Calgary delays reintroducing fluoride to water supply – again

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The reintroduction of fluoride to Calgary's drinking water faces lengthy delays, the city announced Friday.

While fluoride remediation is expected to be completed this September, the city is now expected to complete necessary infrastructure upgrades at the Glenmore and Bearspaw water treatment plants by the first quarter of 2025.

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“This date (September 2024) has been set with the understanding that due to uncertainty in the global supply chain, the dates may change,” the city said. “As a result of this global uncertainty and competition for industry resources, we expect the system to be operational in Q1 2025.”

The later date will also reflect “an integrated schedule developed in collaboration with our general contractor and the city administration,” the city added.

Shortly after being elected, city council voted 13-2 to approve the reintroduction of fluoride in November 2021, after a plebiscite showed 62 percent support for the mineral being added to Calgary's drinking water.

At the time, the administration said infrastructure upgrades needed to facilitate fluoridation at water treatment plants would take two years and cost about $10 million.

But last July, the administration told the board the needed upgrades wouldn't be completed until fall 2024 and would nearly triple the cost to $28.1 million. The city said the original cost estimate did not take into account inflation or additional project scope identified during the detailed design phase.

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Operation and maintenance costs associated with fluoridation are estimated to be approximately $1 million over the next 20 years.

According to the city, there are no expected cost increases due to the extended delay.

“I wonder why it took so long”

Fluoride has been a divisive topic in Calgary for decades, dating back to a city-wide vote on the issue in 1957.

After voting against fluoridation in 1961, 1966 and 1971, Calgarians voted in favor of adding trace elements in a 1989 plebiscite, then again in 1998.

But Calgary ended fluoridation in 2011 after a city council vote. At the time, some elders said that science was not conclusive and that it was unethical to prescribe medicine to the entire population.

However, over the next decade, fluoride deficiency contributed to a local increase in tooth decay and dental infections, especially among children. A February 2016 University of Calgary/University of Alberta research study comparing the teeth of 5,000 children in Calgary and water in Edmonton, which is already fluoridated, found a faster increase in childhood tooth decay in Calgary.

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A member of Calgarians for Children's Health, a group of doctors and dentists who support fluoridation, said the group was upset and surprised by the city's delay.

“It means there's no planning and no organization, it takes a long time to recover from what happened before,” said Dr. James Dickinson, professor of family medicine and public health sciences.

He noted that fluoridation is already a standard part of water supply engineering in the US, much of Canada and other countries.

“It used to be in our water supply and we had a system in place to do it … It's amazing why it's taking so long.”

“It's not like throwing Pepto Bismol in a cup of water.”

But one councilor said upgrading water infrastructure to accommodate fluoride is a complex process and not as easy as most Calgarians think.

“It's not like throwing Pepto Bismol in a cup of water or anything like that,” 9-Con said. Gian-Carlo Carra.

“In its raw form, it is a very toxic substance that poses a threat to its safety. It needs to be handled carefully and very carefully cut into the water supply. It's not an easy job and I wouldn't be surprised if it took longer than expected.”

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Carra said the council's decision to end fluoridation in 2011 was partly because major upgrades to water treatment facilities were needed to continue the practice, and the council didn't want to bear the cost of those upgrades to taxpayers. Following the council's decision, the technology was decommissioned.

While he doesn't deny the mineral's oral health benefits, Carra said fluoride isn't the “silver bullet” for correcting tooth decay that many people think. Rather, he said the worsening of tooth decay is evidence that dental care should be included in Canada's universal health care system.

“Otherwise, water fluoridation provides a small amount of protection, but it's complicated, expensive and messy,” he said.

“It's not an easy thing to do, and I'm not surprised that in an age of rising costs and supply chain disruptions, it (implementation) isn't a tip of the iceberg.”

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