fluoridation in saskatoon

Fluoridation in Saskatoon

Oral Health Coalition May 11, 2011 Leslie Topola

Public Health Services


• Water fluoridation has a sixty year history, and is supported by evidence in hundreds of research papers

• The Canadian Public Health Agency states that fluoridation is 1of 12 Public Health Milestones in the past one hundred years

• In the United States, it is one of the top ten greatest public health achievements of the 20th century

• Saskatoon began fluoridation in 1955

• Moose Jaw was the first Saskatchewan city to fluoridate, in 1952

History


Fluoridation in Canada % population with fluoridated water, 2007

British Columbia 3.7%

Alberta* 74.7%

Saskatchewan 36.8%

Manitoba 69.9%

Ontario 75.9%

Quebec 6.4%

New Brunswick 25.9%

Nova Scotia 56.8%

Prince Edward Island 23.7%

Newfoundland 1.5%

Nunavut 0.0%

Northwest Territories 56.4%

Yukon 0.0%

Canada 45.1%

•Based on FPT Environment Ministries, verified by Dental Directors. *Will be smaller now, after Calgary City Council decision.


Fluoridation

in

Saskatchewan


Yes. • Reduces tooth decay by 18-40%

• Benefits children and adults.

• Accessible to everyone, regardless of socio-economic status, education, or

employment

• Individuals do not have to change their behavior to benefit

Does it work?

Support for Fluoridation?

•College of Dental Surgeons of Saskatchewan •College of Physicians and Surgeons of Saskatchewan •Saskatchewan Dental Assistants Association •Saskatchewan Dental Hygienists Association •Saskatchewan Dental Therapists Association •Saskatchewan Public Health Association •Saskatchewan Registered Nurses Association

Saskatchewan



•Canadian Association of Public Health Dentistry •Canadian Dental Association •Canadian Dental Hygienists Association •Canadian Pediatric Association •Canadian Public Health Association •Health Canada •Public Health Agency of Canada

Canada



•American Dental Association •American Medical Association •Centers for Disease Control and Prevention •National Cancer Institute •Pan-American Health Organization •United States Public Health Service •United States Surgeon General •World Health Organization •Plus over 100 other national and international organizations

International



• There are other sources of fluoride now: toothpaste, mouthwash, and professional fluoride treatments.

• Fluoridation is still effective today in reducing tooth decay.

• Vulnerable populations of all ages benefit from fluoridation. These populations often do not have access to dental care.

Is drinking water fluoridation still needed today?


• Ontario: Municipal councils have voted to continue fluoridation in Toronto, Hamilton, London, Atikokan, Tottenham, Halton, and Norfolk. Fluoridation was discontinued in Dryden, Niagara, and Waterloo.

• Alberta: Calgary has decided to discontinue it. Lethbridge has reaffirmed it.

• Quebec: Dorval has reinstated fluoridation; Quebec City has discontinued.

• United States: 70% of population has access to fluoridated water. This percentage will increase with the addition of San Diego (Feb 2011), and the state of Arkansas (March 2011 – by legislation).

Trends in Fluoridation in Canada and the United States (since 2008)


• 0.7 mg/L of fluoride recommended by Health Canada is safe

• Mild or very mild dental fluorosis is the only established risk associated with the levels of fluoride in fluoridated drinking water systems if ingested during tooth development (age 0 – 8)

• Health Canada’s weight of evidence from all currently

available studies does not support a link with any adverse health effects (cancer, immune system, reproductive, developmental, brain, nervous system or intelligence quotient).

Safety

• Saskatchewan Dental Health Screening Program 2008-09 Report indicates:

Comparison of Dental Indices for Fluoridated Communities and Non-fluoridated Communities in Saskatchewan

Fluoridation and Saskatchewan

Fluoridated Saskatchewan Communities

Non-fluoridated Saskatchewan Communities

Average deft/DMFT

1.61 2.48

Cavities Present 13.5% 24.5%

Cavity-free 58% 44%


*Average deft/DMFT: index used to measure the caries experience of a population. It is the count of the number of decayed, extracted, missing (due to caries), and filled primary and permanent teeth of a group of individuals.


Saskatoon Fluoridated

Regina Non-Fluoridated

Average deft/DMFT 1.57 2.34

Cavities Present 12% 25% Cavity-free 59% 50%

• Saskatchewan Dental Health Screening Program 2008-09 Report indicates:

Comparison of Dental Indices for Saskatoon (fluoridated) and Regina (non-fluoridated)



• Saskatoon Health Region is the only Health Region in Saskatchewan that meets all six Canadian Oral Health Strategy Goals for 2010 for children age 6 and 12.



Canadian Oral Health Strategy Goal:

Saskatoon Health Region

Saskatchewan

At age 6, 50% of children are cavity-free 51% 41.5%

At age 6, no more than 20% of children have unmet dental needs

19% 27%

At age 12, 75% of children have no decay in their permanent teeth

75% 66%

At age 12, no more than 10% of children have unmet dental needs

6.5% 11%

At age 12, average DMFT is 1.0 or less 0.60 0.85

At age 12, a Significant Caries Index (SiC) of 3.0 or less

1.81 3.00


• Fluoride is toxic:

Fluoride is a naturally occurring mineral considered essential for good health.*

In amounts recommended by Health Canada, it is safe and effective.

Toxic at high levels. Many substances are toxic if more than the

recommended amount is taken, such as Vitamins A and D.

*Nutrients in Drinking Water: Water Sanitation, Health Protection, and the Human Environment. World Health Organization. Geneva, 2005.

Common Challenges


• Fluoride added to drinking water is an infringement on personal rights:

Most water contains some fluoride. Adjusting the fluoride level of drinking water to bring it to

a level that will reduce tooth decay is a public health measure based on “public good” versus “individual right”.

Benefit outweighs the risk (mild or very mild fluorosis).

Other examples where additions are made for the public good are the addition of B vitamins to flour, and iodine to salt.

Common Challenges


Can Fluoride be Removed from Water?

• Yes. The two methods that remove fluoride are: - Reverse osmosis - Distillation

• There are other sources of drinking water (bottled water) for those with the strongest opinions.

Summary

• Our recommendation is to continue to fluoridate the City’s drinking water.

• It is a safe, effective and cheap method of preventing caries in children and adults that gets to those who need it most.

fluoridation in saskatoon

Health & Medicine