Thursday, October 13, 2016

The Impact of Fluoride Reduction

In the 1990s, there were two plebiscites in Calgary, Alberta, Canada, and in both votes, the citizens of Calgary voted yes to have our water fluoridated to optimal levels for the prevention of caries, the most prevalent infectious disease in the world.

All was well, but the dissenters were so vocal that they convinced the council members of the city government, in 2011, to vote to stop water fluoridation, saving the citizens a total of $750,000. The elected members of the City Council refused to allow the scientists and health care experts to even address the council and refused to delay the decision a mere six months before the next civic elections. Undemocratically, things changed, and water fluoridation stopped.

Thanks to modern computerized records, I followed the impact of the reduction of fluoride in our water in my patient population. Although we always pointed to the effect on children, I was of the opinion that all members of society, no matter the age, benefited.

In the first two years after fluoride was removed from the water, I worked the same number of days in a 12-month period and the same number of hours. I saw virtually the same number of patients, but my restorative dentistry figures alone (not including crown and bridge, endodontics or extractions) resulted in a $50,000 increase in each year. With more than 800 dental practices in the Calgary region, that translates to a $40 million increase in fillings being done, in an effort to save the citizens $750,000.

A recent study, completed by researchers at the University of Calgary, was completed five years after the removal of fluoride from our water and found the caries rates in Calgary were twice what they were in our sister city Edmonton, which has a similar population size, climate, education system and utilization rates of dental professional services, and also had continuous water fluoridation for more than 50 years.

Those of us who are pro fluoridation tried to reopen the debate and attempt to get a new vote for the next civic election, but the councilors again refused to accept this information, and no change to our status is expected.

One of the forgotten groups, which no one seems to ever mention, is the senior population. With drier mouths, poorer dexterity and a significant number with poor nutrition, dementia and other issues, this group of our population is prone to increased caries without the benefit of water fluoridation. I have found this to be the case in my practice, but my practice is only one example. I hope that researchers look into this more deeply.

A patient was visiting my office recently and, after completing his dental hygiene treatment, he mused: Why not find a way to add fluoride to chewing gum? We already know that xylitol added to chewing gum is antibacterial and that the act of chewing gum increases saliva flow, neutralizing acids and improving oral health.

So I wonder, can we add fluoride to chewing gum? One stick per day could possibly deliver the ideal dosage and protection and could be a cost-effective way to reach the poor, the vulnerable and those in our communities who are most susceptible to the ravages of high caries rates in the absence of fluoridated water. Even our seniors with dementia, who may not be able to brush their own teeth, likely could be able to chew gum once a day.

I wonder how we can come up with a solution that will work for those who are most affected by the lack of fluoride in our water. What do you think?

Larry Stanleigh, BSc, MSc, DDS, FADI, FICD, FACD, FPFA

1 comment:

AnneH said...

What a brilliant idea! You should consider getting some sort of legal protection of it and then contact Wrigley and Cadbury (the two largest chewing gum producers. They would have to love a medical benefit to chewing gum, tapping the senior market,and having dentists -- of all people -- tell patients to chew gum!


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