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Lethbridge Herald (Newspaper) - March 24, 1971, Lethbridge, Alberta Wednoiday, Morcli 24, 1971 - THE UTHBRIDGI HERAID - 5 David I. Balfour uoridation controversy unnecessary Bavid Balfour Is a second year student at the University of Lctlibridge. This article is a condensation of a paper prepared in connection with his prc-dentlstry studies. It should prove of interest because of the con-trovcrsy surrounding tlio past four plebescites in Leth-brldge. A L THOUGH fluoridation pix>grains have been initiated in over thirty countries ammd the world, this subject is still a highly controveraial one as it has been since its inception three decades ago. A fluoridation referendum is now in the wind in Calgary, and it may spark another one here in Lethbridge. With this in mind it is worthwhile reviewing ca--tain aspects of this important question, pai-ticularly in the light of recently-completed research. ? ? ? Some 16,000 fluoridation-re-lated studies have been published in the last thirty-five years, and it is impractical for anyone to evaluate all of these reports. Fortunately, there exist authoritative reviews of these works written by knowledgeable and respected medical and dental researchers. For this article I have combined information from these reviews along with my own assessments of many of the most recent research reports, and have made every effort to distinguish between fact and opinion. One point generally overlooked is that there do exist a substantial number of basic facts concerning fluoridation which are not seriously disputed by either of the opposing factions. For instance, neither side questions the fact that fluoride concetiifirations of one part per million parts of water do significantly reduce dental cavities. It is also an undisputed fact that fluorides are highly toxic in certain concentrations, and have indeed been used as "rat poison." Adequate bone strength, particularly in older people, also requures small concentrations of fluoride. It has recently been shown that trace amounts of fluorides are necessary for repi-oduction in every species that has been thoroughly tested thus fai', but complete information concerning human reproduction is not yet available. Finally, it should be noted that fluorides are naturally present in sea water and almost all fresh water. Thus we see that although too much fluoa-ide is harmful, it is mevitable that we will encounter some daily, and it may indeed be necessary that we do so. This condition is not unique to fluorides, for it has been shown that some otlier elements such as selenium and zinc, which are ordmarily highly toxic, have been found in trace amounts m tlie body and appear to be essential to good health. It is highly logical then' that there must exist an optimum concentration of these elements which will give maximum benefit to the body without injury. Fluorine, in the form of fluoride compounds, m this sense is no different from other trace elements, except that it has been more extensively studied tlian othters. The optimum concentration of fluoride has been established at one part pea- million parts of wata- (1 ppm). ? ? ? MOUons of people have been drinking water with natural fluoride levels up to and above tills optimum concentration for many years. Some natural water som-ces contain more than the optimum, level, and it has been found that concentrations above two parts per million sometimes result in dental fluorosis, which is a light brown staining or "mottling" of the tooth enamel. Although not harmful, this mottlmg is aesthetically undesirable, and some countries such as Italy have chosen to defluoridate some of their water supplies down to the optimum level. This has also iJeen done in North Ameiica in a few areas. As early as 1892 a sliortage of fluoiide ill Bi-itain's fresh water sources was suspected to be the reason behind the higli incidence of tooth cari-ties and decay. Aiiificial fluoridation was first suggested in the 1320's and the first actual progi-ams were initiated in 1945 in the eastera United States. Brantfoa-d, Ontario, was tlie third city in the world to have a r t i ficially fluoindated watCT, also in 1945, From extcJieive r-Uidies of the ]-esidents of these 'kst areas it was soon clear that the incidence of dental caries in children consuming water which contained 1 ppm of fluoride could be reduced by sixty to seventy per cent. Dr. H. T. Dean examijied the teeth of children in five eastern American cities where water supplies had a natural fluorida content of about 1 ppm, and found that 22 per cent of the children examined had perfect teeth and thie other 78 par cent averaged only three cavities each. Children drinking water witii less fluoride were found to average many miore cavities and other tooth ailments. Sunilar fmdings have been repeated many times with artificially fluoridated watei-. One of the first such studies was carried out twenty-five years ago at Grand Rapids, Michigan, and Newburg, N.Y. In these communities a dramatic reduction in cavities due to the fluoride in the water launched a nationwide fluoridation campaign. A 1968 study of the same areas and their control communities revealed a reduction of 50 per cent to 63 per cent in cavities in didldren aged 15 and 16. Another study compared tlile dental costs for 6 to 8 year-old children in these same communities and found that the annual per capita cost was $14.16 in the fluoridated areas as opposed to $32.38 in the non - fluoridated areas. These figures and many others have consistently proven the usefulness of fluoridated water in preventing cavities, and this point is seldom argued anymore. Often the question is heard "Why fluoridate water s;^ plies when there are other ^vays of obtaining fluorides for those who want them?" It is true that there are other methods which can be just as effective as water fluoridation, if the right conditions exist. How- BERRI'S ! \m br >^EA, Ik. "Ncxf year, I'm going to buy one of those, so I hav� more time for jogging, too!" Why teach French? By Philipa West from Alberta Teachers' Association Magazine VK/HY, in Western Canada, are we teaching French to childi-en in the elementary grades? Is it to help develop in them a knowledge of another language and with it an appreciation of another culture? Or is it to help develop in our children a knowledge of the language and culture enjoyed in the Province of Quebec and other parts of our country? It seems we should know why we are teaching French. If indeed it is to help chU-dren's understanding and appreciation of another civilized tongue and culture, then using audio-visual aids which zero in on France specifically is justifiable and wise. We then teach French and France from its source, the Eiffel ToAver, Napoleon's Tomb, the Place de la Concorde. Nearly every otlier country which teaches French as a second language uses France as its reference point, English, German, Dutch children exdiange dwelling plaices with their French counterparts to promote knowledge of French thought, speech and ways of living. But, is this what we're after In Western Canada? Or are we teaching Fraich in an effort to knit our vast country together? If this is our primary aim, why are we teaching directly from France and not from la belle provence, Quebec? In my pai-t of Western Canada, French is tau^t to elementary grades as if Quebec did not exist! No reference is n-jade to the brave explorers such as Charaplain, Brule, Car-tier, who wei-e first to open up this country. Little aclaiowl-edgment is given to resourceful Fi'ench fur traders who paddled and portaged their way up hazai-dous rivers, making friends mth the first Canadians, the Indians. One may argue that early French liistory is taught in social studies, and that's enough. But as most of us are aware "expiOreis" ijicludes a potpourri of explorers from many parts of Europe, and specific knowledge of French exploits is left largely \o chance. If \ve're Ivelatedly trj'"ing to do our pail to knit Canada together, shouldn't we at least have half of our FYench lessons emanating from Quebec? (I'm talking about televised lessons now.) Consider the modem French life flourishing on each side of the lower St. LawTence, tlie gi'eat cities, the paper mills, the mines; and the Ms- toric beauty of the walled City of Quebec itself, with its steep streets and horse-drawn carriages, its fine old churches and historic buildings. Arts in the province of Quebec are blossoming: painting, writing, poetry, music, dancing, (Les Feux Follets went to Expo '70) drama. All these are burgeoning TOtli life, yet we pretend none of them exists so far as French teaching in Western Canada is concerned. It may be argued that the French spoken in Quebec is not the "real" French. For that matter, neither is the English spoken in Western Canada the "real" English! If a foreigner, about to embark on learning English, were to say to you, "OH, I couldn't possibly learn to speak Enghsh in Canada; I have to learn English in England," you'd consider him to be suffering from cultural myopia. A well-spoken, articu-1 a t e, enlightened Canadian, speaking English with a Canadian accent is v/elcome all over the world. His "un-English" accent may even prove an enhiancement. In my view, the same is true of a CanaJdian-French accent. Beautiful Canadian-French is as acceptable as beautiful Canadian-English. "Ah," says an aspiring bDm-gualist, "but I want to speak with a true Parisian accent." Splendid. Has he heard that until recently the "best" French was reputedly spoken in Grenoble, and now it's Neuchatel? On behalf of our groaning taxpayers, of whom I am one, I ui"ge the elementary curriculum planners (French specialists) to search their souls and discover- why we are teaching French. Tlien the planners might ask tliemselves exactly what is to be gained from teaching Parisian French, as opposed to Canadian French, to pupils in our multi-cultural country, one-third of whose population speaks Canadian French. Are we neglecting to consider something important, sucli as the wealth of our French-Canadian heritage? So They Say Combat is a stressful situation which affects people's feelings or emotions ... We are stressed every minute we live and combat is no exception. -Col. Ai-nold W. Johnson Jr., an Army psychiatrist, at the My Lai murder trial, ever, as we shall see, tliese dtber methods are tedious, potentially dangerous, expensive, and are likely to be less efficient than water fluoridation. Fluoride tablets or drops are available from many dentists, druggists, and health units, and they can be as effective as fluoridated water. The p'ob-lem here is a "people" problem. It is extremely difficult to get parent and child co-ordinatmg steadily for the first thirteen years on fluoride tablets or drops. Intermittent exposure is not enough. Topical application of fluoride by a dentist is less troublesome because it needs to be done only two or three times per year. But topical application must also be done fairly regularly, and is again more expensive than fluoridaUng tlite water. Fluoridated food, milk, gum, mouthwashes, and toothpastes have also been shown to reduce tooth decay, but these methods are not as efficient as water fluoridation and are unreliable because of the likelihood of intermittent use. It should be pomted out, however, that water fluoridation is not feasible in many parts of the world, the main reason being the absence of central water systems. For example, in the United States about forty-six million people (23 per cent of the total population) lack a central water system. These people draw thteir water from springs and wells as it is needed and consume it untreated in any way. Suice the most inexpensive and effective method of preventing dental cavities (general water fluoridation) is impossible in such areas, some aJbemative is the only answer. ? ? ? So far the two most effective alternate means have been topical application, and the fluoridation of school water supplies. This laititer method is almost as effective as general water fluoridation, although more expensive. Also, it has the disadvantage that it misses completely the formation of the primary teeth in children, and its beneficial effect on bones is missed! by older persons. In the last ten years a great part of the research on fluorides has centred around their effects on bones and the general health of other body systems. About 90 pa- cent of the fluoride absorbed by the blood is ultimately deposited m the hard tissues (includmg the teeth). All bones contain fluorides in varying amoimts. The effects which fluorides have on bones closely parallel those observed m the teeth. Dr. H. J. Daniel has found evidence of much more deafness from diseases of tlie earbones in low fluoride areas, and a whole range of bone and other diseases is less intense when fluoridated water is consumed. For example, calcification of the aorta has been found to be much more prevalent in low fluoride than in areas vith natural or fluoridated 1 ppm fluoride in water. Recently fluorides have been used as thea-apy in various bone diseases, and is thought to be necessary for normal calcification of the skeleton in genea-al. ? ? ? The excretion of fluoride by the kidney exposes this organ to a risk of damage if the kidney is not functioning normally, as in chronic uremic patients. Again, however, there are beneficial effects from suiliable 1 o w fluoride concentrations. Tlie only detrimental effects ai-e observed when flu-oi-idated water or unflu-oridated water containing a hi'gh natural concentration of fluoride is used in conjunction with artificial kidney machines. But because hospitals can, and most do, use distilled waiter or defluoridate their water by inexpensive filters, this need not be a problem. I have mentioned Uie low cost of fluoridation in relation to oUier methods of flU' oridfi ingestion, and perhaps the followmg figm-es ^^^ll iUus-Li-ate Wiis. The cost of fluoridating a central water system ranges between 8 cents and 10 cents per pei-son pei- year after initial installation. Using the upper 10 cent figure it has been calculated that it would cost 13 million doUars to fluoridate all remaining pubUc water supplies in the Unite d States, which would save 700 milUon doUai-s per year in dentist's fees for fillings alone, along wth millions of looth-aclic5. The a^'erage cost of oiie dental filUng will pay the fluoridation expenses fci- one pei--son for sixty years. Tlie cost of a fluoridation unit depends on its size, which in turn depends on the volumje of water to be treated. The unit senong Brantford, On-tai-io, Canada's first fluoridated city, cost only five hundred dollars. (Currently, a small unit runs from about $2,-000 to $2,500, with the largest one,'; in the neighborliood of $6,000. The cost of school water fluoridation equipment ranges from $250 to $3,-000 and tlie cost of chemicals approximately 20 cents per student per yeai-, as compared to 8-10 cents per person per year for an entire community. Fluoridating water at home is quite a lot of trouble, and costs from $4 to $10 pei- child per year after installation. As for poisoning oneself by drinking fluoridated water at 1 ppm, a person would have to drink about 42 gallons or (Vz a bath-tubful) of water at one sitting to become slightly sick from too much fluoride. To get very sick (to ingest about one gram of fluoride) a person would l;ave to drink more than tliree bathtubfuls or 276 gallons of water in a short time. ? -A- ? In the last decade there has been a distinct shift m the attack on fluoridation, which places the emphasis more on the legality of this measure rather than questioning its safety or effectiveness. No com't decisions has ever been handed down in this country stating, or even hinting, that fluoridation might be harmful. Of those who have gone to court against fluoridation laws, only a handful have been successful, and these cases have been won on procedural grounds. The United States Supreme Court has contmually refused to review fluoridation cases and appeals on the grounds that they do not constitute an important federal question. As well, fewer and fewer cases are being won in the lower courts as precedents are set. Fluoridation has now become mandatory in seven states, and anti-fluoridationists have never won a court case in twelve others. In Canada most provinces give fluoridation authority to city councils, but New Brunswick has \visely allocated this control to its community boards of health. Another past objection to fluoridation is that it is an infringement on individual religious freedom. The courts have replied to diarges concerning reli^us liberty in statements such as the following: "Liberty implies the absence of arbitrary restraint, not immunity from reasonable regulations and prohibitions imposed in the interest of the community." �k * -k Another charge occasionally leveled against fluoridation is that by fluoridating public water supplies the municipality is either "adulterating foods" or "pmcticing medicine when it is not authorized to do so." Frequently such charges include evidence given by a dentist, doctor or pharmacist. Thus people are led to believe that the medical and dental professions are split down the middle on this issue. This split simply does not exist. Fluoridation is not medication, or the administration of a remedy, it is a preventive measure only, like pasteurization, immunization, and vaccination. The number of doctors and dentists opposing fluoridation on scientific grounds is actually about equal to those who object to these other well-established preventive measures. As of June, 1970, more than 6.6 million Canadians were using optim:ally fluoridated water. This is 31 per cent of the total population, and 45 per cent of the population that has piped water. In the Marilimes, Ontario, and Manitoba, fluoridation is increasing, aided by provincial grants and loans. The West remains largely un-fluoridated. Although there ai-e more