What are the risks of not enough or too much fluoride in tap water?
Water with low fluoride concentrations has beneficial effects on teeth, preventing and controlling tooth decay in children and adults. However, too much fluoride can cause adverse health effects.
The major concern with adding fluoride to drinking water is dental fluorosis, a condition that changes the appearance of tooth enamel. Although a large body of scientific evidence from credible sources exists on the relationship between health and fluoride, stories of adverse health effects from media and interest groups have caused widespread concern that is largely unsupported by scientific studies.
Fluoride occurs naturally in water as it leaches (dissolves into water) from rock formations, or is introduced via human activities like chemical, steel, glass and cement manufacturing.
Because fluoride is a naturally occurring mineral it is found in low levels in most drinking water sources in Canada.
Depending on the water’s natural levels of fluoride, treatment plants may either add fluoride to obtain benefits for oral health or treat the water to reduce the level of fluoride to meet federal and provincial requirements for safe drinking water.
The maximum allowable limit set out by Canadian Drinking Water Guidelines, to which Alberta adheres, is 1.5 mg/L. In some parts of the world, due to specific geologic formations fluoride levels can reach 57 mg/L, resulting in elevated occurrence of skeletal and dental fluorosis.
Skeletal fluorosis occurs when fluoride accumulates in bones, causing a non-life-threatening disease in which bones increase in density and become brittle due to structural changes from addition o fluoride. Case studies of crippling skeletal fluorosis from North America are extremely rare, and all include as a likely cause the long-term consumption of drinking water with elevated concentrations of fluoride (2.4-7.8 mg/L), well above the maximum allowable concentration set out by Health Canada of 1.5 mg/L.
Only children whose teeth are developing under the gums are at risk of developing dental fluorosis and only at concentrations higher than the Health Canada guideline limit of 1.5 mg/L.
A Health Canada review of available science, supported by the 2007 Health Canada expert panel, concluded the amount of evidence behind other purported health effects, such as cancer, IQ deficiency, bone fractures, and developmental toxicity does not support a link between fluoride exposure at Canada’s maximum allowable limit of 1.5 mg/L and any of these adverse effects.
Municipal treatment plants that provide drinking water to consumers must follow the Canadian Drinking Water Quality Guidelines, ensuring water leaving the plant does not exceed the fluoride limit.
Approximately 87% of the population relying on the Bow River or its tributaries for source water are serviced by City of Calgary Water Services. In a 1989 plebiscite, Calgarians voted in favour of adding fluoride to the city’s drinking water. By 1991, fluoride was being added at a targeted level of 1.0 mg/L. In 1998, the City and Alberta Health Services reviewed water fluoridation as a public policy, and a panel of five experts recommended a reduction in the level of fluoride to 0.7 mg/L. This change was adopted in 1999 following a second plebiscite where Calgarians again voted 55% in favour of fluoridation. The City of Calgary discontinued the addition of fluoride to city drinking water as directed by Council on May 19, 2011.
Municipality or utility service providers are bound by regulation to adhere to the maximum allowable concentration of fluoride in drinking water as outlined in the Drinking Water Quality Guidelines. Some municipalities choose not to fluoridate their water at all, a decision based on either Council vote or natural fluoride concentrations of the source water.
Contact your drinking water provider, utility services provider or local municipality to find out more about their fluoridation practices. Private drinking water sources, such as groundwater wells or springs, can be tested for fluoride concentrations through accredited laboratories to determine fluoride levels. Talk to your dentist or doctor if you are concerned about any of the potential health effects from fluoride in your water.
Patterson, S.K. (2010). A Review of Water Fluoridation. Alberta Health, Office of the Chief Medical Officer of Health.
Dental Health Services Victoria. (n.d.). People without fluoride in their drinking water. Retrieved July 5, 2017, from https://www.dhsv.org.au/dental-advice/general-dental-advice/people-without-fluoride-in-their-drinking-water
Fawell, J., Bailey, K., Chilton, J., Dahi, E., Fewtrell, L., and Magara, Y. (2006). Fluoride in Drinking-water. World Health Organization. https://doi.org/10.1007/BF01783490
Fluoride in Calgary’s water (n.d.) http://www.calgary.ca/UEP/Water/Pages/Drinking-water/Fluoride.aspx
Health Canada. (2010). Guidelines for Canadian Drinking Water Quality: Guideline Technical Document – Fluoride. Water, Air and Climate Change Bureau, Healthy Environments and Consumer Safety Branch, Health Canada. Ottawa, Ontario. Retrieved from http://healthycanadians.gc.ca/publications/healthy-living-vie-saine/water-paraquat-eau/alt/water-paraquat-eau-eng.pdf
National Health and Medical Research Council. (2007). A systematic review of the efficacy and safety of fluoridation part a: review methodology and results.
We provide Canadian educational resources on water practices to promote conservation and sustainability. Our team crafts current and relevant content, while encouraging feedback and engagement.
The Canada WaterPortal is a registered charity, #807121876RR0001
We recognize and respect the sovereignty of the Indigenous Peoples and communities on whose land our work takes place.
© 2024 All Rights Reserved.
Ross has extensive executive experience in Operations, Governance, Information Technology and Strategy at the board and senior management level including Mancal Corporation, Mancal Energy, Highridge Exploration and Atlantis Resources. He has worked in Oil and Gas, Coal, Commercial Real Estate, Portfolio Management, Recreation, Retail and Water and Wastewater Treatment. His experience is also geographically diverse having overseen operations in Canada, the United States, United Kingdom and Northern Ireland. Additionally, he has been on the board of companies with operations in Argentina, Azerbaijan, Barbados, Kazakhstan, and Russia. He has served on numerous Public, Private and Not for Profit Boards across a number of industries.
Ross has been active on several industry Boards and committees including the Canadian Association of Petroleum Producers (CAPP) and The Schulich School of Engineering Industry Advisory Council at the Schulich School of Engineering.
Brian is a seasoned Cleantech entrepreneur with a proven history of successfully bringing complex water technologies to the market. With over 25 years of experience, he has led various organizations to achieve significant milestones in the industry.
Having started as the founding CEO of the Pressure Pipe Inspection Company (PPIC) and later taking the helm at the Water Technology Acceleration Project (WaterTAP), Brian’s entrepreneurial spirit has been instrumental in driving innovation and growth within the sector.
He is an active investor in the cleantech sector and has served on many boards including the Ontario Clean Water Agency.
Actively engaged in industry associations like AWWA, WEF, IWA, and ASCE, Brian enjoys collaborating with fellow professionals to promote advancements in the field.
Brian holds an undergraduate degree and a PhD in Physics from Queen’s University, which has provided him with a solid technical foundation. As a member of the Institute of Corporate Directors, he brings valuable insights to corporate governance.
