does it have?  The quite differing answers to these two questions are basically what this passionate controversy is all about! FLUORIDE IS SAFEVIEWPOINT: The Canadian Dental Association, the Canadian Medical Association, Health Canada, The World Health Organization, all promote fluoridation. Basically, the collective opinion is "Water fluoridation remains the safest, most effective, and most economical public health measure to reduce tooth decay, and there has not been any evidence that shows a relationship between fluoridation and other diseases in humans". Why is water fluoridated? The fluoridation of drinking water is an important part of the overall strategy to improve the dental health of the population. Fluoride helps to strengthen the structure of the tooth and to repair damage to the enamel from acids in the mouth. Having healthy teeth is critical for healthy nutrition and self-esteem as well as reducing pain and tooth loss that can come from cavities. The major advantage of water fluoridation is that it benefits all members of the community. While some children and adults use fluoridated tooth paste on a regular basis and visit a dentist every year for cleaning and other preventive care, others do not have access to these services for financial or other reasons. Without fluoridated water, these children and adults would be at an added disadvantage. For more detailed information, go to http://www.healthunit.org/dental/decay_prevention/Fluoride%20Factsheet.pdf http://www.cda-adc.ca/en/oral_health/cfyt/dental_care_children/fluoride.asp FLUORIDE IS UNSAFEVIEWPOINT: Millions of people are being chronically poisoned by fluoride!  At best, all the above professional agencies and associations made their endorsement of fluoridation based only on the reputation of the other organizations, i.e. they simply endorsed each other's opinions and did no original work of their own. At worst, for the purpose of financial gain and liability for making a huge mistake in recommending fluoride, leaders of fluoridation submitted untrue or inaccurate data, ignored relevant contradictory data, used unsubstantiated statements, altered data, and actively sought to ruin the careers of any researchers who spoke out against fluoridation. A review of legitimatescientific research done around the world (but not universally accepted) indicates a greater incidence of hip fractures, an increase in bone cancer in young males, an increase in kidney damage, an increase in skeletal fluorosis, an accelerated aging process, an increase in tooth mottling, an increase in genetic damage to chromosomes, a decrease in fertility, an increase in the risk of genetic damage to a developing fetus, inhibition of important enzymes, tooth decay rates that are the same in both fluoridated and non-fluoridated areas, and numerous side-effects from drinking fluoridated water even at the recommended 1 ppm concentration. Fluoride is introduced systemically into your body through tap water, bottled water (some contain 8 ppm), foods and beverages that are prepared or grown in fluoridated areas, some teas, vitamin tablets and drops, some prescription medications, contamination by pesticides and rodenticides, and even some ready-to-eat cereals (such as corn flakes and grape nuts). It should be noted that our government agencies do not agree on what the daily "tolerable" level of fluoride should be! Even if a certain amount of fluoride was beneficial, we have no way of measuring how much anyone is ingesting on any given day. Many countries have not allowed or stopped fluoridation (Belgium, West Germany, Sweden, Denmark, Holland, France, Italy, and Norway). There are numerous websites about the effects fluoride has on the body,  www.nofluoride.com   http://www.fluoridealert.org/, and   www.mercola.comthere are also many books available. Two good suggestions would be "Take a Closer Look at Your Drinking Water” by Dr. Arvid Carlsson, Nobel Laureate in Medicine or Physiology (2000). Sweden rejected fluoridation in the 1970’s and in this book, three scientists have confirmed the wisdom of that decision. Also “The Case Against Fluoride” How the Hazardous Waste Ended Up in Our Drinking Water and the Bad Science and Powerful Politics That Keep it There” by Paul Connett, PhD, James Beck M.D., PhD. & H.S. Micklem. DPhil. This book carefully investigates the science behind water fluoridation-concluding that endorsements from dental and medical establishments do not mean a public-health measure is effective or safe. It brings new research to light-including links between fluoride and harm to the brain, bones, and endocrine system-arguing that the evidence of fluoridation reducing tooth decay, the very reason it is added to drinking water, is surprisingly weak. As an Oral Health professional I decided to write this article to show the readership that there is much more to learn about the facts on fluoride, and that there is a lot of very good information available to all of us. It was not intended as a recommendation for any particular philosophy. Each of us has the sole responsibility to examine the benefits and risks of available options and decide what treatment, will best suit our individual needs. As citizens of Smiths Falls we have the responsibility to do what is best for our town. We could entertain the thought of coming together in a ‘Town Hall’ setting and invite the experts to come so we can hear the answers to both sides of the issue. As with any controversy it is wise to be informed before making a judgement. A very dear person once told me that ‘everyone you meet knows something that you don’t, take the time to listen, they may just teach you something!’   Lori Lawrence R.D.H. Smile Sensations Independent Dental Hygiene Clinic Smiths Falls, ON

Letter to the Editor of MACLEAN’S Magazine