Widespread use of the internet can lead to widespread misinformation. In dentistry, this misinformation comes in the form of anti-fluoridation groups. As dental professionals, it is important that we take a role in counteracting this.
Among anti-fluoridation groups, there is a fear that water fluoridation leads to lower IQ levels among children. They often cite the “Harvard study” as a source to validate these beliefs, yet, as disclosed in a statement by its authors, the study summarized the findings of 27 other studies, 25 of which were conducted in China. In some areas of the country, fluoride concentration was almost 10 times the permissible amount in the United States, and thus did not allow the researchers “to make any judgment regarding possible levels of risk at levels of exposure typical for water fluoridation in the United States,” according to the statement. They recommended that further research be conducted to explore how fluoride may impact brain development.
There also is the argument that water fluoridation has no benefits. The city council of Calgary in Canada voted to discontinue water fluoridation in 2011. This led University of Calgary professor Lindsay McLaren to research the impact of this action.
In this research, she compared 5,000 children in Edmonton and Calgary who were in second grade at the time. It showed a significant increase in the number of tooth surfaces with decay in primary teeth per child in Calgary (3.8 surfaces) than in Edmonton (2.1 surfaces). The data was compared to a similar study done in 2004-05, the only difference being that Calgary stopped fluoridation in 2011. This established that discontinuation of water fluoridation led to an increase in decay in children. The results of the study were published in 2016 in the journal Community Dentistry and Oral Epidemiology.
Misinformation regarding water fluoridation could have the potential to negatively effect a public health measure, but education and advocacy make a positive impact, too.
The city of Denver considered whether or not they should continue water fluoridation in 2015. Many public officials including Dr. William Bailey, former assistant U.S. surgeon general and a faculty member at the University of Colorado School of Dental Medicine, argued to continue water fluoridation in Denver. Other public officials such as Dr. Larry Wolk, a pediatrician and Colorado’s chief medical officer at the time, mentioned CDC recommendations that included water fluoridation as one of the 10 greatest public health achievements of the last century. Eventually, the city decided to continue the water fluoridation.
In 2013, after more than 50 years with water fluoridation, the city of Windsor in Canada voted to stop water fluoridation. In 2018, five years after city stopped the water fluoridation, Windsor and Essex Health County published its oral health update for 2018. According to the report, in the 2016-17 school year, 18,179 children from 119 schools were screened for oral health issues. Between 2011-12 to 2016-17, the percentage of children with decay or requiring urgent care increased by 51 percent. After the report became public, Windsor voted to restart the water fluoridation.
As dental health professionals, it is our duty to educate our patients and the public about the beneficial effects of water fluoridation. We can start by spreading awareness about its advantages and clearing those clouds of misinformation.
~Parth Shah, international dentist
