Communities throughout Canada and the US add fluoride to their
drinking water supplies to prevent dental cavities. As we've
before, some opponents claim that the risk of adverse health
effects outweighs the public health benefits of fluoridation. A
recent report by the U.S. Public Health Service (US
PHS) recommends an optimum fluoride
concentration at the low end of the previously recommended range in
order to reduce dental fluorosis. They did not find a link between
fluoridation and any other adverse health impacts.
The US PHS recommended that the concentration of fluoride
should be decreased to 0.7 mg/L. Health Canada's Fluoride
Expert Panel also recommended a 0.7 mg/L fluoride
concentration in its 2008 report. Both found that at this
concentration the risk of fluorosis – mottling of the tooth enamel
– would be limited while still providing protection from
cavities. The previous 1962 US PHS guidelines recommended a
range between 0.7 mg/L and 1.2 mg/L, depending on the outdoor air
The change is based on new data showing:
an increased prevalence of dental fluorosis in the US;
there is no connection between children's water intake
and outdoor air temperature; and
the contribution of fluoride in drinking water to total
The US PHS reviewed public comments raising concerns about
the impact of fluoridation on bone fractures and skeletal
fluorosis, carcinogenity, IQ and other neurological effects,
endocrine disruption and other issues. For most concerns, it
found that there was no evidence of a connection. For other
concerns, such as the risk of skeletal fluorosis, it found that 0.7
mg/L was well below the concentration that could cause an adverse
Although the US PHA has recommended a reduction, opponents of
fluoridation are unlikely to find much support for their cause in
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The Alberta Court of Appeal's decision in Bokenfohr v Pembina Pipeline Corporation, 2016 ABCA 382 provides an important reflection on admissibility of evidence in the permission stage of an appeal in the oil and gas context.
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