The study adds to a growing debate as to whether fluoride should be mandatory in public drinking water. While some claim that health benefits have been proven over the years, others argue that it is unnecessary, wasteful and harmful.

Dr. Hardy Limeback, head of Preventive Dentistry at the University of Toronto is an outspoken critic of fluoridation and says it’s a noxious substance that threatens public health and creates minimal benefit to a very few who can achieve greater results from other means, such as fluoridated toothpaste, which is universally available and practically unavoidable.

He says the substance dumped in drinking water is a toxic industrial waste product that children under three must avoid entirely to prevent dental fluorosis. Limeback says it accumulates in adults and can cause a litany of aliments from kidney impairment to serious bone and joint disorders. He adds that it’s unethical to medicate an entire population without consulting them.

Several advocacy groups recently joined forces to become the Toronto Coalition against Fluoride. Their goal is to place the issue on a ballot for voters to decide the future of fluoridation. The group is also trying to gain the attention of the mayoral candidates in order to sway them, though the issue is not on everyone’s radar.

Stephan Baranski, a spokesman for the George Smitherman campaign, merely yielded to health officials: “We would listen to Toronto Public Health and their recommendations on the issue.”

The Toronto Board of Health, however, has stated in the past they would yield to the municipal council. Fluoride was first added to the drinking water in Ontario in 1940 and first in Toronto in 1963 at an average concentration of 1.2 to 1.0 ppm. In 1999, the city lowered the fluoridation rates from 1.2 parts per million (ppm) to 0.8ppm, and then again in 2005 down to 0.6ppm.

In April 2007, the board of health responded to a resolution by the Ashbridges Bay Treatment Plant Neighbourhood Liaison Committee proposing that fluoridation be suspended for a 6-month period in order to study the health effects.

The group was denied their request, with a resounding backing of fluoridation by the Toronto Board of Health. “The scientific evidence and Toronto’s experience of fluoridating water for the last 44 years show that water fluoridation is a safe, economical and effective oral health preventive measure that has resulted in improved oral health for Toronto’s population,” the report read. (U of T Prof. Limeback says fluoride is not effectively applied to teeth by drinking it in water and that declining cavity rates are likely due to the universality of fluoridated toothpaste and better diets.)

Mayoral candidate Sarah Thomson spoke about fluoridation in a phone interview, citing the need for more study. “It is a health issue worth investigating,” said Thomson. “As a mom, I’m concerned about my children and I know many other parents are as well,” she said in regards to dental fluorosis, a condition afflicting children overexposed to fluoride. The coalition recently gained an audience with Thomson where the issue was brought to her attention.

Candidate Rocco Rossi commented briefly on the issue. “Are we wasting money? If so, then let’s stop,” he said. “Let’s look at the evidence and decide.”

Toronto is behind other cities in Canada and much of the world where most don’t fluoridate. Nearly all European countries allow little or no fluoridation. About 10% of the population in the United Kingdom and Spain receive fluoridated water; it is obsolete in China and Japan.

“Montreal and Vancouver don’t [fluoridate], so what does it say about Toronto if we want to be a world-class city too?” asks Thomson.

In 1999, the Centers for Disease Control proclaimed the fluoridation of drinking water was one of the top 10 greatest public health achievements in the United States.