Why are we still waiting for fluoridation?

It's an urgent public health issue,

Now that the Easter bunny has come and gone, leaving cavity-promoting sweets at many children's homes, Calgarians might think their city has helped protect their teeth with fluoridation.

After all, Calgarians voted for water fluoridation in three plebiscites: in 1989, 1998 and in October 2021. On Nov. 15, 2021, Calgary city council directed the city manager to ensure the job got done.

Twenty-nine months later, one might expect that fluoridation will arrive shortly. It was promised for June 2024 and then delayed until September 2024. Now, we learn that our public health measure won't be returned until at least December 2024.

What is going on?

We've heard about supply-chain issues caused by the pandemic. Is that still a tenable justification for the delay?

Alberta Environment has approval requirements. But surely those can be expedited because the matter is urgent.

Twenty-two pediatricians wrote to the city last March seeking expediency. They received a form letter in reply. Do the city manager and the people who report to him understand the need to act?

Now, we 21 members of the University of Calgary departments of pediatrics, family medicine and critical care medicine, among other departments, are signing this document to assert again that this matter is urgent.

What do we mean by urgent? We are concerned about avoidable and potentially life-threatening disease, pain, suffering, misery and expense experienced especially by very young children and their families due to dental decay.

Everyone's health is being affected, but children's health most acutely.

In just eight years after fluoridation ended in 2011, the need for intravenous antibiotic therapy for dental infection rose 700 per cent at the Alberta Children's Hospital. Since fluoridation ceased, the cavities (holes) in teeth are more numerous and larger. These might require filling or extractions. They are occurring earlier in a child's life so that treatment may require general anesthesia.

General anesthesia has risks, and requires the dentist and anesthesiologist to work together in a very small space — the young child's mouth that requires a tube in it to support breathing.

Such children are those whose parents can afford to pay for the dentist and the anesthesiologist. Many children do not receive treatment. Untreated dental decay can make it difficult for children to eat, sleep, play, concentrate and attend school.

It is not just children who need fluoridation. Everyone benefits, especially people with disabilities, seniors, Indigenous and new Canadians. Even small cavities are important, especially in permanent teeth because a filling lasts for only 10 to 15 years. Each time the cavity is replaced, it is larger, leading often to a root canal, crown, bridge and implant. This is a very costly sequence.

False claims that fluoridation is harmful are constantly refuted, including the false claim that fluoridation harms babies' brains.

Calgary's electorate has expressed itself very clearly three consecutive times. Calgarians want the return of their public health measure that was removed without an electoral mandate, against the will of the people and against medical advice.

Everyone's health is being affected, but children's health most acutely and for the longest time. Even a month's delay is a long time for a three-year-old child. Six months' delay affects older children, leaving them with lifelong dental problems. As Nelson Mandela said: “There can be no keener revelation of a society's soul than the way in which it treats its children.” What's good for children can often be good for adults. As pediatricians, family physicians and critical care experts, we are seeing avoidable harms to the health of children and adults.

We would like a public answer and an explanation as to why fluoridation reinstatement is to be delayed again.

What will it take for the city to place a high priority on protecting Calgary's children and other residents from avoidable harm, as directed by council in November 2021?