Anti-fluoride activists are fighting again to keep the chemical out of Calgary’s water supply. But there are loopholes in their reasoning.
The wisdom of the health authorities was on everyone’s lips this year and last. In Calgary, it will be on the ballot this fall. Voters will be asked during the citizens’ elections in October if they want to restore fluoride to the water supply. The city council had ended the practice a decade ago, undoing voter decisions in the fifth (1989) and sixth (1998) referendums in the city’s long and winding history with a waterborne anti-void intervention.
What has happened since 2012? One study found that within a few years of stopping fluoridation, decay of children’s milk teeth had increased 65 percent compared to 2005, while the increase in Edmonton, which continues to fluoridate its water, was only 14 percent. “We didn’t look at any small voids that needed to be repaired. They were large cavities, they were destroyed teeth, ”says dental hygienist Denise Kokaram, who, after stopping fluoridation, led a dental program for young people at risk in Calgary.
In 2019, for the benefit of the council, the University of Calgary’s Institute of Public Health summarized the scientific evidence on fluoridation – the abundant evidence it controls tooth decay in both children and adults, and the lack of conclusive evidence of the myriad of harms who have favourited anti-fluoride activists claim from bone loss to brain disease. (Authorities have lowered the recommended levels of fluoride in water to limit the risk of fluorosis, a condition that primarily causes mild tooth discoloration.)
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Something else has also changed. During the final year of the COVID-19 pandemic, the public paid close attention to regulations and advice from major public health agencies such as Health Canada and the United States Centers for Disease Control (CDC), and provincial agencies such as Alberta Health Services. These agencies have advocated adding fluoride to drinking water for decades – the CDC calls it one of the greatest public health success stories. However, when fluoridation is brought before local councils, the word from these establishment bodies will be treated as “one side” of a debate against a gathering of opposing doctors, dentists, scientists and others called anti-fluoride groups conduct. It’s an unbalanced debate in which strong opinions are spared the scrutiny of scientific consensus that has existed for more than 75 years, says Juliet Guichon, associate professor in the Department of Health Sciences at the University of Calgary and president of Pro-Fluoride Advocacy for Calgary (which Kokaram supports).
In the council, the anti-fluoride push came from an unlikely alliance of conservative councilors who accuse residents of losing choices about which health supplements to consume and progressives who – while vigorously defending the scientific consensus on climate change – have doubts about the council Populate popping up the science behind fluoridation or saying the city should focus on providing targeted dental services to populations in need (rather than doing both, for example).
Following a similar debate in 2013, the Windsor, Ontario Council voted 8: 3 in 2013 to end fluoridation of water. Five years later, the local health unit reported that the number of children with tooth decay or urgent care had increased by 51 percent. The council voted 8: 3 to resume fluoridation.
In Calgary, the anti-fluoridation leader for the past 22 years has been a semi-retired family doctor who competed against the health region, most medical colleges, and dental organizations. “The establishment lies to us on many fluoridation issues,” says Dr. Robert Dickson in an interview. He accuses the pros of “drawing the heart” by highlighting the benefits to poor residents who cannot afford good dental care, and claims that fluoride “damages the brains of poor children” at a risk similar to that of lead corresponds to. This seems to be an exaggeration of some controversial studies that have linked fluoride ingestion to lower IQ scores in children. There is extensive scientific research to clarify the severity of this risk and the levels of fluoride at which it could occur (in many parts of the world, fluoride is naturally found in water at higher levels than in fabrics from Calgary faucets). .
Dickson also talks about well-funded print campaigns from big drug companies like Pfizer and Johnson & Johnson – players better known these days for helping vaccines get society out of pandemic hell. He calls the anti-fluoridation movement “a big tent – we have pro-Vaxxers, we have anti-Vaxxers, we have neutral Vaxxers.” His own views on vaccines are “an entirely different topic that I don’t want to discuss”.
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Guichon and other fluoridation advocates complained to the College of Physicians and Surgeons in Alberta about Dickson’s forays into public health. The panel initially rejected the complaint but wrote to Dickson that the Canadian Code of Ethics for Physicians “requires you to indicate when a public opinion contradicts the general opinion”. Dickson followed suit for a while and then stopped using the disclaimer. Subsequent appeals from Guichon’s group prompted the college to open an investigation, which the family doctor was asked to have the courts blocked. The complaint certainly didn’t hinder his advocacy of anti-fluoride ahead of the next Calgary referendum.
Dr. Richard Musto was a senior public health official in Calgary during the 1998 referendum when 55 percent voted to keep fluoridation and a decade ago when the council scrapped it. Now retired, he recalls the nasty messages and threats that came in and kept some colleagues from getting involved in the fight. He has posed himself on all sorts of other public questions, from H1N1 and flu shots to suicide prevention and algal blooms, he said, but has rarely been dismissed as “just a mouthpiece for the government.” That only happened when the topic was fluoride. He had briefed the Calgary Council on all sorts of issues, but only about fluoride had his motives been questioned by elected officials. “Water,” he says, “is a very emotional subject.”
This article appears in print in the May 2021 issue of Macleans Magazine, entitled “A Decade of Decay.” Subscribe to the monthly print magazine here.