Every citizen should have access to fluoridated water because the health benefits are uncontestable, Ontario's chief medical officer of health says.
Arlene King said about 70 per cent of the province's residents currently have access to a water supply that contains fluoride, and "that's not good enough."
Her comments, contained in a new report on oral health and stressed in an interview, are a not-so-subtle rebuke to the growing number of communities that are rethinking fluoridation as a cost-saving measure – chief among them the City of Toronto. There are also groups who oppose adding the chemical to water supplies.
Dr. King said there is an "irrefutable economic argument" in support of community-based water fluoridation. "The average lifetime cost per person to fluoridate is less than the cost of one dental filling," she said. She also dismissed out of hand suggestions that fluoride poses a health risk.
The new report, Oral Health – More than Just Cavities, notes that dental caries – more commonly known as cavities – are the most prevalent chronic condition in humans, affecting 60 to 90 per cent of school-aged children and almost all adults.
They are caused by bacteria that colonize the tooth surface and produce acids that destroy the enamel. Cavities can lead to infection, pain, chewing problems and gastrointestinal disorders. Periodontal or gum disease is also caused by oral bacteria and has been linked to a number of serious health conditions, including heart disease.
"Oral health is about more than cavities and clean white teeth," Dr. King said.
Much of her new report focuses on a lack of access to prevention and treatment of oral health problems, particularly for low-income families.
Unlike most European countries, Canada does not provide publicly insured dental care – unless a condition deteriorates to the point where surgery is required.
There are, however, a number of programs designed to provide dental care to low-income citizens in Ontario. They include the Children In Need of Dental Treatment program, which helps families without dental insurance who need emergency care; Healthy Smiles Ontario, a dental screening program for low-income children and youth; Ontario Works, the social assistance program, which includes dental care at no cost, and the Ontario Disability Support Program, which includes basic dental coverage.
Dr. King said this patchwork of programs needs to be "integrated and aligned" so that more services can be provided without additional cost. She placed particular emphasis on the needs of vulnerable populations such as seniors and aboriginal people.