Opinion: Fluoride's Bumpy Ride Back to the Tap

As water fluoridation returns to Calgary on June 30, residents should be proud and optimistic.

This public health measure is backed by 80 years of research confirming its effectiveness and safety. Over time, we will see a decline in dental decay across Calgary, Chestermere, Airdrie, Strathmore, parts of Foothills County, and Tsuut’ina Nation — all of which receive Calgary-treated water.

Calgarians voted for fluoridation in 1989 and again in 1998. Yet, in 2011, Calgary city council removed it after being bombarded with false and misleading claims. The consequences were soon evident. Dentists began seeing cavities earlier in children, often requiring general anesthesia because they could not co-operate with the dentist.

In 2016, a study led by Dr. Lindsay McLaren at the University of Calgary found that two years after fluoridation ceased, Grade 2 children in Calgary had significantly more tooth decay than those in fluoridated Edmonton.

She repeated the study in 2021. By then, Calgary’s Grade 2 children had never lived with fluoridated water. The contrast was starker — Calgary’s rates had worsened; Edmonton’s remained stable.

In 2017, a despairing Calgary dentist implored us to return fluoridation. We formed Calgarians for Kids’ Health, a volunteer group.

When councillors we met with refused to reinstate fluoridation, we urged city council to send the issue back to voters. They agreed. Our Fluoride Yes campaign in the 2021 municipal election was led by volunteers and funded mostly by local medical and dental professionals and businesspeople.

We were outspent. A loophole in Alberta municipal election law allowed foreign funding for plebiscite campaigns. While we turned away all out-of-province donations, the No campaign did not.

Based on visible expenditures, it spent about three times more than we could, including paying Canada Post to distribute flyers filled with misinformation to 410,000 Calgary homes.

A prominent ‘no’ donor was the U.S.-based Fluoride Action Network, funded and promoted by Joseph Mercola, an ‘alternative medicine’ marketer who encourages fluoridation fear and sells water filters. Without this foreign-funded misinformation, the Yes vote might have been even higher.

Still, 62 per cent of Calgarians voted in favour. Nevertheless, some Calgary residents believe debunked claims. Fluoridation’s return presents an opportunity to reflect on why fluoridation is supported by national and international health authorities.

Dental decay is painful, harmful and common. It is the most prevalent chronic disease of childhood. Untreated, it impairs eating, sleep, learning, and speech. Over 96 per cent of adults also experience decay, with complications such as malnutrition, miscarriage, diabetes, heart disease and Alzheimer’s disease.

People tend to prefer prevention to treatment. Fluoridation reduces decay by about 25 per cent across entire populations, even where fluoride products are used. Fluoridation is one the 20th century’s great public health achievements. Cities like Edmonton, Red Deer, Lethbridge and Toronto use it, as do countries including Australia, New Zealand, Singapore, Ireland, and Brazil.

Fluoridation is safe. The only established side effect is faint white streaks on teeth usually caused by young children swallowing excess toothpaste.

Some studies claim harm to developing brains, but their flawed methods render the studies invalid. U.S. Health Secretary Robert F. Kennedy Jr. amplified this misinformation. Sadly, Florida and Utah have recently turned against fluoridation.

Most people want to help the vulnerable, which fluoridation does. Dr. McLaren’s data showed children with most decay lived in poorer neighbourhoods, had parents who rented and less insurance. People with disabilities including dementia, who might not receive regular oral care, also benefit particularly.

Calgary’s involuntary ‘experiment’ confirmed water fluoridation reduces decay, even in the age of fluoride products.

After nearly 14 years of unnecessary dental harm, hope returns. Calgarians voted for fluoridation twice and never for its removal.

As fluoridation resumes, Calgary stands as a beacon of sensible, compassionate, evidence-based and democratic decision-making.

Juliet Guichon, Jim Dickinson and Ian Mitchell are professors at the Cumming School of Medicine, University of Calgary.