Fluoride proponents urge AHS to put teeth into plebiscite effort

City headed for its seventh referendum on water fluoridation in October election

A proponent of re-fluoridating Calgary's drinking water said it appears the province is abdicating its responsibility to help ensure the chemical makes a return to enhance dental health.

With Calgary heading toward a seventh plebiscite on fluoride as part of this October's municipal election, little has been heard from provincial health authorities on the issue — a stark contrast to the last campaign in 1998, said University of Calgary medical bioethicist Dr. Juliet Guichon.

Back then, the direct involvement by Alberta Health Service's predecessor — the Calgary Regional Health Authority (CRHA) — and its expenditure of $380,000 in 2021 dollars helped prompt Calgarians to vote 55 per cent in favour of keeping fluoride in the city's water supply.

“We would like to have some certainty about what Alberta Health Services will do — if anything,” said Guichon, president of the group Calgarians for Kids' Health.

“There's going to be dissemination of information which requires money and we very much hope AHS will do what was done in the successful 1998 plebiscite.”

That year, the CRHA'S medical officer of health, Dr. Brent Friesen, led the pro-fluoridation forces in a campaign that included building partnerships and educating medical professionals and the general public.

Following that effort, an expert panel urged public health officials' pro-fluoridation messaging be maintained because “there will be continued challenges by those who oppose water fluoridation.”

Since the creation of the AHS in 2008, “it's abandoned the field — they just don't advocate for it because they're afraid they'll be presented with the bill,” said Guichon.

In contrast, she said fluoride opponents will commit considerable resources to the fight because Calgary's removal of the substance a decade ago is considered a bellwether victory.

“If Calgary turns back (toward fluoride), other jurisdictions will turn back,” said Guichon.

City staff say reintroducing fluoride would cost $30.1 million over a 20-year service life, but the cost wouldn't drive up water utility rates.

Calgarians voted down adding fluoride to their water in 1957, 1961, 1966 and 1971, but chose in plebiscites to reintroduce it in 1989 and to retain it in 1998.

A decade ago, city council — without a plebiscite — chose to remove fluoride, but since then studies have shown the move has led to dramatically higher levels of tooth decay, particularly among children.

On Feb. 1 of this year, council voted by a 10-4 margin to hold yet another plebiscite on the issue, on the next municipal election ballot.

When Postmedia recently requested an interview with the province's dental public health officer Dr. Rafael Figueiredo, the AHS said in a written statement, “It's too early yet for us to discuss what role AHS might take in the campaign.”

In the same statement, it described community water fluoridation as “a foundational public health measure to prevent dental disease and improve oral health.”

“Research continues to show that communities with fluoridated water observe 20 per cent to 40 per cent fewer dental caries in comparison to non-fluoridated communities,” it said.

“This preventive measure is recognized by the scientific community as being safe, economical and effective and it reaches all segments of the population, particularly people with lower income, for whom other preventive measures may be inaccessible.”

Even so, opponents argue such fluoridation is medicating without consent, while there are other means available of individually delivering fluoride through toothpaste or supplements. And, they argue fluoride is a toxic substance with dubious, even negative, health outcomes.

The U.s.-based Centers for Disease Control has said fluoridating drinking water supplies is one of the 20th century's greatest health achievements.