Oct 26th 2015

1. Community Water Fluoridation
Saskatchewan
Oral Health Coalition
Meeting
October 26, 2015
Regina, Sk.

2. Facts
• 70 years ago , Grand Rapids, Michigan became the world’s first city to
adjust the level of fluoride in its water supply (1945)
• Moose Jaw was the first Saskatchewan city to fluoridate, in 1952
• Earlier studies showed that Community Water Fluoridation (CWF) reduced
tooth decay in children by 60% and in adults 35%.
• Today studies prove that CWF continues to be effective in reducing tooth
decay by 20 – 40%. Even during the era of wide spread availability of
fluoride from other sources (toothpaste, gels, varnish, mouthwash)
• The Centres of Disease Control and Prevention proclaimed water
fluoridation as one of the 10 great public health achievements in the 20th
Century,

3. Facts
• According to the Findings and Recommendations of the Fluoride Expert
Panel for Health Canada – “CWF remains an effective public health method
to reduce the prevalence of decay in the Canadian population”
• The Canadian Public Health Agency states that fluoridation is 1 of 12 Public
Health Milestones in the past 100 years.
• Over 405 million people world-wide enjoy the benefits of fluoridated water.
• The use of fluoride in the prevention of tooth decay continues to be
endorsed by over 90 national and international professional health
organizations including the Saskatchewan Ministry of Health, Health
Canada, the Canadian Dental Association, the Canadian Medical
Association and the World Health Organization.

4. CWF in Saskatchewan
• Currently the cities of Humboldt, Melfort, Moose
Jaw, Saskatoon, Swift Current, Prince Albert &
Weyburn account for the most significant
numbers of residents in the province that have
access to CWF.

5. CWF in Saskatchewan
Communities with CWF:
➢ 2000 = 66
➢ 2005 = 75
➢ 2010 = 58

6. CWF in Saskatchewan
➢ 61 Communities have discontinued CWF
since 1969
➢ 12 Communities have discontinued CWF
since 2005

7. CWF in Saskatchewan
In 2010:
➢ 36% population access to CWF
➢ 33% to optimal CWF
➢ 2% access to optimal natural fluoride
➢ 36% access to optimal adjusted and
natural fluoride levels

8. Sask. Community Fluoride Data
• Currently all health regions are updating
their fluoride levels in all communities.
• Data collected in 2000, 2005, 2010
• Data updated every 5 years

9. CWF Health Regions - 2010

10. Saskatchewan / Canada
Saskatchewan (2010):
➢ % with CWF = 36%
Canada (2007):
➢ % with CWF = 54.9%

11. CWF in Canada (2010)

12. • The past couple of years have
shown a decrease in optimal
levels of fluoride being
maintained in Saskatchewan
communities
• The 2015 CWF Data Document
will be available early next year.
Recent Surveillance Shows

13. • 2010 CWF Status in Saskatchewan
58 communities were fluoridating in 2010
48 communities with optimal level of CWF
(.7 mg/l) in 2010
• 2013 CWF Status in Saskatchewan
36 communities are actually fluoridating in 2013
18 communities with optimal level of CWF
(.7 mg/l) in 2013

14. Dental Benefits
• Reduces tooth decay by 20 – 40%
• Benefits children & adults
• Accessible to everyone, regardless of
socio-economic status, education or
employment
• Individuals do not have to change their
behavior to benefit

15. CWF Still Needed?
• Other sources of fluoride: toothpaste,
mouthwash, varnish, and professional
fluoride treatments
• CWF is still effective today in reducing
tooth decay
• Vulnerable populations of all ages benefit
from CWF. These populations often do not
have access to dental care.

16. Safety
• 0.7 mg/L of fluoride recommended by Health
Canada as optimal, well below the maximum
acceptable concentration of 1.5 mg/L
• Mild or very mild dental fluorosis is the only
established risk associated with the levels of
fluoride in CWF 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.

17. 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
& effective
- Toxic only at high levels (as per dosage as many other
elements)
- Many substances are toxic if more than the
recommended amounts is taken, such as Vitamins A & D
* Nutrients in Drinking Water: Water Sanitation, Health Protection and the Human
Environment. World Health Organization. Geneva, 2005

18. Common Challenges
• Fluoride added to 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, Vitamin D to
milk, and iodine to salt

19. Fluoride Removal
Can Fluoride be Removed from Water?
Yes!
The 2 methods that remove the fluoride are:
1. Reverse Osmosis
2. Distillation

20. Conclusion
For almost 70 years community water
fluoridation has assisted communities
improve oral health. It seems natural that
in its quest to improve the oral health of
our communities that we continue to
support water fluoridation in
Saskatchewan.