Fluoride: It’s time for another plebiscite

Posted by on Feb 19, 2021 in Brian's Blog, Public Health | 0 comments

It’s a public health issue that never goes away. Should our drinking water be fluoridated? In four successive plebiscites – held in 1957, 1961, 1966 and 1971 – Calgarians voted no. Each time the issue came back to the table through the lobbying of Alberta dentists, backed by federal government scientists and provincial health department officials. They said water fluoridation was a cheap and effective way to prevent tooth decay.

The fifth vote, in 1989, endorsed fluoridation. A sixth plebiscite, in 1998, was held with a view to reversing that endorsement. It was driven by a lobby of anti-fluoridationists claiming there were health risks involved. This plebiscite failed to win a majority. Fluoride continued to be added to the city’s water supply for the next 10 years. But city council did follow through on a recommendation by University of Calgary scientists that the fluoride level in the water be reduced from one part per million to 0.7 parts per million. This was to help prevent over-exposure to the chemical, which was also available in toothpaste, mouthwash, dental treatments and some foods and beverages.

In 2008, Councillor Druh Farrell tried to get council to stop the fluoridation process. “I personally have never been in favour of medicating our drinking water,” she said. She characterized fluoride as a “serious poison” and pointed to studies linking water fluoridation to cancer.

Farrell failed to get council majority support for her 2008 bid. But she tried again three years later, and this time she succeeded. There was no public vote involved. Nor was there any expert consultation. Council simply held a one-day public hearing and then voted unilaterally 10-3 to eliminate fluoride from the tap water. A plebiscite, said Councillor Gian-Carlo Carra, would have been a “tyranny of the majority.” Farrell said the issue had been debated “vociferously” around the world for 50 years. “It became an established point of view,” she said, “but now the wisdom of it is being questioned around the world.”

The vote left Calgary’s chief medical officer disappointed. “The evidence that supports fluoride in the water is unchanged over the past 20 years,” said Dr. Richard Musto. “I don’t know why council has decided to take this step. But we’ll work with them.” A Calgary dentist, Dr. Bryce Adamson, predicted that tooth decay in Calgary children would start to increase within three to five years.

This week, the forebodings proved justified. A study showed that childhood tooth decay rates are increasing faster in Calgary than in Edmonton, where the water is still being fluoridated. The researchers suggest the disparity is linked to Calgary’s decision to remove fluoride from the water, but Councillor Farrell suggests there could be other factors involved. “It’s over-simplified to think that fluoride is the silver bullet,” she says. “It doesn’t absolve us of the responsibility to look at issues of poverty, access to dental care, access to a healthy diet and lack of equity.”

The anti-fluoridationists have argued – to council’s satisfaction, apparently – that it’s ethically questionable to impose mass fluoridation on an entire population even after the population has voted in favour of adding fluoride to the water. But is it also ethically questionable to treat our drinking water with such chemicals as chlorine (used for sterilization) and aluminum sulphate (used for coagulating and settling suspended solids before filtration)? Matters relating to the health of our citizens and the safety of our water supply should hardly be reduced to such academic abstractions.

This is an issue that should be put before the Calgary electorate again. The health authorities agree that Calgary as a whole made the right decision in 1989 when it endorsed fluoridation. Just ten elected municipal representatives overturned that decision in 2011, for reasons that now seem shallow at best. If there were indeed some health risks associated with water fluoridation, we never saw someone come forward with solid proof of a cause-effect relationship. On the other hand, several studies have shown that water fluoridation helps prevent tooth decay. The citizens of Calgary should be allowed to have their say again.

UPDATE. Mayor Naheed Nenshi also believes the public should vote on this issue again. Click HERE to read the CBC story on this.

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