Lack of fluoride in Calgary drinking water leads to rise in kids' tooth decay, study indicates

Tooth decay in children in Calgary has worsenedsince the city stopped adding fluoride to drinking water in 2011, according to a new study.

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The study, published Wednesdayin the journal Community Dentistry and Oral Epidemiology, compared Grade 2students in Calgary and Edmonton, which still adds fluoride to its drinking water.

Lindsay McLaren, theresearcher with the University of Calgary's Cumming School of Medicine who led the study,told the CalgaryEyeopener's David Gray thatthere weremorecavities in both Calgary and Edmonton over the period of the study, but "it got worse in Calgary, where fluoridation was stopped, than in Edmonton."

McLaren said the study is clear about the cause and effect at play.

"We designed the study so we could be as sure as possible that [the increased tooth decay] was due to [fluoride] cessation rather than due to other factors," she told the CBC.

"We systematically considered a number of other factors ... and in the end, everything pointed to fluoridation cessation being the most important factor."

Fluoridation decided by municipality

Health Canada notes that provincial and territorial governments regulate thequality of drinking waterin their jurisdictions, withthe fluoridation of drinking water supplies decided by each municipality, in collaboration with the province or territory and possibly inconsultation with residents.

Brandy Payne, Alberta's associate minister of health, told CBC News it's too soon to say whether the province will reconsider its policies regarding fluoridation in view of the study.

"This is a relatively new finding, so we are going to take a look at the report and go from there with an evidence-based decision," she said.

The controversial issue has been debated in Calgary for years. Fluoride hasboth beneficial effectsin "reducing the incidence of dental caries"and negative effects"in causing enameland skeletal fluorosisfollowing prolonged high exposure," according to the World Health Organization. In the case of fluorosis, theteeth can become permanently discoloured, and accumulation of fluoride in the bones and joints can damage them and cause pain.

Denise Kokaram, of the Alex Dental Health Bus, says water fluoridation is the cheapest, most economical way to protect dentalhealth in children especially for families who can't afford dental care.

"It's not unusual for us to see a child with almost full-mouth decay in the population that we're looking at, and considering that we're in Calgary, we shouldn't be seeing that degree of disease here and we are," she said.

"And to think of that rising, and those children suffering and in even more pain, when it's such an easy thing to remedy to remedy or at least assist with."

Kokaram says of the 1,700children and youth the Alex treated last year, about 50 per cent had tooth decay.It's continuing to collect its own statistics to track the decay rate among its clients.

Meagan Heck,head of the Calgary Dental AssistantsAssociation andwho also works in a dentist'soffice,says she`s not surprised by the findings of the study.

"We're definitely busy with the kids, and what we're seeing is that kids who get cavities, if they don't come in frequently to the offices, we don't catch them soon enough, so without fluoridation the cavities get larger really quickly," she said.

"And kids don't brush their teeth regularly as it is. They have a high sugary diet."

Why Calgary stopped

Calgary's city council voted 10-3 in 2011to stop adding fluoride tothedrinking water.

Ward 7Coun.DruhFarrell was one of thosein favour of removing it, arguing that helping families who couldn't afford fluoridated toothpaste would be a better idea than giving it to the entire population.

Ward 3 Coun.Jim Stevenson also voted to remove fluoride from Calgary's water, saying there was insufficient medical proof that keeping it would have any benefit.

"We as a council have to show some leadership here," he told the CBC in 2011.

"I would really question our right to put [fluoride] in, butI don't question at all our right to remove it."

One of the arguments in favour of fluoride removal was its availability in sources other than drinking water, such as toothpaste.

McLarensaid fluoride given by dentists isone source, but not everybody has access to such care.

"Our findings, and others, suggest that community fluoridation continues to have an effect above and beyond these other sources of fluoride," she said.

McLaren saidthe tooth decayincrease found in her study is more significant in children's baby teeth than in adult teeth,and she added there is a need to continue to monitor the trend.

Fluoride removala cost decision: councillor

Ward 9 Coun.Gian-CarloCarra was another one of the majority on council who voted to stop adding fluoride to the water.He welcomes the new study.

"I'm glad we're getting some localized and pretty clear science pointing to the fact that community fluoridation actually has an effect," he told the CBC.

"I would say that when we made the decision, that information was not as cut and dry."

Carra said at the time of the 2011 vote,council faced a cost of about $10 million to upgrade the city's fluoride injection system, plus an ongoing maintenance cost of $1 million annually.

"Theconversationwe were having withthe province was thatfluoridationis a public healthissue.... I, at least, and several of the deciding votes on council would be very happy to continuefluoridationif theprovincewas goingto pony up and cover its costs in terms of public health."

Carra told the CBC that if the decision were in front of council today with the new data, he would advocate for fluoridating Calgary'sdrinking water withthe province paying the cost.

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