The “F” word

CALGARY – It’s an issue that is so divisive that it returns to the forefront again and again.
The ‘F’ word, or fluoride, has divided Calgarians over whether the city should be adding it to the public water supply.
This Wednesday, council will hold a public hearing to once again consider the arguments on either side.
Fluoride has been added to Calgary water since 1991.
The chemical helps developing teeth harden to prevent tooth decay – but does a low concentration in our water really make a difference?
There’s compelling evidence on both sides.
“The degree of benefit now that we’re going to achieve is less than it was decades ago,” says Dr. Richard Musto with Alberta Health Services.
Dr. Musto agrees that better diets, dental care and hygiene have lessened the need for fluoride in city water, however, says there is strong evidence to support that fluoridated water prevents tooth decay.
“Dental decay is still an issue that affects many parts of the community and this is the best and simplest way to get that benefit to everybody.”
The benefit, according to dentist Dr. Bryce Adamson, is how often he is filling cavities.
“In areas without fluoridation dentists have to be more aggressive with how they treat cavities.”
In B.C.’s Okanagan, fluoride was taken out of the water supply in the mid-90s and although no official research has been done, dentists there have noticed a change.
“My own experience in chatting with my colleagues, everyone is seeing an increase especially in younger kids. It’s particularly in the lower socio-economic groups,” says Dr. Adamson.
Still, critics like Dr. James Beck say the research shows otherwise. In his book “The Case Against Fluoride”, he argues that study after study shows the benefit of adding fluoride to the water supply is almost nil.
“In the study of 39,000 children, in 80 some odd different communities, the difference in the fluoridated area there was on average 0.6 of a surface. That’s a benefit that’s almost immeasurable.”
A benefit that he says is outweighed by risk because fluoride only helps teeth when applied topically.

So, while it’s well known that fluoride can harden and strengthen teeth as well as prevent tooth decay, how else does it affect the human body?
Fluoride is one of the most reactive elements on the periodic table and some even go so far as to call it a toxin.
While fluoride creates strong healthy teeth for some kids, it can go too far.
One 11-year-old Calgary girl, who asked to be known as Jessica, suffers from fluorosis, or large white spots on her teeth.
“The biggest adverse affect from fluoride is something called fluorosis,” says Dr. Adamson.
“Fluorosis is either white or brown staining on the teeth and it’s actually areas of the tooth that are super hardened.”
Dr. Adamson says in a city with fluoridated water, a small percentage of children will have fluorosis which can make teeth brittle.
However, public health officials say they don’t feel it’s a big enough concern.
“We do acknowledge that fluorosis, which is usually barely perceptible … is usually higher in areas where there is fluoridated water but we know there are also reasons why you can get those spots,” says Dr. Musto.
For critic Dr. James Beck, fluorosis is just one of the many reasons he’s against putting the chemical in drinking water.
He says studies have linked fluoride with hip fractures, thyroid problems, even brain development.
“The fluorine element is a very reactive element that biochemically interacts with enzymes and impedes their functions.”
Beck also argues that because fluoride is a drug, ethically it shouldn’t be administered unless individuals have given informed consent.
Dr. Musto argues that from a public health perspective, there isn’t enough evidence.
“The fact of the matter is that in any area of scientific endeavour, one has to look at all the evidence and everybody that has done that in a systematic, organized way have concluded that there is not sufficient evidence to support these claims of harm.”
It’s little comfort for Jessica, who at this point in her life, just wants to spots to go away.
“I wish they would just be gone – they’d be nice and white.”

Dr. Richard Musto, Dr. Bryce Adamson and Dr. James Beck will be presenting arguments to a city commitee on Wednesday.