FLUORIDE IN DRINKING WATER IN OXFORD COUNTY

Health Information Advisory

Environmental Health Update for Residents, Health Care Professionals & Community Partners
January 25, 2013

FLUORIDE IN DRINKING WATER IN OXFORD COUNTY
This Health Information Advisory is to advise residents, health care professionals and other users of the municipal drinking water system that fluoride levels in the following communities in Oxford County have tested above the Maximum Acceptable Concentration (MAC) of 1.5 mg/L

								Fluoride range at which water is still acceptable to drink**
	Community			Fluoride levels
Brownsville			1.74 to 1.77 mg/L			1.5 mg/L	1.5 – 2.4 mg/L
Ingersoll			1.0 to 1.98 mg/L
Lakeside			1.55 to 1.56 mg/L
Springford			1.66 mg/L

* The County of Oxford is required to test for fluoride samples in municipal drinking water every five years.
**If children 6 years of age or younger are in the household, it is recommended other sources of fluoride are reduced, e.g., by using non-fluoride toothpaste, using bottled water for baby formula (after it has been boiled and cooled). See page 2 for more information.
Understanding fluoride levels
The County of Oxford does not add fluoride to drinking water. Fluoride is naturally present at varying levels in the water in Oxford County.
Water supplies that contain naturally occurring fluoride between 1.5 and 2.4mg/L are considered acceptable to drink by the Ontario Ministry of the Environment. The bacteriological safety of municipal drinking water is not affected by fluoride levels, meaning that the water is safe to drink.
When fluoride levels are in the 1.5 - 2.4 mg/L range, the Ontario Ministry of Health and Long Term Care recommends heightened public awareness to educate people on how to control too much exposure from other sources of fluoride, such as food and toothpaste. This is to protect against dental fluorosis in young children. 

Health Consideration: Dental fluorosis in young children

Fluorosis is a dental condition caused by exposure to fluoride while teeth are forming in the gums (usually ages 0-6 years). Fluorosis can cause small white flecks on teeth or larger white areas or, at higher fluoride levels, pitting or brown areas. Fluorosis is a cosmetic condition, not a health condition.
Drinking water below the maximum acceptable concentration of 1.5mg/L will protect against moderate dental fluorosis in children while helping to protect against cavities. However, it is difficult to predict if fluorosis will occur and what it will look like. The following recommendations are intended to minimize the effects of fluoride in the water system if fluoride levels are above 1.5mg/L:

1. Water treatment. Use a home treatment system to remove or reduce the fluoride content if there are young children in the home. Only reverse osmosis and distillation processes remove fluoride. Charcoal filters do not remove fluoride.
   
2. Use other sources of water. If it is not possible to use a home treatment system, consider using water from another source with a lower fluoride level (e.g., non-fluoridated, bottled water) for drinking, cooking, mixing juices or making baby formula, especially when there are young children in the home. Bottled water, like tap water, must be sterilized when it is used to make baby formula.
   
3. Non-fluoride toothpaste. Consider using non-fluoride toothpaste for children up to and including 6 years of age, or no toothpaste for children up to 3 years of age, especially for children who may swallow toothpaste. Parents should only use a small amount of toothpaste (pea-size or a smear) regardless of fluoride levels in the water, and should always supervise the amount of toothpaste being used.
   
4. Don’t use fluoride supplements. Fluoride supplements should not be used in areas with naturally occurring fluoride.
   
5. Consult with your dentist. A fluoride treatment at the dentist is not likely to contribute to fluorosis; however, parents should discuss the use of any dental products with their 
   dentist.
   
   

Fluoride levels in non-municipal drinking water (private wells)
Some private wells in Oxford County may also contain naturally-occurring fluoride levels above the recommended level of 1.5 mg/L. Public Health recommends regular testing of well water: three times a year for bacteria and once a year for fluoride and nitrates. Visit www.oxfordcounty.ca/health to learn more.

More information
If you have questions about fluoride in your drinking water, please consult your health care professional, or call Public Health & Emergency Services at 519-539-9800, ext. 3410, toll-free 1-800-755-0394. More information is available online at www.oxfordcounty.ca/fluoride. 

Issued by:
Dr. Douglas A. Neal
Acting Medical Officer of Health Oxford County Public Health

Dr. Wayne McKay
Dental Consultant
Oxford County Public Health