Getting the F out of the Water

“Do you realize that fluoridation is the most monstrously conceived and dangerous communist plot we have ever had to face?”

So asks General Jack D. Ripper of Peter Sellers’ jittery Captain Mandrake in a scene from the 1964 classic Dr. Strangelove.

“It’s incredibly obvious isn’t it? A foreign substance is introduced into our precious bodily fluids without the knowledge of the individual. Certainly without any choice. That’s the way your hard-core Commie works.”

Communist plot. Big Pharma ruse. Pick your theory of choice—at one point or another, the decades-long debate over putting fluoride in public water supplies to improve dental health has worn it. And now the debate appears to be coming to Yellowknife.

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A Facebook group called Fluoride Free Yellowknife has been growing steadily over the past six months, and founder Wade Friesen says his group is planning to roll out a “grass roots” information campaign in the coming months, with the intention of bringing the issue to City Hall.

At this point in time, it’s fairly marginal. As of writing, there are only 175 members in the online group. And does yet another social media group revolving around dubiously-sourced articles really warrant attention? Probably not.

That said, members of the group have been meeting with city councillors. And we certainly would not be the first municipality in Canada to head down the anti-fluoridation route, in the face of opposition from the medical community, due to public pressure. Since 2005, more than 30 Canadian municipalities have opted to discontinue fluoridation. In 2011 Calgary ‘caved to chemophobes,’ in the words of Globe and Mail health writer André Picard. Prince George’s city council went the same way in 2014.

None of the Yellowknife councillors who are part of the Facebook group, four in total, said they’d made up their minds on the issue. But the very prospect deserves some attention.

So what’s the debate?

Yellowknife has been adding fluoride to its water system since at least 1977, according to Chris Greencorn, the City’s director of Public Works & Engineering. The rationale? “Not all our residents have access to adequate dental health care,” says Greencorn. “This is a means to provide passive dental hygiene assistance to our residents”

Fluoridation in Yellowknife costs around $10,000 a year. Currently our dosage levels—0.4mg of fluoride per litre—are far below the 1.5mg/L maximum concentration allowed by Canadian Drinking Water Guidelines, and even below the optimal concentration recommended for dental health (0.7mg/L).

Still, those against fluoridation argue that fluoride is a poison, plain and simple, and medicating people without their consent is a breach, at least as Friesen tells it, of our charter rights.

Now he’s right, in part, that fluoride can be poisonous. Drastically elevated levels of fluoride in drinking water has been linked to a range of medical and developmental problems. But it’s all about dosage. As the NWT’s Chief Medical Officer Dr. André Corriveau, puts it, “salt is a poison, sugar can be poisonous, it’s about the dosage and about the equipment and monitoring and training…  A place like Yellowknife has shown you can do it safely.”

“We had the same issue with immunization,” continues Corriveau. “There seems to be an undercurrent of people who somehow maintain information that’s not entirely accurate or has been misrepresented. They extrapolate conclusions that aren’t warranted.”

Friesen is quick to point out, when charged with relying on dubious information to make his case, that “the first number of studies showing that asbestos was harmful were all debunked and was referred to as [quack] science in its time as well… same can be said of lead and countless other things we’ve since learned are actually harmful… If “science” has taught us anything, it is to question everything.”

This is fair enough. And as a recent article from the Guardian points out in detail, fluoridation research over the decades has always been dogged by professional bias and baggage, and there may be other more effective public health interventions to reduce cavities. But nonetheless, with major health organizations supporting the use of fluoride—Health Canada, the Canadian Public Health Association, the Canadian Dental Association, the Canadian Medical Association, the US Food and Drug Administration and the World Health Organization, all included—the burden of proof is very much on the shoulders of those against using it. And the information buzzing around Yellowknife’s anti-fluoride camp seems, by and large, to come from sources that can hardly be called reputable.

Perhaps, as Corriveau admits, “the additional benefit [of public fluoridation] may not be as much as in the ’60s, because fluoride is available in toothpaste.”

But, “it’s still a very worthwhile public health intervention whenever possible,” he says. And the effects of phasing it out are not negligible. A recent study from the journal Community Dentistry and Oral Epidemiology found that Grade 2 students in Calgary had an average of 3.8 more cavities in 2013-14 than they did in 2004-05. That’s compared to Edmonton, which still adds fluoride to the water, where cavities increased by an average of 2.1 over the same time period.

“Trends observed for primary teeth were consistent with an adverse effect of fluoridation cessation on children’s tooth decay, 2.5–3 years post-cessation,” the study notes. It’s been enough to convince Calgary’s mayor Naheed Nenshi, to call for the reintroduction of fluoridation.

It’s still the earliest of days of the nascent anti-fluoride campaign in Yellowknife, and it may grow no further than Facebook. But should a campaign kick off in force, let’s hope cooler heads prevail among our city councillors than in other city halls across the country.



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