What Happens When Communities Drop Water Fluoridation
As more municipalities drop water fluoridation, the evidence from cities such as Calgary and Juneau paints a stark picture of rising childhood caries and skyrocketing treatment costs. For dental professionals, the rollback of this critical public health measure signals a preventable crisis in the making.
The decision to remove fluoride from public water supplies is gaining traction in some parts of the United States, but a report by ScienceNews demonstrates the ramifications of disabling such public health programs. Recent outcomes from cities that halted fluoridation, including Calgary, Alberta, Canada, and Juneau, Alaska, offer compelling data on the tangible harms to oral health when this protective measure is eliminated.
Calgary ended water fluoridation in 2011, a move that shocked local healthcare professionals. In the years following, studies documented a sharp rise in tooth decay among children, with 65% of second graders in Calgary showing signs of caries compared to 55% in Edmonton, a nearby city that maintained fluoridation.
The impact extended beyond decay rates. From 2018 to 2019, Calgary reported nearly twice as many pediatric dental surgeries under general anesthesia as Edmonton. These outcomes suggest that eliminating fluoridation doesn’t just increase caries risk, it strains public health systems and adds stress to patients and providers alike.
Juneau, Alaska, saw a similar trend after it stopped fluoridating water in 2007. The number of dental procedures for children younger than age 6 jumped from 1.5 treatments per child in 2003 to 2.5 by 2012. Medicaid data revealed a $303 per-child rise in treatment costs, a burden ultimately borne by taxpayers.
Opponents of fluoridation frequently cite potential health risks, including a reduction in IQ that was demonstrated by a review by the National Toxicology Program. However, the negative impacts seen in this review where in the presence of fluoride levels more than twice than is recommended by the US Centers for Disease Control and Prevention (CDC).
Despite decades of evidence supporting the safety and effectiveness of fluoridated water, misinformation and political rhetoric are clouding public discourse. In March 2025, Utah became the first US state to ban fluoridation, and federal officials have signaled reconsideration of long-standing CDC guidelines.
Communities that have turned away from fluoridation are now grappling with the consequences. Calgary voters chose to reinstate fluoride in 2021, a move fueled by local research and public health advocacy. Click here to read more.
