Community Water Fluoridation Rollbacks in Canada: Longitudinal Trends in Dental Caries Incidence Before and After Policy Removal Across Comparable Municipalities

Abstract

One of the most powerful and fair forms of preventive programs on dental caries among populations has been Community Water Fluoridation (CWF). Nevertheless, the past few years have seen a rise in policy backsliding among Canadian local government because of popular cynicism, perceived health threats and changing governance priorities. The proposed research assesses changes in the dental caries incidence in similar Canadian municipalities before and after CWF stops between 2015 and 2024. Based on the municipal health surveillance data, school-based oral health surveys, and simulated longitudinal epidemiological datasets, the paper will establish significant changes in indices of Decayed, Missing, and Filled Teeth (DMFT) in children after the cessation of fluoridation. The results show that the prevalence of caries increased at the highest rate between two to five years following cessation, especially in the low-income group and the peri-urban groups. The discussion indicates the need to apply evidence-based continuity of policy and emphasizes the socio-behavioral and ethical ambiguities of CWF decisions.