Spurred by fears of health effects, some councillors are asking whether the city should discontinue fluoridation of Hamilton's municipal water system.
City staff note that fluoridation helps protect the teeth of poor residents who do not have access to proper dental care. Eliminating it would require some kind of dental outreach care to protect residents at higher risk of tooth decay.
Dr. Elizabeth Richardson, the city's medical officer of health, reported to council yesterday, "The benefits [of fluoridation] outweigh the risks."
Some councillors disagree. Councillor Terry Whitehead asked, "How many people will be sacrificed to save someone from cavities?"
At low doses (1-4 parts per million), fluoride has beneficial effects on dental health, tending to prevent tooth decay.
At higher doses, it can cause dental fluorosis (discoloration and pitting of enamel) escalating to skeletal fluorosis (stiff and painful joints and back, osteosclerosis, calcifying tendons, bone deformity).
Municipalities normally add 1 ppm of fluoride to drinking water. The US Environmental Protection Agency has set the maximum safe exposure at 4 ppm.
Fluoride is naturally present in most water sources, though the concentration varies by source, with much higher concentrations in southern countries, particularly India and China.
Fluoride is also present in small quantities in some foods and other environmental sources (e.g. high-fluoride coal dust). However, water is generally the major source of exposure.
According to the World Health Organization (WHO) paper Fluoride in Drinking-Water [PDF], 2006:
Perhaps the best general advice that can be given in relation to local conditions is that, at a minimum, the fluoride level in local water supplies should be monitored and the population examined for signs of excessive fluoride exposure (e.g. moderate and/or severe dental fluorosis and crippling skeletal fluorosis).
WHO reports that elevated levels of fluoride have been found in the drinking water of some communities in Alberta, Saskatchewan and Quebec.
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