CDA Essentials 2019 • Volume 6 • Issue 4

16 | 2019 | Issue 4 N ews and E vents Implementation Issues ❙  Decisions about CWF programs are complex and involve many different stakeholders from all levels of government, public health, and the general public — all of whom may have very different opinions on water fluoridation. Issues of access to municipal water and oral health care, as well as oral health status, should be considered when discussing and making decisions regarding CWF. Ethical Considerations ❙  Even though there are strong ethical arguments in favour of CWF, it will remain ethically controversial. CADTH’s review found that CWF was ethically justifiable from a public health perspective because of its health benefits and equitable approach. Environmental Assessment ❙  While fluoride is common in the environment, very little of the total fluoride found in the environment is from CWF. a About CADTH and HTA Reviews Created in 1989 by Canada’s federal, provincial, and territorial governments, CADTH is an independent, not-for-profit organization responsible for providing health care decision-makers with objective evidence to help make informed decisions about the optimal use of health technologies. Among its functions, CADTH undertakes comprehensive Health Technology Assessments (HTAs), at the request of government departments and agencies. The HTA on Community Water Fluoridation (CWF) was initiated at the request of the Office of the Chief Dental Officer of Canada and an HTA Protocol was published in February 2018. CADTH formally solicits feedback from stakeholders during the HTA consultation period. The Canadian Dental Association consulted with its corporate member provincial dental associations and provided CADTH with formal input on the CWF report. CADTH’s HTA reports are produced by a multidisciplinary team of researchers and are peer-reviewed by external clinical, economic, and methodological experts as well as internal CADTH staff. ➜ “There is consistent evidence that CWF protects against dental caries in children and adults and leads to improved oral health outcomes with very uncommon and minor side effects, and that CWF programs are cost saving from a societal perspective.”