Montreal should fluoridate its drinking water

For the sake of dental health, let’s overcome baseless fears, Jason Chung and Kelvin Ian Afrashtehfar say.

It’s cheap, effective, safe and prevents disease, yet there is public resistance due to uninformed fears. No, this isn’t another screed against antivaccination advocates, but rather a critique of fellow Montrealers who are against fluoride in the drinking water.

Dental caries is a near universal concern for Canadians, with 96 per cent of adults having experienced at least one cavity in their lifetimes. Given that our Medicare system does not generally fund dental care, it can be a costly one as well, with one-third of Canadians having no dental insurance at all.

To combat this, dental experts have been pushing for introducing fluoride into the city water supply as a public health measure for decades. Organizations such as the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), the Canadian Public Health Association (CHPA) and the Ministère de la Santé et des Services sociaux (MSSS) cite research that shows that fluoridation of municipal drinking water reduces caries in the entire population.

We don’t even need to look far for confirmation of these claims. A 2016 study showed that children in Dorval, a municipality that does fluoridate, had three times fewer caries than children in municipalities in Greater Montreal that do not fluoridate. Other studies suggest that fluoridated water in Montreal could reduce caries in children ages 0-9 by 25 per cent, and 20 to 40 per cent in the overall population.

Yet, most Montreal municipalities emulate the rest of Quebec in refusing to fluoridate the drinking water. In fact, a 2009 study showed

If politicians step up, they may find that promoting fluoridated water brings with it certain additional benefits.

that only 6.4 per cent of Quebec’s population enjoyed access to fluoridated water, and the City of Montreal has never fluoridated its water.

Why?

The reasons are generally nebulous and ill-informed. Some cite alleged links between fluoride and reduced IQ — a claim that has been debunked by Health Canada. Some fear “chemicals” in the drinking water — without realizing that water itself is a chemical compound. Others still cite environmental concerns even as research shows that the levels of fluoride runoff would never reach levels “which would harm any plant or animal species,” according to research available on the CDC website.

Simply put, Montreal residents and their politicians are ignoring experts at a rate that would make U.S. President Donald Trump blush. In a city with fantastic universities and an enviably educated population, it’s hard to understand why the forces of anti-fluoridation are winning.

Montrealers must demand that municipal officials demonstrate courage and stop viewing this as a political problem, but a public health concern to be tackled through facts. Politics doesn’t change the scientific fact that fluoridated drinking water will reduce incidence of dental caries. Politics also doesn’t change the fact that this method of intervention is safe and tested — by many, many cities across the globe, in fact.

If politicians step up, they may find that promoting fluoridated water brings with it certain additional benefits. Residents will likely have more money in their pocket by having lower dental bills. Poorer residents would particularly benefit from this — not a small concern in a city where one in four residents between 18 and 64 are classified as the “working poor.” Fewer children will have to undergo general anesthetic for severe caries. At the very least, Montrealers will win by having to visit the dentist less.

All this could be achieved for less than a loonie per resident per year. Your call, Montreal.

Jason Chung, a native Montrealer and McGill University law graduate, is currently a researcher and attorney at NYU School of Professional Studies Sports and Society, in New York. Kelvin Ian Afrashtehfar, who holds a Master’s degree in Dental Sciences from McGill University’s Faculty of Dentistry, is a visiting clinical research fellow in Implant Dentistry at the School of Dental Medicine, University of Bern, Switzerland.