Saskatchewan community fluoride status 2013

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Nov 4th 2013

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  • I’m not here to extol the virtues of fluoride that is something that could be left for a completely separate PowerPoint which I hope I wouldn’t need to present to this group as I would be singing to the choir so to speak… but instead today we are going to discuss the historic and present day Saskatchewan community fluoride status.
  • A snap shot of a few years ago. Since then communities like Calgary voted to discontinue water fluoridation. Other communities have also discontinued or are fluoridating at less than optimal amounts.
  • There are other sources of drinking water (bottled water) for those with the strongest opinions.
  • Saskatchewan community fluoride status 2013

    1. 1. Developed by: Fluoride and Oral Health Focus Group October 2013
    2. 2. “An overwhelming body of reputable scientific evidence attests to the safety and effectiveness of community water fluoridation.” Dr. Paul Andrews SOHP Annual Conference 2013
    3. 3. • Community water fluoridation (CWF) has been identified by the Canadian Public Health Association as one of the twelve great public health milestones in the past 100 years • The use of fluoride in the prevention of tooth decay continues to be endorsed by over 90 national and international professional health organizations, and is advocated by Saskatchewan's Medical Health Officers Saskatchewan Ministry of Health’s Position Statement on Community Water Fluoridation http://www.health.gov.sk.ca/Default.aspx?DN=2b8566d8-567e4276-8b21-6c6cf3f87639 Additional Position Statements on Fluoride http://oralhealthalberta.ca/wp-content/uploads/2011/11/WF-Position-Statements.pdf
    4. 4. Dental Health of Grade 1 and Grade 7 Saskatchewan Students by access to community water fluoridation 2008 - 2009 Fluoridated Saskatchewan Communities Non-fluoridated Saskatchewan Communities 1.61 2.48 Cavities Present 13.5% 24.4% Cavity-free 58.1% 43.9% Average deft/DMFT
    5. 5. Every $1 invested in adding fluoride to drinking water saves $38 in dental care. Return On Investment = 3700% http://www.youtube.com/watch?v=TVZxtuZhN_M
    6. 6. Fluoride Expert Panel Recommendations 2008 • Optimal amount 0.7 mg/L - p.p.m. • The MAC (Maximum Allowable Concentration) is 1.5 mg/L To adopt a level of 0.7 mg/L as the optimal target concentration for fluoride in drinking water, which would prevent excessive intake of fluoride through multiple sources of exposure The current (MAC) of 1.5 mg/L of fluoride in drinking water is unlikely to cause adverse health effects, including cancer, bone fracture, immunotoxicity, reproductive/developmental toxicity, genotoxicity, and/or neurotoxicity (Intelligence Quotient - IQ)
    7. 7. • Water fluoridation has a proud sixty year history in Saskatchewan • Moose Jaw was the first Saskatchewan city to fluoridate, in 1952 Provincial Estimates for Community Water Fluoridation Province Total Population Population With CWF Population Without CWF Percent With CWF Percent Without CWF Alberta (2007) Saskatchewan (2010) Manitoba (2009) Canada (2007) 3,290,350 2,457,406 832,944 74.7% 25.3% 1,036,285 372,236 664,049 36% 64% 1,214,403 920,800 293,603 75.8% 24% 31,611,911 14,258,078 17,364,803 45.1% 54.9% Source: Provincial or Territorial Environment Ministries, Dental Directors of each Province, Ministries of Environment. Dental Health Promotion Working Group of Saskatchewan.
    8. 8. http://www.health.gov.sk.ca /SK-community-fluoridedata-2010
    9. 9. The Ugly Truth…
    10. 10. 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
    11. 11. Since 2010 these communities have officially discontinued CWF: Meadow Lake (July 2011) Melville (May 2012) Rosetown (May 2012) Watson (March 2012, too expensive) Wynyard (Too expensive) Since 2010 two communities reinstated CWF: Naicam (March 2012) Prince Albert (Feb 2013)
    12. 12. Community Water Fluoridation Status 2013 *Reinstated since 2010 Red = less than optimal Green = optimal or more
    13. 13. As of January 2013 these communities are NOT fluoridating but have not officially discontinued. They state they will continue but presently are experiencing equipment related difficulties etc: Langenberg Moose Jaw and communities it serves (Baildon Colony) Luseland Saskatoon and communities it serves (Aberdeen, Allan, Bradwell, Clavet, Dalmany, Elstow, Hague, Martensille, Osler, RM Corman Park, St. Isidore de Bellevue, Warman)
    14. 14. Fluoridating but not to optimal levels: Balgonie Carnduff Canora Kindersley Swift Current Wadena Weyburn (McTaggart) La Ronge Wakaw and communities it serves (Annaheim, Bruno, Cudworth, Domrey, Humboldt, Lake Lenore, Muenster, St Louis)
    15. 15. Fluoridating to optimal levels: Assiniboia Eston Gull Lake Indian Head Melfort and communities it serves (Beatty, Gronlid, Kinistino, RM of Kinistino, Star City, Star City Colony, Weldon) Moosomin Naicam Outlook Prince Albert Quill Lake Tisdale
    16. 16. Some communities in Saskatchewan have adequate naturally occurring fluoride levels in their community water supply
    17. 17. The SDPHN has approached MHOCOS for assistance with this issue
    18. 18. The majority of Canadians know about and support the idea of community water fluoridation yet we are experiencing downward trends in CWF Support Community Water Fluoridation. Encourage communities which are planning to upgrade water systems to consider community water fluoridation
    19. 19. So Why the Downward Trend? Anti-Fluoride Movement • There are passionate people that actively oppose fluoride • They are well organized • Their views are based on opinion rather than facts which can be dangerous • Even though there is strong scientific based research that totally contradicts their opinions… they, are being heard.
    20. 20. • We must be confident in our views and willing to express them • Be familiar with the arguments and ready to respond to them • Don’t get over technical Here are a few sites to check out for more information: When public action undermines public health: a critical examination of antifluoridationist literature Jason M Armfield http://www.anzhealthpolicy.com/content/4/1/25 Suggested responses to antifluoridationist arguments http://www.anzhealthpolicy.com/content/4/1/25/table/T2 Four of the papers most commonly used by antifluoridationists and the assessment of the methodological quality of each paper http://healthevidence.ca/downloads/Fluoridation_Evidence,_summarized_by_Health_Evide nce_16.Dec.11.pdf
    21. 21. What Else Can Be Done? Develop additional strategies to decrease the number of children with tooth decay i.e. • Earlier 1st visit to the dental office • Increase the number of fluoride mouthrinse programs and fluoride varnish clinics in communities assessed at high risk for decay • Implement programs that provide early oral hygiene skill development in communities at high risk to decay. (e.g. toothbrushing programs) • Finding a solution for those vulnerable individuals that have access or barriers to treatment • Support the consideration for a Provincial Dental Health Officer, who can communicate and coordinate with the appropriate authorities regarding Regional, Provincial and National oral health needs and goals
    22. 22. Saskatchewan Ministry of Health Website Info on Fluoride http://www.health.gov.sk.ca/community-water-fluoridation
    23. 23. References: CDA Position on Use of Fluorides in Caries Prevention (Revised April/2010) Findings and Recommendations of the Fluoride Expert Panel (Jan/2007) MHOCOS Letter of Approval of Fluoride Guidelines (Feb/2001) Fluoride in Drinking Water – Prepared by the Federal Provincial Territorial Committee on Drinking Water – Heath Canada A Review of Water Fluoridation – Dr. Steven K Patterson Attitudes of Canadians Towards Water Fluoridation (Quinonez C. Locker D. Public opinions on community water fluoridation. Can J Public Health. 2009 Mar-Apr; 100(2):96-100.)
    24. 24. * Saskatchewan Ministry of Health’s Position Statement on Community Water Fluoridation http://www.health.gov.sk.ca/Default.aspx?DN=2b8566d8-567e-4276-8b216c6cf3f87639 Additional Position Statements on Fluoride http://oralhealthalberta.ca/wp-content/uploads/2011/11/WF-PositionStatements.pdf Public Health - A Return on Investment video clip http://www.youtube.com/watch?v=TVZxtuZhN_M
    25. 25. When public action undermines public health: a critical examination of antifluoridationist literature Jason M Armfield http://www.anzhealthpolicy.com/content/4/1/25 Four of the papers most commonly used by antifluoridationists and the assessment of the methodological quality of each paper http://healthevidence.ca/downloads/Fluoridation_Evidence,_summarized_by_Health_Evide nce_16.Dec.11.pdf Suggested responses to antifluoridationist arguments http://www.anzhealthpolicy.com/content/4/1/25/table/T2 Saskatchewan Ministry of Health Website info on Fluoride http://www.health.gov.sk.ca/community-water-fluoridation

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