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Warren Loeppky, a pediatric dentist based in Calgary, has dedicated the last two decades to caring for the dental health of children. In recent years, he has observed a troubling trend: an increase in tooth decay among his young patients, often necessitating treatment under general anesthesia due to the severity of their conditions.
“It’s always sad seeing a young child in pain,” Loeppky reflects. “Dental decay is very preventable. It breaks your heart to see these young kids that aren’t able to eat.”
Loeppky attributes part of this rise in dental issues to various influences, including diet and genetics. However, he particularly highlights the impact of a significant decision made by the local government: in 2011, Calgary ceased adding fluoride to its drinking water.
This decision stirred considerable concern within the medical community, as noted by Juliet Guichon, a legal and ethics scholar at the University of Calgary. Guichon, who organized a group advocating for the reintroduction of fluoride into the city’s water supply, described the changes as shocking to healthcare professionals who understood the implications for public health.
Numerous studies have indicated that fluoride serves as a safe and effective preventive measure against tooth decay, helping to fortify tooth enamel by working in concert with minerals such as calcium and phosphate. Proper oral health is often linked to overall health, amplifying the importance of preventive measures.
The Centers for Disease Control and Prevention (CDC) in the U.S. advises that communities should add 0.7 milligrams of fluoride per liter of drinking water; however, the decision ultimately rests with local and state governments. As of 2022, approximately 63 percent of Americans received fluoridated water.
Despite its widespread use, the practice of water fluoridation is facing increasing scrutiny. For instance, Utah recently became the first state to prohibit fluoridation, and many municipalities nationwide are reevaluating their stance on the matter. Furthermore, on April 7, Health and Human Services Secretary Robert F. Kennedy Jr. indicated intentions to urge the CDC to rescind its fluoridation recommendations.
Opponents of water fluoridation have raised concerns for decades, citing potential health risks such as tooth discoloration and unfounded fears of bone cancer, among other arguments against what they consider mass medication. In more recent debates, research suggesting a potential association between fluoride and reduced IQ levels in children has also emerged, although these studies often involve fluoride concentrations significantly higher than those typically found in drinking water.
Comparative experiences in Calgary and Juneau, Alaska—where fluoridation was discontinued in 2007—serve as cautionary examples for other communities reconsidering fluoride levels in their water systems. Researchers and health professionals from both cities have shared insights regarding the consequences of ceasing fluoride addition.
Lindsay McLaren, a quantitative social scientist at the University of Calgary, studied the impact of the city’s fluoridation withdrawal on local children’s dental health. She coordinated a project recruiting dental professionals to assess the dental status of second-graders in Calgary compared to those in Edmonton, a comparable city that continues to fluoridate its water. After years without fluoride, her team found that 65 percent of Calgary’s second-graders exhibited signs of tooth decay, in contrast to 55 percent in Edmonton. McLaren notes this disparity, while seemingly minor, indicates a significant public health issue.
Further studies have corroborated these findings. A 2024 analysis revealed that the rate of dental treatments requiring general anesthesia for decay-related issues was higher in Calgary than in Edmonton—32 versus 17 per 10,000 children.
Bruce Yaholnitsky, a Calgary periodontist, stressed the obvious nature of these findings, indicating the need for scientific validation of what was already perceived within the dental community.
In Juneau, concerns over dental health also prompted scrutiny following the city council’s decision to end fluoridation. Local public health researcher Jennifer Meyer observed alarming levels of dental decay among children and sought to understand the implications. After the 2007 cessation, a report from a review commission showed a divided opinion on safety, leading to the controversial decision to stop fluoridation.
Meyer, along with her colleagues, analyzed Medicaid data and discovered a notable increase in the average number of dental procedures related to tooth decay among young children, from 1.5 treatments per child in 2003 to 2.5 in 2012. This increase paralleled significant cost hikes for dental interventions, ultimately impacting taxpayers.
Meyer expressed the hidden financial burden imposed by such legislative decisions, arguing that removing a proven public health measure amounts to a concealed tax on community health.
Calls for the reinstatement of fluoridation continue amidst ongoing debates in various jurisdictions. Meyer mentioned a recent systematic review by the National Toxicology Program, which suggested a potential link between high fluoride levels and lowered IQ in children, although these levels exceed safe consumption guidelines.
Juneau currently remains without fluoridation. In Calgary, however, public sentiment shifted, leading to a referendum in 2021 where 62 percent of voters opted to reinstate fluoride in the water supply. Guichon credits advocacy efforts and research findings for this upsurge in public support, underscoring a growing recognition of the benefits of fluoride.
“More people voted to reinstate fluoride than voted for the mayor,” Meyer noted, highlighting the community’s engagement with public health matters. “Yet in America, we are entering a dark time.”
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