2. Fluoridation in Saskatoon
History
• 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
3. Fluoridation in Saskatoon
% Canada
Fluoridation inpopulation with 2007
fluoridated water,
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.
5. Fluoridation in Saskatoon
Does it work?
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
6. Fluoridation in Saskatoon
Support for Fluoridation?
Saskatchewan
•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
7. Fluoridation in Saskatoon
Support for Fluoridation?
Canada
•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
8. Fluoridation in Saskatoon
Support for Fluoridation?
International
•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
9. Fluoridation in Saskatoon
Is drinking water fluoridation still needed today?
• 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.
10. Fluoridation in Saskatoon
Trends in Fluoridation in Canada and the United States
(since 2008)
• 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).
11. Fluoridation in Saskatoon
Safety
• 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).
12. Fluoridation in Saskatoon
Fluoridation and Saskatchewan
•
Saskatchewan Dental Health Screening Program 2008-09 Report
indicates:
Comparison of Dental Indices for Fluoridated Communities and
Non-fluoridated Communities in Saskatchewan
Fluoridated
Saskatchewan
Communities
Average
deft/DMFT
Cavities Present
Cavity-free
Non-fluoridated
Saskatchewan
Communities
1.61
2.48
13.5%
24.5%
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.
13. Fluoridation in Saskatoon
Fluoridation and Saskatchewan
• Saskatchewan Dental Health Screening Program 2008-09
Report indicates:
Comparison of Dental Indices for Saskatoon (fluoridated) and Regina
(non-fluoridated)
Saskatoon
Fluoridated
Regina
Non-Fluoridated
Average deft/DMFT
1.57
2.34
Cavities Present
12%
25%
Cavity-free
59%
50%
14. Fluoridation in Saskatoon
Fluoridation and Saskatchewan
• 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.
15. Fluoridation in Saskatoon
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
Canadian Oral Health Strategy Goal:
16.
17. Fluoridation in Saskatoon
Common Challenges
• 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.
18. Fluoridation in Saskatoon
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.
19. Fluoridation in Saskatoon
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.
20. 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.
