Volume 8 • 2021 • Issue 5

The evolution of this research paper Dr. Lindsay McLaren, a professor at the Department of Community Health Sciences and the O’Brien Institute for Public Health at the University of Calgary, has been studying fluoridation cessation in Calgary for several years. Calgary city council decided to fluoridate its municipal water supply in 1989 based on a plebiscite, and fluoridation was implemented in 1991. Then, Dr. McLaren says, began a coordinated effort to reverse the decision. “In 2011, there was a policy window, and through a number of coinciding factors, the Calgary city council voted to stop fluoridation,” she says. What was the policy window?The fluoridation infrastructure needed to be upgraded, which costs several million dollars. An election in 2010 had caused large turnover among council members along with a new mayor. Also, provincial legislation had changed so that municipal decisions around fluoridation no longer required a plebiscite. Is Calgary part of a trend toward fluoridation cessation? According to the Public Health Agency of Canada, 43% of the Canadian population was exposed to fluoridation in 2007 and the number had fallen to 39% in 2017. “That change might mostly reflect the decision in Calgary,” Dr. McLaren says. “It’s helpful to think about the full history of community water fluoridation. It began in the late 1940s. Then it steadily increased in the 1950s, ’60s and ’70s. After that, it plateaued. Now, there’s this slight decrease, which is largely caused by the change in Calgary, a city of about 1.3 million.” The prevalence of caries in the primary teeth was significantly higher in Calgary than in Edmonton, which suggests that ending fluoridation negatively impacted children’s oral health. Additional Resources Read the new study published in Community Dentistry and Oral Epidemiology at: onlinelibrary.wiley.com/doi/full/10.1111/cdoe.12685 Read more about the decision-making process in Calgary that lead to fluoride cessation: onlinelibrary.wiley.com/doi/full/10.1111/ropr.12318 Learn about the team’s earlier study on fluoridation cessation at: sciencedirect.com/science/article/pii/S0033350616304656 onlinelibrary.wiley.com/doi/full/10.1111/cdoe.12215 Surveys show that people often don’t know if they live in a community with fluoridated water. “Sometimes people assume it is, even if it isn’t,” Dr. McLaren says. “That is often the case with public health. If it’s doing its job, people don’t necessary know about it, it operates in the background.” About three years after municipal fluoridation was voted out by the Calgary city council, Dr. McLaren and her research team did an initial investigation that showed increases in childhood caries, which was published in Community Dentistry and Oral Epidemiology in 2016 and Public Health (Elsevier) in 2017. “At that point, our research pointed to short-term poor dental health outcomes as a result of discontinuing fluoridation, and it prompted us to pursue further research” Dr. McLaren says. “This recent study provides even more robust evidence that fluoridation cessation was a poor decision from the point of view of children’s dental health.” 39 Issue 5 | 2021 | SupportingYour Practice