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Fluoride’s Strange History

What is fluoride?

Fluoride is a compound that contains fluorine, a natural element that can help prevent tooth decay by inhibiting the loss of minerals from tooth enamel and strengthening areas that are beginning to develop cavities. Fluoride can be found as an active ingredient in dental products such as toothpaste, applied topically in the form of gels and varnishes, and added to community water supplies. While too much fluoride can cause discoloration of teeth, known as fluorosis, it is considered to be both safe and effective for the prevention and control of decay.

Last month the American Association of Pediatric Dentistry (AAPD) celebrated National Children’s Dental Health Month. This year they marked the 75th anniversary of community water fluoridation, with the slogan “Fluoride in water prevents cavities! Get it from the tap!” Research shows that community water fluoridation has lowered decay rates by over 50 percent, meaning that fewer children grow up with cavities.

Have you ever wondered how fluoride came to be used in the battle against tooth decay? And how it ended up in our water supply? Let’s take a look at the fascinating history of fluoride and its importance in our oral health.

Fluoride’s history

It all started in 1901, when a young dental school graduate named Frederick McKay moved to Colorado Springs, Colorado to open a dental practice. It was there that he noticed that many of the locals suffered from brown stains on their teeth. Sometimes, these stains were so dark that it appeared as if their teeth were caked in dark chocolate.

McKay, together with colleagues like Dr. G.V. Black, found that nearly 90% of children native to Colorado Springs suffered from the stain. They were surprised to discover that the mottled teeth were highly resistant to tooth decay, and that the Colorado Springs area was not unique — there were pockets of brown stain throughout the country. McKay began to conduct informal studies to find the cause of the stain, examining the local diet, soil conditions, and air quality. He traveled to other areas of the country that were experiencing the same problem. Among these was Bauxite, Arkansas, a town owned by an aluminum plant called the Aluminum Company of America (ALCOA). The residents of Bauxite were afflicted with mottled teeth, but nearby towns were not. In 1931, ALCOA’s chief chemist, HV Churchill, began to examine the water in Bauxite, Arkansas, to see if there was a link between this staining and the presence of aluminium in drinking water. Instead, Churchill’s study found high levels of fluoride in the water, and he urged McKay to test samples from Colorado Springs. Together they concluded that increased levels of fluoride were in fact staining teeth.

Upon learning of McKay and Churchill’s findings, the National Institute of Health (NIH) decided to investigate water-borne fluoride, and the effects on teeth. Learning that small amounts of fluoride would not stain teeth, H. Trendley Dean at the NIH went back to McKay’s writings where he observed the cavity resistance of those with the brown stain, wondering whether adding fluoride to drinking water at physically and cosmetically safe levels would help fight tooth decay. In 1945, as part of a study to see if the number of cavities would decrease, Grand Rapids Michigan voted to add fluoride to its drinking water. After 11 years, Dean announced that the cavity rate among children in Grand Rapids had dropped more than 60%. This was a major scientific breakthrough and helped revolutionize dental care.

Why is fluoride important?

The Center for Disease Control (CDC) has called community water fluoridation one of the 10 great public health achievements of the 20th century, due to its effectiveness and low cost. In fact, the American Dental Association (ADA), American Association of Pediatric Dentistry (AAPD), American Academy of Pediatrics (AAP), US Public Health Service (USPHS), and World Health Organization (WHO) all advocate for fluoridating community water supplies. More than 70 years of scientific research has consistently shown that an optimal level of fluoride in community water is safe and effective and prevents tooth decay by at least 25% in both children and adults.

Today, just about every toothpaste on the market contains fluoride as its active ingredient; water fluoridation projects currently benefit over 200 million Americans, and 13 million schoolchildren now participate in school-based fluoride mouth rinse programs.

Is your child getting enough fluoride?

How do you know if your child is receiving the recommended amount of fluoride? A pediatric dentist can help by looking at many factors, such as your child’s age, risk of developing dental decay and current dietary sources of fluoride, including infant formula, bottled, filtered and well waters. Dr. Robin Croswell and the professionals at Capital City Pediatric Dentistry can assess your child’s needs, and let you know if the amount of fluoride they are receiving is right for them.

Sources: NIH, Ohio State University and Miami University, British Dental Journal,, AAPD

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