Nearly four years after Calgarians voted in favour of reintroducing fluoride to their drinking water, the city is preparing to follow through on public support this week.
The City of Calgary is planning to once again add fluoride to its drinking water, beginning Monday. Previously, the city added fluoride to its water for 20 years between 1991 and 2011, before council directed administration to discontinue the practice.
When Calgarians were given the chance to vote on whether to reverse that decision during the 2021 municipal election, more than 61 per cent voted in favour of community water fluoridation.
Adding fluoride to drinking water is a public health measure meant to prevent tooth decay. Many organizations, including Health Canada and Alberta Health Services, say the practice has been proven to strengthen teeth and prevent cavities.
James Dickinson, a professor of family medicine and community health sciences at the University of Calgary, said this will be particularly beneficial for people like children or seniors in continuing care centres who may not brush their teeth consistently, and for people who may face barriers to regularly visiting a dentist.
“It becomes part of the dental structure. The enamel on the tooth, the fluoride actually gets into it and makes it a stronger compound that is more resistant to acid and decay,” Dickinson said.
Fluoride naturally occurs in water at varying levels, but the city will now ensure its water includes 0.7 milligrams per litre of the mineral, to match the optimal rate suggested by Health Canada. Added fluoride at this level doesn’t change the taste, smell or look of water.
After the 2021 plebiscite supporting the health measure, city council voted 13-2 to renew community water fluoridation. Since then, the city has said resource challenges and uncertainty with the global supply chain created delays that pushed back a planned September 2024 implementation to this summer.
Community water fluoridation is a practice seen in some other major Alberta cities like Edmonton, Red Deer and Lethbridge, as well as across the country in Toronto, Ottawa and Winnipeg.
The health measure will also impact communities that Calgary supplies water to like Chestermere, Airdrie, Strathmore, and parts of Foothills County, Rocky View County and Tsuut’ina Nation.
Juliet Guichon, a professor in the University of Calgary’s Cumming School of Medicine, has long supported water fluoridation. She also serves as the president of Calgarians for Kids’ Health, which advocated for council to reconsider its 2011 decision.
She praised the democratic value of reintroducing fluoride to Calgary’s water, because residents never voted against the practice.
“Voters value their health and they expect elected officials to support their health,” Guichon said.
“It respects everyone in Calgary’s need for oral health protection. And over time, we will see the benefits in a reduction of cavities.”
Debate over whether Calgary should fluoridate its water supply dates back long before the 2021 plebiscite.
Calgarians voted against introducing the public health measure four times between 1957 and 1917, before a 1989 plebiscite was successful in securing voter support. It was then added to the city’s water supply in 1991, and supported by voters once again in another plebiscite in 1998.
The decision to now bring it back is driven by a decade of data that showed fluoride’s removal hurt Calgarians’ dental health across the city, said longtime Ward 9 Coun. Gian-Carlo Carra.
For instance, University of Calgary research in 2021 found that Grade 2 students in Calgary were more likely to have cavities than kids of the same age living in Edmonton, where water has been continuously fluoridated since 1967.
The cost of fluoridation continued to be a reason some councillors continued to oppose the idea, even after the most recent plebiscite. Reintroducing the necessary equipment for fluoride to the Glenmore and Bearspaw water treatment plants cost the city $28.1 million, and the practice will cost another $1 million annually, which the city will cover through local water rates.
When he voted in favour of the 2011 decision to end fluoridation, Carra said he was skeptical of how large of an impact it had, and he believed public health measures weren’t a municipality’s responsibility to fund.
Now, Carra said he believes if the municipal government can act on the ground level to improve public health, it should do so, and sees the cost the city has paid to improve public health as relatively small.
“We took it out as a cost-saving measure, and I think in retrospect it was a mistake,” Carra said.
“We had 10 years of data that showed that taking fluoride out of the water did have a negative impact on the dental health of our city.”
