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For 65 years, since January, 25 1945 community water fluoridation has been known as a safe, healthy and most cost efficient way to effectively prevent cavities for everyone. Fluoridation water has also been recognized as one of the 10 greatest public health achievements of the 20th century by the Center of Disease Control and Prevention, CDC (1). All of this would not be possible without Dr. F McKay, who upstart the whole revolution of community water fluoridation.
In 1901, Dr. McKay opened his dental practice in Colorado Springs, Colorado, where Dr. McKay noticed right away that his patients’ teeth had discolored enamel and it is known by the local resident as “Colorado Brown Stain or Mottled enamel.” The stain cannot be removed by brushing or polishing, so Dr. McKay investigated why only certain people in the local cities had it and what the cause was.
Then in 1909, McKay collaborated with Dr. G. V. Black, a renowned dental researcher, investigated and conducted studies on the Brown Stain. They found out that 90% of the city’s locally born childre
n had signs of the brown stain. Also from the investigation, McKay and Black found out that mottled enamel resulted from developmental imperfections in children’s teeth and that teeth with the brown stain were very resistant to decay (2). Ultimately, McKay hypothesized that there was something in the water supply that caused the brown stains on the teeth.
It is not until 1923, that McKay went to Oakley, Idaho to meet up with parents who had noticed their children's teeth had brown stains and the stains only appeared after Oakley constructed a communal water pipeline to a warm spring that is five miles away. So McKay advised the town leaders to leave the pipeline altogether and as a result, the children’s permanent teeth did not have brown stains.
Then a chief chemist, H. V. Churchill, of the Aluminum Company of America, examined the water samples that McKay collected in the towns that had brown stains. The result of the water samples was that there was a high level of fluoride in the water, 2 ppm F to 12 ppm F, and that water borne fluoride is the cause for the brown stain. However the first architect of fluoride studies is Dr. H. Trendley Dean, head of the Dental Hygiene Unit at the National Institute of Health (NIH).
Dean and his team of researchers investigated and examined the epidemiology of mottled enamel in 21 different communities, to study the safe levels of fluoride in the community’s water. From the studies and observation of the 21 communities, they found out that there is less cavities associated with greater concentration of fluoride and high levels of fluoride will cause mottle enamel or fluorosis (3); Dean replaced the term mottled enamel with fluorosis.
The result from Dean and his team of researchers, led to the creation of the optimal range of fluoridation in community water supply, 0.7 mg/L – 1.2 mg/L. Then in January 1945, Dean and his team tested out the optimal levels of fluoride in big cities. For the experiment, two cities in the same state were chosen, so that one city is the control, non-fluoridation, while the other is the experiment, fluoridation. The cities were Grand Rapids and Muskegon, Michigan; Newburgh and Kingston, New York; Evanston and Oak Park, Illinois; Brantford and Sarnia, Ontario, Canada (the listing of these cities are by fluoridation and non-fluoridation) (3). And the phenomenal outcome of the experiment is that there is a 50% to 70% of reduction in caries in children that live in the communities with fluoridated water. From this mind blowing result, cities throughout the US began to put fluoride in their community water (3).
It is from that moment on, that fluoridated water become a part of the community water supply. And today 75% of people in the US are using public water that have the optimal level of fluoride to prevent caries (4). It is not just the US that fluoridates public water. Singapore, Republic of Ireland, Israel, United Kingdom, Chile, South Korea, Spain, Canada, Brazil, Malaysia, Vietnam, Australia, and New Zealand, all fluoridate their public water (3).
References:
(1) Centers for Disease Control and Prevention. (2011, January 07). Cdc honors 65 years of community water fluoridation. Retrieved from http://www.cdc.gov/fluoridation/65_years.htmhttp://www.cdc.gov/fluoridation/65_years.htm
(2) NIDCR. (2011, March 25). The story of fluoridation. Retrieved from http://www.nidcr.nih.gov/OralHealth/Topics/Fluoride/TheStoryofFluoridation.htm
(3) Harris, N., Garcia-Godoy, F., & Nathe, C. (2008). Community water fluoridation. In Primary Preventive Dentistry (pp. 212-244). Upper Saddle River, New Jersey: Person.
(4) Centers for Disease Control and Prevention. (2011, August 13). Community water fluoridation. Retrieved from http://www.cdc.gov/fluoridation/statistics.htm
(5) Image: Centers for Disease Control and Prevention. (2006, March 6). Retrieved from http://en.wikipedia.org/wiki/File:McKayandBlackCDC01.jpg
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