Statement on drinking water fluoridation
The Canadian Association of Physicians for the Environment (CAPE) does not support fluoridation
of drinking water for the following reasons.
1) The decline in caries in communities that are fluoridated has been highly significant — but so has
the decline that has occurred in non-fluoridated communities. There has, in fact, been a general
decline in dental caries throughout the Western world, and the decline in fluoridated cities has not
exceeded that in non-fluoridated communities. For example, BC drinking water is 95% non-
fluoridated, whereas drinking water in Alberta is 75% fluoridated; yet the two provinces have similar
rates of caries. Furthermore, Europe is 98% non-fluoridated, but global European dental health is
generally equivalent to or better than that in North America. Whatever the reason for the decline in
dental caries, it can not be concluded that it is the result of drinking water fluoridation.
2) The incidence of toxic effects in humans from fluoridation may well have been underestimated.
The most serious potential association is with osteosarcoma in boys, which appears to have been
loosely associated with age of exposure to fluoride. It is true that the CDC has (as has the original
researcher) acknowledged that current data are tentative, but a further larger-scale study is pending
from the Harvard School of Dentistry. At the very least, such data are grounds for caution.
3) Animal studies have shown a wide range of adverse effects associated with fluoride. It has been
shown to be a potential immunotoxin, embryotoxin, neurotoxin and harmful to bony tissues,
including both dental and ordinary bone. In addition, it can damage (inhibit) thyroid function in
several species, including humans. Its effect on ecosystem balance has been little researched, but is
unlikely to be positive.
4) The intake of fluoride from drinking water is uncontrolled, and can lead to dental fluorosis in
children who are inclined to drink large amounts of water. Both natural and artificially flouridated
water can cause this effect, which is, of course, simply a visible representation of an effect on the
entire bony skeleton. The cost of repairing teeth damaged by fluorosis is not trivial; moderate to
severe effects can require $15,000 or more in dental fees.
It seems clear that a) fluoridation is unlikely to be the cause of the decline in caries in Europe and North
America b) the potential for adverse effects is real, and c) current evidence points in the direction of
caution. Over the last decade, recommendations with respect to acceptable fluoride exposure have
steadily declined, and cautions have increased. Any dental benefit that may accrue from fluoride
exposure is fully achieved by controlled topical application of fluoride compounds by trained dental
professionals, not by fluoride ingestion. [The analysis of Dr. Hardy Limeback, Head, Preventive
Dentistry, at the University of Toronto, further clarifies these points.]
On the basis of this “weight of evidence” we believe that fluoridation of drinking water is scientifically
untenable, and should not be part of a public health initiative or program.