The blue winter light filters through the windows of Calgary’s municipal building as Stephanie Green holds up a glass of tap water, examining it like she might a specimen. “What’s most concerning isn’t what you can see,” she tells me, “but what you can’t.”
Green is one of several Calgary residents behind a legal challenge that has gained momentum in recent weeks, questioning the city’s decision to reintroduce fluoride into the municipal water supply after a 2021 plebiscite showed 62 percent of voters supporting the measure.
“This isn’t about conspiracy theories,” Green clarifies immediately. “It’s about informed consent and bodily autonomy.”
After a decade without fluoridation following a 2011 council vote to remove it, Calgary began adding fluoride back into its drinking water in July. The city has allocated $30 million to implement the change, with annual maintenance costs projected at $2 million—all to address what dental health advocates describe as a growing crisis in children’s oral health.
Dr. Juliet Guichon, president of Fluoride Yes!, the group that championed the successful 2021 plebiscite, points to data showing cavity rates increased significantly during Calgary’s fluoride-free decade. “Children’s dental health deteriorated measurably after fluoride was removed,” she explains during our phone conversation. “This is particularly true for children in lower-income neighborhoods who may not have the same access to regular dental care.”
A 2016 study published in Community Dentistry and Oral Epidemiology compared Calgary children to those in Edmonton, which maintained water fluoridation, and found Calgary children experienced more tooth decay after fluoridation ended.
But for Paul Connett, a retired chemistry professor and director of the Fluoride Action Network who’s advising the Calgary challengers, the issue transcends dental health. “Fluoride is the only chemical added to water for the purpose of medical treatment,” he tells me via video call from his home office surrounded by research papers. “We don’t use the water supply to deliver vitamins, supplements, or any other medicine.”
The legal challenge hinges on several arguments, including that mass fluoridation violates Section 7 of the Canadian Charter of Rights and Freedoms, which protects security of the person. The challengers point to Health Canada’s recommendation that formula-fed infants receive fluoride-free water when possible, suggesting this acknowledgment undermines universal application.
Walking along the Bow River later that afternoon, I meet Jason Carter, another plaintiff in the case. As a father of three young children, his concerns are personal. “I’m not anti-science,” he says, watching his kids skip stones across the water. “I’m pro-choice when it comes to what goes into my family’s bodies. If fluoride has benefits, make it available to those who want it, not mandatory for everyone.”
The City of Calgary maintains its position is supported by overwhelming scientific consensus and democratic process. In a statement, officials noted that fluoridation at the recommended level of 0.7 parts per million is endorsed by Health Canada, the World Health Organization, and the Canadian Dental Association as safe and effective.
Dr. William Ghali, a public health researcher at the University of Calgary not involved in the legal proceedings, offers perspective on the scientific evidence. “The consensus among public health professionals strongly supports community water fluoridation,” he explains. “The benefits in preventing tooth decay are well-documented, particularly for vulnerable populations, while the risks at recommended concentrations have been extensively studied and found to be minimal.”
This tension between individual choice and public health initiatives isn’t new. Similar debates have arisen around chlorination, vaccination, and food fortification programs like adding vitamin D to milk or folate to flour.
Alberta Health Services estimates that every dollar invested in fluoridation saves approximately $38 in dental treatment costs. For families without dental insurance—about 32 percent of Albertans according to Statistics Canada—preventative measures like fluoridation can mean the difference between basic oral health and painful, expensive emergencies.
Patricia Zawadiuk, a dental hygienist who works in several Calgary schools, has witnessed the consequences firsthand. “I’ve seen children unable to concentrate because of tooth pain, missing school for preventable dental procedures,” she tells me between appointments. “Fluoride isn’t a silver bullet, but it’s an important tool in a comprehensive approach to oral health.”
Back at the municipal building, as council members file in for an unrelated meeting, Green emphasizes that the legal challenge isn’t seeking to prohibit fluoride entirely, but rather to create an opt-in system. “People who want fluoride have multiple options—toothpaste, mouthwash, supplements, professional treatments,” she argues. “Those of us who prefer not to consume it have essentially no choice when it’s in the water supply.”
The legal challenge, expected to be heard later this year, raises fundamental questions about the balance between public health initiatives and individual rights—questions that resonate far beyond Calgary’s water treatment facilities.
As I leave the river pathway, where the water continues its journey through the city and eventually into thousands of homes, the fundamental tension of the debate lingers: At what point does a public health measure become a personal choice, and who should decide where that line is drawn?
For now, as both sides prepare their arguments, Calgarians continue to fill their glasses from taps that once again contain fluoride—some with relief, others with reservation, and many simply unaware of the quietly intensifying debate flowing through their pipes.
