When it comes to fluoride in his community’s water, the mayor of Lambton Shores, Ont., Gord Minielly, has one thing to say: “Better out than in.” But he’s not the only one calling the shots. On the other side of the debate is Mike Bradley, mayor of nearby Sarnia, who is pro-fluoridation. The two communities share a water supply—which is fluoridated. And that’s where things get messy. “It’s been an issue every year since it was put in in the ’60s,” Bradley says.
Fluoride debates are old hat here. Sarnia was involved in Canada’s ﬁrst-ever water ﬂuoridation experiment. In 1945, the city paired with Brantford, Ont., to study the effects of adding ﬂuoride to drinking water. Sarnia was the non-ﬂuoridated control city for 11 years. When Brantford’s tooth decay rates dropped, Sarnia began ﬂuoridating too. Today, Bradley says it’s time to “put it to the public”—to settle the issue with a referendum on water ﬂuoridation, which would coincide with municipal elections in 2010. He’s not the only civic leader making that call.
More than 50 years after fluoride found its way into Canadian taps, the controversy has been resurrected. Battle lines are hardening as anti-fluoridation groups swell in size and municipal elections loom. What’s more, in some cities fluoridation equipment is on its last legs. As it breaks down, investment demands test local commitment to fluoride. In Gander, Nﬂd., the issue of funds for machinery inspired a paralyzing local confrontation that led to a two-year halt on ﬂuoridation.
Quebec City voted last year to shut off its ﬂuoride taps, while Dorval, Que., reintroduced ﬂuoridated water after a ﬁve-year hiatus. Edmonton opted in July to lower ﬂuoride levels; months earlier, Calgary rejected a motion to do away with the additive. In British Columbia, anti-ﬂuoride activists in Prince George are ramping up their attacks, following the lead of Vancouver, which eschews ﬂuoridation. And in Ontario, Waterloo has set the stage for a plebiscite in 2010 that threatens to make ﬂuoride a high-priority election issue.
The issue was ignited last year, when Health Canada published a report from an expert panel that advised the federal agency to lower recommended ﬂuoride levels—again. Falling targets have been a national trend. In the last 40 years, Health Canada’s optimum ﬂuoride level has been almost halved. That’s partly because we are exposed to more ﬂuoride now—in what we eat and drink, for example—than when water ﬂuoridation was ﬁrst conceived.
Still, ﬂuoridation is backed by a veritable force of health authorities, including the Public Health Agency of Canada, the Canadian Medical Association, the Canadian Dental Association and the World Health Organization. In the U.S., the Centers for Disease Control and Prevention laud ﬂuoridation as “one of the 10 great public health achievements of the 20th century.” But no matter how fervently the chief dental ofﬁcer of Canada, Dr. Peter Cooney, espouses the beneﬁts of ﬂuoridation, it’s up to each community to decide for itself whether or not to add ﬂuoride to the local water supply. Even today, less than half of Canadians—about 45 per cent—drink ﬂuoridated water.
One by one, communities of every size are re-weighing their options. Sometimes a shortage of ﬂuoride itself can even tip the scales. A few years ago, the question of ﬂuoridation was raised in Ottawa when shortages meant the city had to go ﬂuoride-free for months. Certainly, how each place ﬁnally decides varies widely and is determined by a number of factors—from the cost of new ﬂuoridation machines to political will to the strength of anti-ﬂuoridation lobbies to which medical information sounds most convincing. In other words, all too often, decisions that have an impact on the health of millions of Canadians are up for grabs.
As the medical and political realities of water ﬂuoridation collide, it’s clear the issue is as much a quagmire today as ever. In the 1960s, anti-ﬂuoride advocacy was often relegated to the domain of grassroots extremists. But today, even the head of preventative dentistry at the University of Toronto, Dr. Hardy Limeback, has done an about-face on ﬂuoridation. Until 10 years ago, he supported it. But “new evidence,” he told Maclean’s in a recent email, has “convinced [him] even more that a precautionary approach would be wise when considering launching new ﬂuoridation programs.” Limeback has called for a moratorium on fluoridation “until there is better data on its benefits and safety.” The question now isn’t just how much ﬂuoride is too much, but do we need it at all?