March 21, 2019

Archives for April 2012

Dr. Hardy Limeback (BSc, PhD, DDS) — A Brief Bio

Dr. Hardy Limeback is a recently retired full professor and former head of Preventive Dentistry at the Faculty of Dentistry, University of Toronto, a position he served for 18 years. His career started with a BSc and PhD in Biochemistry, followed by dental school with graduation in 1983. As a professor, he conducted laboratory research on the proteins responsible for tooth development and studied the effects of fluoride on teeth and bone. An author (and co-author) of over 150 papers, book chapters and abstracts, Dr. Limeback served as president of the Canadian Association for Dental Research (1998-99) and served on the US National Academy of Sciences Subcommittee on Fluoride in Drinking Water. He recently authored and edited a textbook in preventive dentistry (Comprehensive Preventive Dentistry – Wiley-Blackwell, June 2012). His clinical experience included working part-time as an associate general dentist and as Chief Dentist for the Metropolitan Toronto Homes for the Aged. Since 1993 he has been operating his own dental office. Dr. Limeback continues to practice today as a solo practitioner in Mississauga, Ontario, Canada.

We are honoured and delighted to have Dr. Limeback’s wealth of experience and knowledge shared on our informational website.

Robert J. Fleming, President / Spokesperson
Canadians Opposed to Fluoridation ~ Canadiens Opposés à la Fluoration (COF-COF)

Q&A: Ontario’s chief medical officer fights for healthier smiles

COF-COF News Find 300 x 300By: Jennifer Pagliaro, Toronto Star, Toronto, Ontario 29-Apr-2012 – Dr. Arlene King calls tooth decay one of the “most prevalent chronic diseases” — one we can prevent, in part through fluoridation.

The chief medical officer for the province wants all Ontarians to be proud of their smile.

Dr. Arlene King said people need to be better informed about the links between oral health and whole-body health. In a report released Friday, she argues more action on access to oral healthcare.

Calling tooth decay one of “the most prevalent chronic diseases,” King highlighted several recommendations, including fluoridation of drinking water across the province, at a time when the issue has been hotly debated across the GTA.

The Star spoke with King about why putting fluoride in our drinking water is so misunderstood and the implications for accessible preventative care.

Q: Over the years there’s been some objection to fluoridated drinking water, with academics and other professionals claiming we already get enough through toothpaste or other dental applications, and that fluoride in excess could be harmful. What you would say to those arguments?

A: Seventy per cent of the population of Ontario benefits from fluoridated drinking water. And this has been cited both in Canada and in the United States as one of the top 10 achievements in the last century in terms of public health.

The adding of fluoride to drinking water is safe, it works and it is effective.

We have very, very strict regulations governing the optimal amount of fluoride that exists in our community water supplies.

The most common side effect of excess fluoride is a condition called dental fluorosis. That is a condition where there’s a change in the appearance of the teeth that is caused by a change in enamel formation, which occurs during tooth development. Mild and even moderate fluorosis has no effect on tooth functioning. That being said, the prevalence of serious fluorosis in Canada is very low.

Q: Earlier this year, Halton Region was poised as the first GTA community to potentially ban fluoride in their water. But after a close vote they maintained the status quo. I’m wondering why you think there’s such heated debate over the topic.

A: I think it’s related to a lot of the challenges we’re having with some of the most significant public health achievements of the last century — and that is a proliferation of information available, largely online, that needs to be vetted thoroughly by health professionals in order to enable interpretation by the public and by decision makers.

Q: In Toronto, there was a recommendation that city council cut fluoridation and they could save $1.9 million. What are the economic implications of having fluoridation for drinking water across Ontario?

A: It is probably one of the most cost-effective health interventions that exist. The cost to fluoridate a community is less than the cost of one dental filling —and that’s the average lifetime cost per person.

Q: You mentioned in your report this patchwork of services related to oral health for low-income families. So I’m wondering if you think programs like Healthy Smiles Ontario are doing enough to improve health through preventative care.

A: I’m concerned that by reducing the number of communities in the province of Ontario that don’t have access to fluoridated drinking water, that we actually make an impact on some of these important public health programs that have been put in place. That being said, there is a need to review our publicly funded programs and expenditures to basically try to get as much bang as possible for our buck.

The solution is a real shift, to try to do as much prevention in as many people as humanly possible, to prevent that downstream load of dental disease later on in life.

This interview has been edited and condensed.

Okotoks Settles Fluoride Issue: Council votes 6-1 to end fluoridation

By: The Eagle 100.9 FM, Okotoks Online, Okotoks, Alberta 25-Apr-2012 – The Town of Okotoks is taking the Fluoride out of it’s drinking water.

In a 6-1 vote council agreed to repeal the existing fluoridation bylaw and direct administration to apply to Alberta Environment to stop putting it into the town’s water.

Councillor Florence Christophers, who originally brought the motion forward, was pleased that it passed.

“I think it’s a cautious, conservative way forward. I think it basically says to our community there’s some doubt around this issue, the science isn’t clear and we’re asking for that science before we deny you the choice,” she explains. “I take very serious the ethical argument that there’s many, many citizens in our community that really want to be given the choice about whether or not this pharmaceutical, this chemical is in their bloodstream.”

She stresses that Fluoride is not the only option for good dental hygiene, pointing to the province of PEI as an example.

“60 percent of 12 year olds in their province have never had a cavity – it’s the lowest in Canada. And do they fluoridate? They don’t. They’ve done it in creative ways – they’ve worked with schools, they’ve done really great promotion campaigns around dental hygiene – that gets me excited!  Let’s get to the root of the issue instead of putting a controversial pharmaceutical in our water and dividing our community on this.”

A second motion passed will see administration consult with Alberta Health Services to ensure a program is in place to provide topical fluoride treatments or fluoridated toothpaste for individuals at risk of dental cavities and may need assistance.

Mayor Bill Robertson was the lone vote against the motion as he tried, unsuccessfully, to put the issue to a plebiscite as part of the next municipal election.

About 66-percent of respondents to the town’s survey said they either somewhat or strongly opposed the use of Fluoride in public drinking water.

Town council votes to stop fluoridation: Councillors want program for low-income residents

By: Don Patterson, Okotoks Western Wheel, Okotoks, Alberta 25-Apr-2012 — Fluoride will be removed from Okotoks’ drinking water, but town councillors still have a few more steps to take before the Town stops adding the chemical for good.

Councillors voted 6-1 on April 23 to stop adding fluoride to drinking water, but they still need to approve a bylaw at a future meeting before the practice finally stops.

The vote is a victory for coun. Florence Christophers who proposed stopping fluoridation in January. She has argued science is divided on the effectiveness and safety of the practice and it comes down to a matter of choice.

“It’s a call for clearer science and until we have it, to me, I really believe the citizens deserve the option of whether or not to have this pharmaceutical floating in their blood stream,” said Christophers.

Opponents of fluoridation say the chemical contributes to a range of health problems including florosis of the teeth and creating brittle bones. Supporters of fluoridation say it’s a low-cost, effective public health program to prevent tooth decay, especially among low-income people who may not be able to afford dental care.

The Okotoks community is also divided on the issue, but there is support for stopping fluoridation in Okotoks. A survey on the Town’s website showed 66 per cent of respondents opposed fluoridation, with 33 supporting it. The Town also received comments on both sides of the issue through letters, its website and at a public hearing.

Council also approved a motion to consult with Alberta Health Services to ensure a program is in place to provide fluoride toothpaste or topical treatments for people at risk of dental decay. However, there was some concern this would not happen.

Christophers voted against this motion because she had wanted the Town to take the lead on creating such a program.

“I just think there’s such an opportunity here for our community to step up to the plate to work together in partnerships to make sure we are taking oral health seriously,” he said.

Okotoks mayor Bill Robertson cast the lone vote against removing fluoride saying there are benefits to having fluoridation, particularly for children.

“I tend to err on the side of protecting our most vulnerable people,” he said.

Robertson unsuccessfully tried to have a plebiscite held in conjunction with the Oct. 2013 municipal election. He was the lone member on council to support a plebiscite.

“I would’ve preferred it go to a pleblicite,” he said. “It’s been such an emotional issue in the community and I had a number of people say I’d like a say in this.”

Robertson pointed out fluoridation was first brought in because of a plebiscite in 1989, but the results of the 1989 vote are not known. A 1998 referendum saw 1,442 people support keeping fluoride in water over 879 who didn’t.

Robertson said the Town could use the $8,700 it puts into fluoridation towards an oral health program.

However, he questions whether the proposed program will get off the ground and he won’t support the final bylaw to stop fluoridation without a program in place. He said Calgary hasn’t been able to create such a program since fluoride was removed from the city’s drinking water last year.

Coun. Stephen Clark also doesn’t think the Town should have to run a program, saying the Province already has existing programs that can help low-income families.

However, he has some concerns an Okotoks-specific program will never get off the ground.

Clark also spoke out against a plebiscite.

“If Alberta health can’t give us clear direction, the medical community can’t give us clear direction, I don’t know how our community can give us a clear direction,” he said.

Coun. Matt Rockley also opposed a plebiscite saying it could force the will of a possible slim majority on the town.

With strong opinions on both sides of the issue in town, he said it’s a tough decision for a councillor to make and it’s unfortunate the issue is left to laymen to decide.

“Here I am, a municipal councillor, I have no medical training , I have doctors on one side saying it’s good to put fluoride in water I have doctors on the other side saying it’s not good to put fluoride in water,” said Rockley.

Periodontal Disease and Atherosclerotic Vascular Disease – Does the Evidence Support an Independent Association, A Scientific Statement from the American Heart Association


A link between oral health and cardiovascular disease has been proposed for more than a century. Recently, concern about possible links between periodontal disease (PD) and atherosclerotic vascular disease (ASVD) has intensified and is driving an active field of investigation into possible association and causality. The 2 disorders share several common risk factors, including cigarette smoking, age, and diabetes mellitus. Patients and providers are increasingly presented with claims that PD treatment strategies offer ASVD protection; these claims are often endorsed by professional and industrial stakeholders. The focus of this review is to assess whether available data support an independent association between ASVD and PD and whether PD treatment might modify ASVD risks or outcomes. It also presents mechanistic details of both PD and ASVD relevant to this topic. The correlation of PD with ASVD outcomes and surrogate markers is discussed, as well as the correlation of response to PD therapy with ASVD event rates. Methodological issues that complicate studies of this association are outlined, with an emphasis on the terms and metrics that would be applicable in future studies. Observational studies to date support an association between PD and ASVD independent of known confounders. They do not, however, support a causative relationship. Although periodontal interventions result in a reduction in systemic inflammation and endothelial dysfunction in short-term studies, there is no evidence that they prevent ASVD or modify its outcomes.

Periodontal Disease And Atherosclerotic Vascular Disease – Does The Evidence Support An Independent Association, A Scientific Statement From The American Heart Association 18-Apr-2012

Fluoride discussion takes a bite out of City Hall

COF-COF News Find 300 x 300By: Emma Reilly,, Hamilton, Ontario 17-Apr-2012 – One side says it’s safe, effective and affordable.

The other argues it’s a dangerous form of mass medication.

And both sides are equally convinced their argument has teeth.

The great debate about fluoride played out for hours at City Hall on Monday as councillors received an annual report about water fluoridation.

Even though councillors weren’t at the decision stage, Monday’s meeting was rowdy, raucous and drew a crowd of a size City Hall hasn’t seen since the days of the Pan Am stadium debate.

While the delegates were divided about fluoride, they were united by their fervency. Whether they argued fluoride was one of the greatest public health achievements of the 20th century or that fluoride causes cancer, bone decay and a host of other diseases, each side argued their case with equal tenacity.

Heading up the pro-fluoride camp were Dr. Arlene King, Ontario’s medical officer of health, Dr. Peter Cooney, chief dental officer with Health Canada, and Dr. Ron Yarascavitch, a representative of the Royal College of Dental Surgeons of Ontario.

King argued that fluoridation has been studied extensively over the past 60 years and scientific evidence has shown it to be safe and effective.

“I want to assure you and support your medical officers of health in saying that water fluoridation is safe, highly effective and most importantly, reaches the entire population,” she said.

However, King faced some pointed questions from Councillor Terry Whitehead about her background and areas of expertise.

Whitehead — who has an autistic son — suggested there was a link between autism and fluoride and asked King if she was an expert on that disorder. That prompted Mayor Bob Bratina to spring to King’s defence.

“I know that there’s no intention of trying to embarrass anybody by suggesting they’re not an expert,” Bratina said.

The anti-fluoride representatives at the meeting — including academics, chemists, politicians, former Green Party candidate Peter Ormond and former water distribution managers — made up the majority of delegates at Monday’s meeting. This group clapped after every anti-fluoride presentation, called out during the meeting and gathered in the lobby outside council chambers after the meeting for a group photo.

One member of the gallery began yelling at councillors when the meeting lost quorum, accusing them of being biased and cutting off any opposition as they listened to two hours of pro-fluoridation arguments.

“If you continue, we’re just going to end the meeting right now and leave the chamber,” said Bratina, who was chairing it.

Bratina also stepped in to prevent one delegate from what he characterized as personal attacks against Dr. Chris Mackie, an associate medical officer of health.

While councillors have dealt with their annual fluoridation report, the issue isn’t set to die out anytime soon.

Councillor Brian McHattie introduced a notice of motion Monday asking for a variety of actions relating to fluoridation, including asking Health Canada to enact greater controls and for the province to provide further studies.

“It just makes me awfully nervous,” McHattie said about the potential impact of fluoridation. “I hope we’re on the right path.”

POLL: Teeth bared in fluoride report debate

COF-COF News Find 300 x 300By: Emma Reilly,, Hamilton, Ontario 16-Apr-2012 – City councillors are into their fourth hour of discussion about fluoride in Hamilton’s water.

The city’s public health staff is presenting its annual report about water fluoridation and a decision isn’t expected to be made today. Still, a steady string of delegates have shared their thoughts about the effects of fluoride at this afternoon’s public health committee meeting.

Some spoke in support of fluoridation, including Ontario’s medical officer of health Dr. Arlene King, and Dr. Peter Cooney, the chief dental officer with Health Canada. Many more spoke out against the practice — including Councillor Terry Whitehead, who argued that there’s a link between fluoride and autism.

The meeting has been raucous, with the antifluoridation advocates shouting out to the mayor and delivering a hearty round of applause after every delegate.

Brewer’s ‘Daily Dose’ 11-Apr-2012

New Studies: Fluoridation Fails to Reduce Cavities in New York City and Nationally

By:, New York 11-Apr-2012 

New research shows that fluoride chemicals added to U.S. public water supplies are not reducing tooth decay as promoted and promised by government agencies, reports the New York State Coalition Opposed to Fluoridation, Inc. (NYSCOF).

Using federal statistics, the West Virginia University Rural Health Research Center reports that urban U.S. children, with more exposure to fluoridated water and dental care, have just as many cavities as less fluoridation-exposed rural children. (1)

The researchers write: “For children’s dental health measures, it was found that fluoridation rates were not significantly related to the measures of either caries or overall condition of the teeth for urban or rural areas.”

The Centers for Disease Control (CDC) says fluoridation reduces tooth decay. But, this study and others shows it hasn’t. Tooth decay crises are occurring in all fluoridated cities, states and countries. And, the CDC reports the incidence and severity of children’s primary tooth decay recently increased.

“Fortunes are wasted on fluoridation schemes that fail to prevent cavities while unnecessarily exposing children to fluoride’s adverse drug effects,” says attorney Paul Beeber , NYSCOF President.

New York City spends millions of dollars annually on fluoridation. Yet another study proves fluoridation fails in NYC also.

NYC’s Chinese-American 2-to-11-year-olds, living in the low-income area of Manhattan’s Chinatown have much more primary tooth decay when compared to white and other minority groups nationally (NYS Dental Journal June/July 2011).

Most of NYC’s Chinese-American children are U.S. born – 63% have primary tooth decay compared to only 38% of children in a national study.

The authors write, “This high prevalence of caries in the primary dentition is also similar to a national survey of children in mainland China, where three out of four children were found to be affected by caries in primary teeth,” averaging about 5 decayed teeth.

More evidence that fluoridation fails New York is here

Legislation ( Int 0463-2011 ) is pending to stop fluoridation in New York City. Council Member Peter F. Vallone, Jr, the chief sponsor, says “There is a growing body of evidence that fluoride does more harm than good.”

“Fluoride is neither a nutrient nor required for healthy teeth. Fluoridation must end,” says Beeber.–fluoridation-fails-to-reduce-cavities-in-new-york-city-and-nationally-146994825.html

Coming clean: Good hygiene key to curbing rising tooth decay rates in kids

Photograph by: Tim Fraser, Postmedia News

By: Rachel Naud, National Post, Canada 10-Apr-2012 — Like many moms, Alison Duncan got tired of fighting a losing battle with her four-year-old daughter, Taylor. Every day, twice a day, tooth brushing was met with screams and tears.

“We tried to talk to her, calm her down, tell her it’s really important,” says the Toronto stay-at-home mom. “We’d sing songs to pass the time, we bought funky toothbrushes that would sing to her, fun toothpaste — all the gimmicks and gadgets. But she wasn’t having it.”

Duncan found the only way to get Taylor’s teeth brushed was to let her do it herself. But when Taylor had her first dental appointment at age three, the dentist discovered she already had four cavities.

Contrary to what many people believe, the rate of Canadian children with cavities are rising.

“We just found that for the first time in 40 years, the incidence in cavities in children in fluoridated communities has gone up,” says Dr. Diederik (Diedo) Millenaar, a pediatric dentist in Vancouver and president of the B.C. Society of Pediatric Dentistry.

A recent Canadian Health Measures Survey collected information on the average number of baby (or primary) teeth that were either decayed (d), missing (m) or filled (f). This survey’s “dmft” count indicated the severity of the disease. For instance, if a child had a dmft count of four, it meant the child had four teeth that were either decayed, missing or filled.

Results of the survey indicated that 48% of children ages six to 11 with their primary or baby teeth had a dmft count of at least one. Moreover, the average number of teeth that are decayed, missing or filled in this category was 1.99.

“The numbers can be attributed to the fact that parents think they’re traumatizing the child with brushing, as well as the availability and frequency children are eating processed snacks,” says Millenaar. “Also, people are ill-informed on the value of fluoride. Parents choose not to use it. Or there are some cities that don’t have fluoride in their water. Calgary just took [fluoride] out of its drinking water and they experienced a 30% increase in their level of tooth decay.”

For Duncan, treating her daughter’s tooth decay was more of a nightmare than the daily brushings. During her first treatment at the family dentist, Taylor was traumatized by the drill and the dentist was only able to fix one cavity. From there, they went to a pediatric dentist who used laughing gas, which upset Taylor even more and left her screaming and looking for her mother, who was sitting beside her the whole time. The only other option was fully sedated oral surgery to fix the remaining three cavities.

“But where do we go from there,” asks Duncan. “We can’t just keep taking her for surgery every time she gets a cavity.”

Millenaar says there are many things parents can do to avoid Duncan’s situation and keep on top of their children’s oral care, and they can start before children even pop their first tooth.

He advises parents to take a cloth or a small toothbrush and wipe or lightly brush the gums where the teeth are coming in. “It’s meant to get the child stimulated so they know it’s a normal thing to do when their teeth show up,” says Millenaar. “Most people usually start when the first tooth is there but I encourage to do it earlier if they can.”

Millenaar also says parents should not put their babies to bed with bottles of milk or juice, as the natural sugars can cause tooth decay. He says water is the best option if a child needs a bottle to sleep.

When it comes to diet, he suggests parents stay clear of sugary, processed snacks and opt for more fibrous fare such as apples, carrots or crunchy, tough bread. “Anything that really promotes chewing and is tough to tear apart,” says Millenaar. “It’s good for the teeth and makes the body produce more saliva.”

When it comes to brushing, Sophia Baltzis, a dental hygienist in Laval, Que., advises parents to have younger children lay down on a bed with their heads propped on the parent’s lap.

“That way parents have direct access and can see and brush that way,” says Baltzis. “Try to brush in a circular motion for at least two minutes, passing over every tooth.”

Flossing in a C-motion is also important, says Baltzis who says it can be introduced as early as age one if no spaces can be seen between the teeth.

And last, Millenaar says parents should make brushing non-negotiable. “Don’t apologize for brushing your child’s teeth,” Millenaar says. “When they fuss, take your time, be supportive but don’t rush. Brushing teeth is a lot easier than getting them fixed later on.”

Fluoride debate heats up, Okotoks public hearing attracts a crowd


Dr. James Beck, University of Calgary medical biophysics professor, addresses town council during a March 26 public hearing about the future of fluoride in town water. Photograph By: Don Patterson/OWW

By: Don Patterson, Okotoks Western Wheel, Okotoks, Alberta 05-Apr-2012 — The debate over removing fluoride from Okotoks’ drinking water is heating up.

About 60 people turned out to a public hearing on March 26 to hear experts speak on both sides of the fluoride issue in Okotoks and add their voices to the debate.

Medical experts squared off to lend their advice on whether town council should remove fluoride from town water. A prominent opponent of flouride discussed potential health impacts and ethical questions over the practice. On the other side, Alberta Health Services (AHS) physician, Dr. Richard Musto, spoke out in support of the practice as safe and effective in preventing tooth decay.

“AHS supports fluoridation of water as a simple, safe and cost efficient means of protecting teeth from decay,” said Musto, Alberta Health Services medical officer of health.

Musto said fluoride makes teeth more resistant to acids produced by bacteria, it reduces the ability of bacteria to produce acid it helps to repair damaged enamel. He said fluoridation of water combined with topical use provides the most effective protection.

Musto said there are volumes of research in support of the practice. He presented data from screening programs of students in the Calgary region between kindergarten and Grade 2 showing Okotoks has a lower rate of tooth decay compared to communities without flouridation in their water, such as High River and Cayley. He also cited studies from Quebec and York University which, he said, show an increase in tooth decay after fluoridation was eliminated.

Musto said scientific reviews have concluded more research needs to be done in areas where people are raising questions, but there isn’t enough scientific evidence to show a risk of fluoride at current levels.

According to Musto, fluoride levels in Okotoks range between 0.7 and 0.9 mg per litre, well below the highest acceptable concentrations of 1.5 milligrams of fluoride in drinking water allowed by Health Canada.

Musto maintained there’s no controversy over the safety of fluoridation at recommended levels.

Fluoride opponent Dr. James Beck, University of Calgary medical biophysics professor, said promoters of fluoridation are trapped in a myth that it’s a good thing.

“It’s not substantially effective, it’s not safe and it’s not ethical,” he said.

Beck said recent studies show little to no benefit for fluoridation, adding that stopping fluoridation is not a threat to dental health in the community, The main benefits from flouride, Beck explained, comes from topical use, not ingestion.

Beck said there is a potential for harm to a variety of parts of the body, including bones, thyroid, brain, cardio vascular system and kidneys, due to fluoride exposure. He said the chemical poisons the functions of enzymes in the body and hyperthyroidism is more prevalent in communities with fluoride.

“There is a substantial probability of harm, there is little or no evidence of benefit and there are alternatives that are known to be effective,” he said.

He also argued adding fluoride to water doesn’t meet medical ethical standards. He said a person should have a choice to ingest a drug and that administration should be monitored by a medical professional. While some may say fluoride is not a drug, he counters it fits the definition of a substance that is not a nutrient and is used to prevent disease. As well, he said the Supreme Court of Canada deemed fluoride a medication.

Some Okotoks residents supported the practice saying it promotes dental health in the community.

Okotoks resident Heather Avis said it’s also important to provide a source of fluoride for low-income people who can’t afford dental care.

“These are the most vulnerable people in our community,” she said.

Adding fluoride to water is not much different than wide-scale use of drugs and medical treatments, such as vaccination, to protect peoples’ health, she said.

Okotoks resident Dot Greenshields said she grew up in a community without fluoride and while she had good dental care growing up and she still ended up with cavities. By comparison, her children, who were raised in Okotoks, have had fewer cavities.

Penny Judson, Millarville resident and dental hygienist, worries there could be increased fluorosis as a result of people not using fluoride supplements properly.

Most opposed to fluoridation said it should be a choice.

“If you want to put it in,” said Judy Anne Niemi. “If you don’t want to put it in, don’t put it in.”

She is worried about the potential health effects of fluoride.

Colleen Osentis said the Town has taken away her right to choose whether she wants to ingest fluoride. She questioned whether the Town would pay for filter systems to remove fluoride for the people who don’t want it.

Town council is scheduled to make a decision on the matter on April 9.