On June 30, Calgary resumed adjusting fluoride levels in its drinking water, nearly four years after 62 per cent of voters supported reinstating fluoridation.
Fluoride occurs naturally in the Bow and Elbow Rivers, but this move will raise levels to 0.7 milligrams per litre, the amount recommended by Health Canada. Medical experts in Canada and globally agree that fluoridation is a safe, effective way to help prevent tooth decay, especially in children. Yet, strong opposition to the measure persists.
Calgarians are no strangers to controversies concerning fluoridation. In fact, the 2021 vote was Calgary’s seventh. Calgary has voted on fluoridation more than any other major city in Canada. Between 1958 and 1971, Calgarians voted four times against adjusting fluoride levels. Back then, many North Americans believed that fluoridation was an “international Communist conspiracy to sap and impurify all of our precious bodily fluids,” to quote Stanley Kubrick’s classic satirical film Dr. Strangelove. Over the years, the reasons for opposing fluoridation have changed, but the debate remains intense.
In 1989, 55 per cent of Calgarians voted for fluoridation, which began in 1991. A 1998 vote confirmed public support. But in February 2011, city council decided, without a plebiscite, to stop adjusting fluoride levels. Advocates of fluoridation were caught unawares since fluoride had not been a major issue in the October 2010 election.
So why did city council change its mind?
Calgary has always had an active group of fluoridation opponents. They are part of a larger international movement that claims adjusting fluoride in water is unsafe. Most scientists and health professionals affirm fluoridation’s safety, but the opponents worked hard to convince members of city council otherwise. Still, before 2011, they hadn’t succeeded in shifting the majority.
Two key developments helped change that. First was Hurricane Katrina in 2005. Surprisingly, the tragic natural disaster in the Gulf of Mexico affected Calgary’s water. It disrupted the North American supply of fluoride, which is a byproduct of phosphate fertilizer production, much of it based in Louisiana. Consequently, some cities in Canada and the U.S., including Calgary’s neighbour, Red Deer, had to stop fluoridation temporarily. Although Calgary maintained its supply, the disruption reignited public interest in the issue.
Second, Calgary’s fluoridation equipment was aging and due for a $20 million replacement. Unwilling to spend the money, council chose to stop fluoridating the water.
Unwilling to spend the money, council chose to stop fluoridating the water.
By 2016, consequences had emerged. A 2021 study led by Lindsay McLaren compared dental health in Calgary and Edmonton, which had kept fluoridation. The findings showed that after Calgary stopped fluoridation, children’s tooth decay worsened significantly compared to Edmonton.
Dentists had already begun sounding the alarm. In 2017, a group of citizens, led by Juliet Guichon, a University of Calgary professor of law and ethics, formed Calgarians for Kids’ Health. The grassroots group campaigned for fluoridation’s return, citing research showing that the measure reduces dental decay by about 25 per cent.
Soon, Calgary was being cited, both in Canada and around the world, as an example of the negative effects of removing fluoride. Even some city councillors, like Gian-Carlo Carra, said that with hindsight they would not have voted to end fluoridation. But city council still didn’t want to reverse its 2011 decision. So, it put the matter to Calgarians again. In 2021, Calgarians gave their strongest “yes” yet.
Now that water fluoridation is returning, some people wonder if Calgary’s fluoride wars are finally over. That may be optimistic.
Opponents remain active and are now bolstered by prominent supporters like Robert F. Kennedy Jr., the U.S. Secretary of Health and Human Services. Even though supporters of fluoridation can celebrate their recent success, they will need to remain vigilant if they want to protect their victory.
If Calgary’s past is any clue, the controversy over fluoridation has a way of resurfacing in unexpected ways.
The goal of dentists is to work themselves out of a job. I saw first hand what happens when fluoridation is stopped without informing the public. In larger families where the older children grew up with fluoride and the younger ones without the results were obvious. The older children didn’t have lesions or deep pits and grooves that need sealants or restorations while the younger ones required multiple restorations. Council allowed citizen to hold a plebiscite but when the results were in and 66% of the vote was for restoration, council declared it had agreed to hold a plebiscite but not to be bound to the results. It isn’t a pleasant experience for both parties to be doing restorations on a 2.5 year old. There is a better safer solution with community fluoridation. That early start with a high rate of carries predicts one’s dental future.
Thanks for your article, Aaron, and your interest in this polarizing, long contentious and failing public health policy that is practiced in less than 5% of the world, and has just been completely banned in Utah and Florida. I would much appreciate, as an MD who has extensively followed fluoride and fluoridation for 3 decades, to speak with you personally. My cell is +1(403)560-4574. Email below and our website is http://www.fluoridefreecanada.ca of which I am the current Chairperson.
Thanks, Dr Bob Dickson
RFK Jr’s anti-fluoridation stance is based on cherry-picking from junk science.”Garbage in garbage out.” You can do a lot when you edit the science you wish to use and prune it of everything that doesn’t agree with your stance. Science is a methodology, not a belief system and is dependent on the data one carries. It is an ongoing open debate unlike medicine which is authoritative. In medicine it is frequently a case of eminence over evidence.