Presentation on theme: "Office of the Chief Dental Officer"— Presentation transcript:
1Office of the Chief Dental Officer Health Canada’s Position on FluorideCommunity Issues CommitteeLethbridge, AlbertaFebruary 28, 2011
2Health Canada’s Involvement to date. By Invitation;Present Science (from Health Canada’s expert review panel);Present International Information;Respect Provincial / Territorial / Municipal Parameters.
3Oral Health and Overall General Health Dental disease is:the #1 chronic disease in children & adolescents;(U.S. Surgeon General’s Report, May 2000)five (5) times more common than asthma;one of the main reasons preschool children receive a general anaesthetic;the second most expensive disease category in Canada;47% of Canadians have had dental disease by 6 years of age, 96% have had it in their lifetime.Oral health is linked to a number of systemic diseases.
4Health Canada’s Position on Fluoride: As part of normal activities to update drinking water guidelines, in Spring 2006, Health Canada (HC) initiated a review of fluoride.The process included:-Contracting 3 researchers to prepare papers in the following areas:level of dental fluorosis in Canada,non-dietary sources of fluorides,fluoride's impact on the body (neurological, bone, etc)-HC prepared a paper on fluoride in soil, air and food by age group;-The papers were reviewed by 3 other experts with similar backgrounds;-All 6 experts, HC reps, chair of the Federal Provincial Territorial Committee on Drinking Water, Canadian Dental Association and US Environmental Protection Agency were brought together to consider all the research.
5Findings of Review Total Daily Intake: General decrease in recent years (Use of supplements has decreased and concentrations of fluoride in infant formulas have decreased)Dental Fluorosis:First 3 years of age is period of most significant concern;Point of concern should be moderate dental fluorosis (Dean’s Index);Other Health Effects:No conclusive evidence related to bone fracture, cancers, intelligence quotient, skeletal fluorosis, immunotoxicity, reproductive and developmental toxicity, genotoxicity and neurotoxicity based on a Maximum Allowable Concentration (MAC) of 1.5 mg/L.
6Recommendations from Review The MAC of 1.5 mg/L for fluoride in drinking water should be reaffirmed.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.Findings and recommendations of the Fluoride Expert Panel Meeting, January 2007.
7Fluorosis 60% 24% 12% 4% <0.3% → 6 - 12 year olds Normal teeth Questionable1Very MildMildModerate /severe260%24%12%4%<0.3%1 ill defined and could be due to antibiotic usage, infection, severe fever, trauma etc.Note:Initial WHO central calibrationRecalibration on first day of each new siteRecalibration at mid point of each siteRecalibration before end2 Statistics Canada criteria for withholding reporting value:Highly unstable numbers (<10)Coefficient of variation > 33.3%For information regarding measures spread in data see the Statistics Canada web site:
101961-2009 Trends in Water Fluoridation and Dental Decay in Canada. Children’s Decay (DMFT) RatesDr. Carlos Quinonez, Faculty of Dentistry, University of Toronto
111972 / 2009 Canadian Decay (DMFT) Comparisons. * Although we have made great improvements in oral health in Canada, there is still a lot of work to be done.
12Who supports Fluoridation? World Health Organization (WHO)Pan American Health Organization (PAHO)American Medical / Dental AssociationsCanadian Dental AssociationHealth Canada (HC)Canadian Association of Public Health DentistryCanadian Pediatric SocietyCanadian Public Health AssociationToronto Public HealthCenters for Disease Control and Prevention (CDC)Ontario Association of Public Health DentistryRoyal College of Dental Surgeons of OntarioOntario College of Dental HygienistsOntario Dental AssociationRecent US Surgeon General’s ReportFederation Dentaire Internationale (FDI)
13Examples of Studies That Support Water Fluoridation Oral Health in America: A Report of the Surgeon General, 2000Systematic Review of Water Fluoridation. UK/International study, 2000Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. US Department of Health and Human Services Centers for Disease Control and Prevention, 2001Forum on Fluoridation. Ireland, 2001A Systematic Review of the Efficacy and Safety of Fluoridation. National Health and Medical Research Council, Australian Government, 2007
15Health Canada continues to recognize the benefits of ConclusionsHealth Canada continues to recognize the benefits ofcommunity water fluoridation, and supports it as a safe and aneffective method to prevent tooth decay.