Comment: Health and ethical questions revolve around fluoridated water

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A healthy smile should not be dependent on socioeconomic status. For decades, fluoride has been hailed as a champion in the fight against tooth decay among people of all walks of life. Its introduction to municipal water supplies in the 1940s was a watershed moment in preventive dentistry. However, as of 2017, several Canadian municipalities have stopped adding fluoride to drinking water, and as recently as 2022 38.8 percent Canadians have access to fluoridated water.

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Ending public water fluoridation has left a gaping hole in oral health, especially among them vulnerable populations. according to Inuit oral health research In 2008-'09, a majority of Inuit in Canada reported poorer oral health and higher incidence of oral pain compared to non-Indigenous Canadians. children from low income households Bear the burden of this decision, because dental problems are the main cause going to the emergency room.

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From its occurrence in natural water sources to artificial supplementation, fluoride has consistently demonstrated its prowess in maintaining dental health. US Centers for Disease Control and Prevention (CDC) addresses community water fluoridation one of the 10 greatest advances in healthcare of the 20th century. The dramatic reduction in tooth decay in fluoridated areas speaks volumes for its effectiveness.

It's time to recognize that what we consume affects more than just our dinner plate or dessert plate, it also affects what we drink, including our tap water.

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So what was the rationale behind some jurisdictions banning drinking water fluoridation?

Studies from Mexico and Canada 2019 suggested a possible link between systemic fluoride intake and neurotoxicity, particularly during fetal development. Although the evidence is inconclusive, it has given ammunition to critics of fluoridation.

In 1984 World Health Organization found insufficient evidence to link fluoride to cancer or birth defects. But it suggested a guideline value of 1.5 mg/l for reduction dental fluorosis (a a condition characterized by the presence of white spots or discoloration of the teeth). This the guideline value has been reassessed In 1996 and 2004, there was no evidence to suggest a need for revision.

Concerns about potential health risks, however small, seem to have prompted some areas to err on the side of caution. Ontario, Alberta and Manitoba have the highest percentage of community fluoridation in Canada, ranging from 70 percent to 76 percent. At one percent, Quebec is among them lowest rates Water fluoridation in Canada.

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However, the main question arises during the discussion: IIs it ethical to ignore the oral needs of the marginalized?

And wealthy people can afford dental care, the same cannot be said about those who are struggling for a living. although there was an increase in funding for dental care in 2023Focusing on expanding coverage and building a foundation for oral health access, prioritizing preventative measures such as community water fluoridation offers greater promise than focusing solely on curative measures.

Mass treatment of the city's water supply may not appeal to some, but it does unemployed and underprivilegedit can mean the difference between a healthy smile and a lifetime of toothache.

Additionally, the economic implications of stopping fluoride cannot be ignored. with dental costs have skyrocketed and as insurance companies and families are burdened, the return on investment in fluoridation is becoming increasingly clear. Even small towns benefit, with every dollar invested in fluoridation a 20x return, According to the CDC.

A delicate balance must be struck between public health concerns when discussing fluorides. and health hazards. The potential risks warrant consideration, but must be weighed against the actual benefits of fluoride, especially for those on the fringes of society. After all, a healthy smile knows no socio-economic boundaries.

Swetha Raja is a dental student at McGill University and an international dentist from India with an interest in global health.

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