Canada Lowers Fluoride In Water Supply
Cut children's fluoride exposure, report to Health Canada urges
MARTIN MITTELSTAEDT
From Tuesday's Globe and Mail
July 29, 2008 at 4:08 AM EDT
An expert panel Health Canada commissioned to study the risks of fluoride
exposure says the government should cut the recommended amount in drinking
water, encourage the use of low-fluoride toothpaste by children and have
makers of infant formula reduce levels in their products.
The proposals were made in a report submitted to the federal government in
January of 2007, but made public last month with little fanfare when Health
Canada posted a summary on its website.
Fluoride is such a staunch cavity-fighter that it has been routinely added
to toothpaste and municipal water supplies for decades. Traces are also
found in infant formula.
But it has recently emerged as a controversial chemical for some
public-health advocates because of contested research linking it to
intelligence-quotient deficits in children; osteosarcoma, a rare type of
bone cancer in young boys - which felled Canadian icon Terry Fox - and the
mottling of youngsters' teeth, a condition known as fluorosis.
Although the panel concluded the "weight of evidence" supports neither an
association between fluoride and cancer, nor the findings of IQ deficits,
its three recommendations would lead to reduced exposure if implemented,
particularly for children.
The panel recommended reduced fluoride exposure because it was worried
children might be getting too much of the chemical from diet, water and
toothpaste, placing them at increased risk of fluorosis, said Steven Levy, a
panel member and a research professor at the University of Iowa's College of
Dentistry.
The call for children's low-fluoride toothpaste, which is common in Europe,
was made because of concerns that youngsters might inadvertently swallow the
substance while brushing. The panel said lightly fluoridated toothpaste is
"already available in other countries" and Health Canada should "promote and
encourage" its use.
In Canada, children's toothpaste, which sometimes is candy-flavoured, has
about the same amount of fluoride as adult toothpaste. But some varieties,
sold mainly at health-food stores, do not contain any of the chemical and
are labelled "fluoride free."
In a response to questions from The Globe and Mail, Health Canada said in an
e-mail that it will accept the panel's recommendation to cut the fluroide
level in drinking water to 0.7 parts per million from the current guideline
allowing a range of 0.8 ppm to 1 ppm.
Fluoride is added to the municipal water supplies of about 13.5 million
Canadians, or about 43 per cent of the population. But the practice varies
widely by province, with almost no fluoridation in Quebec and British
Columbia and about 70 per cent of people receiving treated water in both
Ontario and Manitoba.
The impact of Health Canada's change may be muted because some jurisdictions
are already ignoring the department's water-fluoridation guideline and are
applying even more stringent limits.
Toronto, for instance, cut allowable levels in 2005 to 0.6 ppm. A report
issued by its public-health department last year says "credible scientific
evidence" supports the lower figure.
But the adoption of a new federal guideline will mark the continuation of a
long-running reduction of fluoride in water supplies. When fluoridation
began in the 1960s, it was customary for water to contain as much as 1.2
ppm.
In its response to The Globe, Health Canada said it is not concerned that
millions of Canadians have been exposed for several decades to levels much
higher than the new guideline will call for because the current maximum
acceptable concentration in water supplies is 1.5 ppm.
The panel's summary does not specify an optimum fluoride concentration for
children's toothpaste, although some types available in Europe contain a
quarter to a half of the amount, ranging from 1,000 ppm to 1,500 ppm, common
in North American products.
Because toothpaste is spit out after use, it is allowed to contain far
higher fluoride concentrations than drinking water, which is ingested.
Dr. Levy said "it would be good" to have toothpaste available in North
America for children up to age 4 that would contain about half the fluoride
of regular toothpaste.
Health Canada said it is aware that youngsters might swallow toothpaste and,
as a safeguard, already recommends that those under 6 be supervised when
brushing and be given only pea-sized amounts on their brushes. The
department also said parents should contact a poison-control centre or other
medical help "right away" if more toothpaste than is used for brushing is
swallowed.
Infant formula contains traces of fluoride, because of the small amounts
naturally contained in its ingredients, according to two manufacturers, Mead
Johnson Nutritionals and Nestlé Canada Inc., which said their ready-to-use
products contain less than 0.3 ppm.
There are currently no industry or regulatory standards for fluoride in baby
formula.
Health Canada said cutting the recommended amount in municipal drinking
water to the 0.7-ppm level "will help address this concern" over "the risk
of excessive fluoride exposure from formula." It said adverse effects would
occur only after "extended periods of exposure" in infants consuming large
quantities of reconstituted formula.
MARTIN MITTELSTAEDT
From Tuesday's Globe and Mail
July 29, 2008 at 4:08 AM EDT
An expert panel Health Canada commissioned to study the risks of fluoride
exposure says the government should cut the recommended amount in drinking
water, encourage the use of low-fluoride toothpaste by children and have
makers of infant formula reduce levels in their products.
The proposals were made in a report submitted to the federal government in
January of 2007, but made public last month with little fanfare when Health
Canada posted a summary on its website.
Fluoride is such a staunch cavity-fighter that it has been routinely added
to toothpaste and municipal water supplies for decades. Traces are also
found in infant formula.
But it has recently emerged as a controversial chemical for some
public-health advocates because of contested research linking it to
intelligence-quotient deficits in children; osteosarcoma, a rare type of
bone cancer in young boys - which felled Canadian icon Terry Fox - and the
mottling of youngsters' teeth, a condition known as fluorosis.
Although the panel concluded the "weight of evidence" supports neither an
association between fluoride and cancer, nor the findings of IQ deficits,
its three recommendations would lead to reduced exposure if implemented,
particularly for children.
The panel recommended reduced fluoride exposure because it was worried
children might be getting too much of the chemical from diet, water and
toothpaste, placing them at increased risk of fluorosis, said Steven Levy, a
panel member and a research professor at the University of Iowa's College of
Dentistry.
The call for children's low-fluoride toothpaste, which is common in Europe,
was made because of concerns that youngsters might inadvertently swallow the
substance while brushing. The panel said lightly fluoridated toothpaste is
"already available in other countries" and Health Canada should "promote and
encourage" its use.
In Canada, children's toothpaste, which sometimes is candy-flavoured, has
about the same amount of fluoride as adult toothpaste. But some varieties,
sold mainly at health-food stores, do not contain any of the chemical and
are labelled "fluoride free."
In a response to questions from The Globe and Mail, Health Canada said in an
e-mail that it will accept the panel's recommendation to cut the fluroide
level in drinking water to 0.7 parts per million from the current guideline
allowing a range of 0.8 ppm to 1 ppm.
Fluoride is added to the municipal water supplies of about 13.5 million
Canadians, or about 43 per cent of the population. But the practice varies
widely by province, with almost no fluoridation in Quebec and British
Columbia and about 70 per cent of people receiving treated water in both
Ontario and Manitoba.
The impact of Health Canada's change may be muted because some jurisdictions
are already ignoring the department's water-fluoridation guideline and are
applying even more stringent limits.
Toronto, for instance, cut allowable levels in 2005 to 0.6 ppm. A report
issued by its public-health department last year says "credible scientific
evidence" supports the lower figure.
But the adoption of a new federal guideline will mark the continuation of a
long-running reduction of fluoride in water supplies. When fluoridation
began in the 1960s, it was customary for water to contain as much as 1.2
ppm.
In its response to The Globe, Health Canada said it is not concerned that
millions of Canadians have been exposed for several decades to levels much
higher than the new guideline will call for because the current maximum
acceptable concentration in water supplies is 1.5 ppm.
The panel's summary does not specify an optimum fluoride concentration for
children's toothpaste, although some types available in Europe contain a
quarter to a half of the amount, ranging from 1,000 ppm to 1,500 ppm, common
in North American products.
Because toothpaste is spit out after use, it is allowed to contain far
higher fluoride concentrations than drinking water, which is ingested.
Dr. Levy said "it would be good" to have toothpaste available in North
America for children up to age 4 that would contain about half the fluoride
of regular toothpaste.
Health Canada said it is aware that youngsters might swallow toothpaste and,
as a safeguard, already recommends that those under 6 be supervised when
brushing and be given only pea-sized amounts on their brushes. The
department also said parents should contact a poison-control centre or other
medical help "right away" if more toothpaste than is used for brushing is
swallowed.
Infant formula contains traces of fluoride, because of the small amounts
naturally contained in its ingredients, according to two manufacturers, Mead
Johnson Nutritionals and Nestlé Canada Inc., which said their ready-to-use
products contain less than 0.3 ppm.
There are currently no industry or regulatory standards for fluoride in baby
formula.
Health Canada said cutting the recommended amount in municipal drinking
water to the 0.7-ppm level "will help address this concern" over "the risk
of excessive fluoride exposure from formula." It said adverse effects would
occur only after "extended periods of exposure" in infants consuming large
quantities of reconstituted formula.
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