After 14 years without fluoride in its water supply, Calgary will officially reintroduce the mineral on Monday, June 30.
“Starting Monday, June 30, fluoride will be reintroduced into Calgary’s drinking water,” the City of Calgary’s Water Services department confirmed in a statement.
“Health Canada, Alberta Health, and Alberta Health Services support the practice of Community Water Fluoridation as a safe and effective public health measure to prevent and reduce tooth decay, especially those most vulnerable and without access to dental care,” the statement added.
The move follows a 2021 plebiscite during Calgary’s municipal election, in which 62 per cent of voters supported reintroducing fluoride to the city’s water system. City council subsequently directed administration to proceed with the necessary infrastructure upgrades at Calgary’s two water treatment plants.
“Calgary showed us how it could be done.” Montreal physician Dr. Christopher Labos.
The decision was backed by research. In August 2021, the University of Calgary’s Cumming School of Medicine published a study comparing dental health outcomes among Grade 2 students in Calgary and Edmonton. The study found that 64.8 per cent of Calgary children had one or more cavities in their baby teeth, compared to 55.1 per cent in Edmonton, where water remains fluoridated. The findings built on earlier research suggesting a link between fluoride removal and increased rates of early childhood caries.
Calgary and fluoride: A timeline
- 1957, 1961, 1966, 1971 – Calgarians vote against fluoridation in four plebiscites.
- 1989 – A fifth plebiscite results in support for fluoridation.
- 1991 – Fluoride is added to Calgary’s water at 1.0 mg/L.
- 1998–1999 – Following a review, the level is reduced to 0.7 mg/L. A plebiscite during this period shows 55 per cent support.
- 2011 – City council votes to discontinue fluoridation.
- 2021 – A plebiscite sees 62 per cent support for reinstating fluoride.
(Timeline from City of Calgary)
A broader debate
Calgary’s experience is increasingly cited in broader debates over water fluoridation. In the United States, Health Secretary Robert F. Kennedy Jr., a vocal critic of fluoridation, has called it “industrial waste” and linked it to health concerns, including reduced IQ in children. In April, Florida became the second U.S. state to ban water fluoridation, following Utah.
However, a 2024 study published in JAMA Health Forum warned that removing fluoride from community water systems could lead to increased tooth decay in children and an estimated $9.8 billion in additional dental costs over five years. The study cited Calgary as an example of a city that reinstated fluoridation in response to rising dental disease after its removal in 2011.
Read related link: Fluoride: When, where, why
Read related link: Here’s where Canadian experts stand on fluoridating drinking water
Lessons for Montreal
Calgary’s case has also been referenced in Montreal, where the city began phasing out fluoridation on Nov. 21, 2024, at the Pointe-Claire and Dorval water treatment plants. The decision, made by the Agglomeration Council, will remain in effect until existing fluoride supplies are depleted.
“We’ve had fluoride out of the water for over 10 years. That was 10 years we could track against other cities,” Calgary city councillor Gian-Carlo Carra told the Montreal Gazette in a June 8 interview. “The data shows that it helps.”
Montreal physician and science communicator Dr. Christopher Labos, who wrote about the issue prior to the city’s decision, echoed that sentiment. “Many people in Montreal aren’t aware of it, and unfortunately the reasons for removing fluoride were largely financial and possibly politically motivated by events south of the border,” he told Oral Health Group.
Kennedy gave Montreal citizen ‘moral support’
A March 2024 report from Montreal’s water department noted that the reconsideration of fluoridation began with a 2020 citizen petition led by Ray Coelho, a former candidate for the now-defunct Canadian Nationalist Party. CBC reported in November that Coelho said he had spoken with Kennedy several times, and that the U.S. health secretary congratulated him in a text message after the city’s plan became public the previous month.
“He gave me moral support, which is good,” the CBC quote Coelho as saying.
Meanwhile, Lachine borough Mayor Maja Vodanovic told Oral Health Group that the decision to end fluoridation at the Dorval and Pointe-Claire plants—serving about five per cent of Montreal’s water supply—was “solely guided by operational and economic factors.”
Currently, the only municipality in Quebec that fluoridates its water is Saint-Georges, in the Chaudière-Appalaches region, serving about 33 000 people.
Despite Montreal’s stance, Labos remains optimistic. “Calgary showed us how it could be done,” he said. “Both Montreal and Quebec’s provincial public health departments support fluoridation, and Quebec has a program to subsidize its implementation. It will simply take the political will to make it happen.”
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