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Ecologist p230

The Fluoridation Campaign

By Thomas Outerbridge

The United States began fluoridating its water supplies in the 1940s. The fluoridation campaign, which involved public health authorities and industry, was based on observations that children's teeth appeared to be healthier when drinking water contained measurable levels of fluoride compared to fluoride-tree water. Adding fluoride to water was also a convenient way of getting rid of dangerous industrial wastes, and from being considered a potent poison, fluoride suddenly acquired the status of an essential element. In fact, as Outerbridge indicates, sound scientific evidence of the benefits of fluoridation is lacking. Instead, the epidemiology on which the pro-fluoridation lobby bases its conclusions is of dubious quality.

From its chemical isolation 100 year's ago until the 1940s, fluorine was something to be kept out of the environment. In 1925 the town of Oakley, Idaho changed it's water supply in order to avoid the dental mottling caused by fluoride in the water. In 1943 the Journal of the American Dental Association described fluorides as "general protoplasmic poisons." How is it then that fluoride is now hailed as 'beneficial and essential', and why are there now fluorine deficiency areas'? What has given fluoride such a completely different image?

Fluoride As Industrial Waste

Fluorine pollution from industrial sources has a long history. Nearly all mined and quarried materials contain fluoride compounds. The extraction and refining of these materials inevitably leaves fluoride wastes.

Originally, copper cad iron smelters were the worst Offenders in terms of fluorine fumes and fallout. Around 1900, the very existence of the smelter industry, both in Germany and Great Britain, was threatened by successful suits for fluorine damage, and by burdensome laws and regulations.

Near Anaconda, Montana, cattle developed 'copper teeth' remarkably similar to 'Texas teeth', which was later diagnosed as fluorine poisoning. Tall stacks were built at the Anaconda smelters and those of other towns, to carry fluorine into the upper air.

Then came the aluminium and superphosphate fertiliser industries. In 1912 Bartolucci reported fluorine poisoning of cattle near a superphosphate factory in Italy. The poisoning of cattle around a Swiss aluminium plant between 1912 and 1918 was identified as fluorine poisoning by Christiani and Gautier.

During the 1920s there was growing concern about the hazards of fluoride wastes in Europe and the US. Thus, in 1933, Dr Floyd DeEds, senior toxicologist with the Department of Agriculture, published a 60 page report on chromic fluorine poisoning. He noted the poisoning of plants and animals near aluminium factories, and pointed out that the superphosphate factories were releasing 25,000 tonnes of fluorine into the air, and 90,000 tonnes onto the topsoil each year. He wrote:

"Only recently, that is within the last ten years, has the serious nature of fluorine toxicity been realized, particularly with regard to chronic intoxication. It is from the viewpoint of chronic intoxication that fluorine is of importance to the public health. A review of the literature shows that the public health aspect of fluorine is manifested in industrial hygiene, in agriculture, and in foods. The latter aspect of the problem is particularly important be cause of the recommendation and increasing utilisation of fluorine compounds in agriculture."[1]

In 1933, Moller and Gudjonsson wrote of chronic fluorine poisoning among Danish cryolite worker. In 1937, Kaj Roholm published Fluorine Intoxication; A Clinical~Hygienic Study.

In the 1940s, as a result of World War II, there was an enormous increase in the amount of fluoride wastes being produced. "Aluminiun, which had been used for pots, pans, and a few aeroplanes, was needed for an entire air fleet" with the consequence that:[2]

"During the 1940s, the Aluminium Corporation or America (Alcoa) alone faced annual claims running into millions of dollars for loss of stock and crops from fluorine poisoning."[3]

In the 1940s the petroleum industry became a fluoride polluter with the substitution of hydrogen fluoride for sulphuric acid in the production of high-test gasoline. One such petroleum plant, it has been estimated, required 500-750 tonnes of hydrogen fluoride yearly.

How much of this goes directly into the atmosphere and how much remains in the gasoline to appear in car-exhausts, has never been told.

In any case, the first such plant was put into operation in Los Angeles in 1942, and by a strange coincidence, that was the year of the first complaints of irritation is also the first noticeable effect of hydrogen fluoride for most people.

For several years the Los Angeles papers told about the hydrogen fluoride in the smog; but by the time the reports reached Seattle, fluorine wasn't mentioned. Now it isn't mentioned even in LA, and we are told there is no fluoride in the LA smog. This is strange since there is fluoride in the air of every major city, with or without smog.[4]

Industries were moving into parts of the country not previously exposed to fluorine pollution. For example, steel plants were started in California and Utah, and aluminium factories were built in Washington and Oregon.

At Provo, Utah, some $30 million in damage suits were filed. "Even the deer in the hills around Provo had mottled teeth".[5] In 1950, $9 million was spent on the steel plant there, for the installation of clean-up equipment.

An aluminium plant in Troutdale, Oregon was built and operated for the government by Alcoa during the war. Five tonnes of fluorine (in the form of cryolite, aluminium fluoride, and calcium fluoride) had to be added daily to the baths or molten cryolite, in which the aluminium was made, to replenish losses. An estimated 7.000 pounds a day escaped into the atmosphere.

In 1946 this plant was rented from the government by Reynolds Metals, and in 1950, at a cost of over $2 million, emission controls were installed. In the meantime, millions of dollars in damage suits were filed and many hundreds of thousands paid out in settlements and judgements.

US Government Response to a Growing Problem

In 1931, H.V. Churchill was able to confirm the connection between the mottling or teeth and fluorine. At this time, the US Public Health Service (PHS) (which was under the Treasury and the Secretary of the Treasury, Andrew Mellon, one time owner of Alcoa) had to recognise fluorine as a potential health hazard. Consequently, Dr H.T. Dean was employed in 1933; his job was to determine the maximum fluorine concentration which could be safely permitted in public water supplies. The PHS was not interested in other sources of fluorine ingestion; it was concerned only with fluorine taken up through drinking water.

In 1935 Dean wrote:

"For public health purposes we have arbitrarily defined the minimal threshold of fluorine concentration in domestic water supply as the highest concentration of fluoride incapable of producing a definite degree of mottled enamel in as much as 10 por cent of the group examined."[6]

Dean found that a fluoride concentration or 1.0 ppm would satisfy the 'minimal threshold'. However, by 1938 he had discovered that "where the fluoride content was just over 1.0 ppm, the examiner might find 'very mild' or 'mild' fluorosis in 25-30 per cent of the children."[7] Rather than change the allowable concentration of fluoride, Dean:

"adopted a new method of reporting in which the per cent of damage did not appear. He invented what he called the 'community index of dental fluorosis'."[8]

On the basis of Dean's work, which consisted primarily of his 21 Cities Study, the PHS in 1942 set 1.0 ppm as the maximum tolerance for fluoride in public water systems. The 21 Cities Study, often referred to by fluoridation proponents, was a survey of over seven thousand children, between the ages of twelve and fourteen, from 21 cities across the US. The cities had water supplies containing naturally occurring fluoride concentrations ranging from 0.0 ppm to 2.6 ppm.

All the variations among the cities in the number of decayed, missing, or filled (DMF) teeth were attributed to the varying fluoride concentrations in the water. In nine of the 21 cities, with fluoride concentrations from 0.0 ppm to just 0.2 ppm, the number of DMF teeth per too children ranged from 1037 to 673. Meanwhile the DMF teeth per 100 children in the remaining 12 cities, where fluoride concentrations ranged from 0.3 ppm to 2.6 ppm, were correspondingly lower, lying between 652 to 236.

At the 1951 Delaney Committee hearings to Investigate the Use of Chemicals in Food and Cosmetics, Dean was questioned about the 21 Cities Study under cross-examination:

Dean explained the embarrassingly high incidence or mottled enamel at Maywood, Illinois, where the DMF teeth per 100 children was 258, (1.2 ppm) and at Marion (0.4 ppm) on the grounds that there had been changes in their water supplies during the life-time of the group examined. This, however, had not prevented their being retained as a part of the study.[9]

Dean did not mention that similar changes had occurred in Galesburg, Elmhurst, Aurora, East Moline, Joliet, and Elgin, and probably at Lima. This reduces the 21 cities to twelve, nine of which had fluoride concentrations of 0.2 ppm or less, and one, Colorado Springs, with 2.6 ppm. The 21 Cities Study - the principal study by which the 1.0 ppm fluoride concentration was established by the PHS as acceptable for all pubic drinking water - reduces to two cities, Kewanee, Illinois with 0.9 ppm, and Pueblo, Colorado with 0.6 ppm.

A Market for Industrial Waste

Growing public awareness of, and concern over, fluorine pollution, and growing industrial fluorine wastes, could not both continue forever. As well as all of the studies on the ill-effects of fluorine; during the 1930s research was began into how fluoride waste could be incorporated into the environment.

Dean's work had been on naturally fluoridated areas, and was designed to see what was a permissible fluoride concentration for water supplies. Dr Gerald Cox, working at the Mellon Institute on industrial grants, was looking for a market for industrial fluoride wastes. The connection between mottled enamel and small reductions in caries had already been made. In 1916, G.V. Black and F. McKay claimed that on the evidence available mottled teeth may display an absence of caries, and in 1939 Cox suggested that "the present trend toward complete removal of fluoride from water and food may need some reversal."[10]

The same year a paper appeared by Cox which proposed artificial water fluoridation as a means or reducing tooth decay. Cox was supported by Oscar Ewing, former counsel to Alcoa, who later became Director of Social Security of the PHS. Ewing was instrumental in persuading the PHS to endorse artificial water fluoridation, which it did in 1950.

Fluoride in the water as a caries prevention measure. was given greet publicity when in 1943, Readers Digest published an article called "The Town Without a Toothache." The town was Hereford, Texas, with a water supply containing a natural fluorine concentration of 1.5 ppm to 2.5 ppm. Dr C.W Heard, the dentist whose report started the publicity, accepted that fluorine might be responsible for the relatively low caries rate in Hereford. But he also suspected other factors, such as the high mineral content of the water and soil, and the food grown on that soil. All of the locally produced foodstuffs were round to be high in phosphorus, calcium, iron, magnesium. and trace minerals. However, the picture in Hereford changed, and in 1951 Dr Heard wrote;

"It is not true that Hereford, Texas, is a town without toothache. This phrase has been used effectively by people interested in marketing sodium fluoride all over the country.

I have practised dentistry here for years and incidence of tooth decay originally was very low. Considerable research by some dental authorities brought the suggestion that the relatively high content of natural fluorine might be the reason. I accepted this conclusion for a time.

However, as the town grew, and people began to live on processed food tooth decay increased by leaps and bounds. The increase persisted in spite of the fact that people were drinking the same water they drink when they were eating natural and unadulterated foods.

The dental investigators made a serious mistake when they gave fluorine the credit for our good teeth. They overlooked the food grown in our rich, well-mineralised soil ..."[11]

By the time Herd wrote this, the 'Fluoridation Campaign' had been underway for several years and already had the approval and support of the USPHS, the American Dental Association (ADA), the American Association of Public Health Dentists, State and Territorial Dental Health Directors, the American Public Health Association, the American Water Works Association, the National Research Council, and the American Medical Association (AMA) (the latter limiting its approval to endorsement of the 'principle' of fluoridation).

Artificial Water Fluoridation

The idea of artificial water fluoridation was first put into practice in 1945. Ten-year pilot programmes were begun at Grand Rapids, Michigan and Newburgh, New York. Studies were also begun in Evanston, Illinois, and two in Brantford, Canada. It is on the basis of those studies that the 'Fluoridation Campaign' gained "unqualified endorsement" from the PHS in 1950.

The scientific validity of these studies is questionable in that respect. The control, the fluoride-free city to be compared with Grand Rapids over a ten-year trial period was Muskegon, Michigan. Grand Rapids began artificial fluoridation of the water supplies in January 1945. However, five years later, in June 1950, Dr Leonard Scheele, the US Surgeon General. declared before the Congressional Committee that the US Public Health Service gave an "unqualified endorsement" to water fluoridation (HR74, page 1500).[12] Furthermore, Muskegon's water supply was fluoridated in July 1951, half way through the trial. The reliability of a mean rate depends on the number of subjects included in the study. Yet;

Because of the small number of subjects included in some age groups in some years in Muskegon, little relevance can be placed on the values stated. In twelve categories, fewer than twenty children were examined. One 'group' consisted of only one child whereas the largest contained 462. In the test city the variation in sample size was even greater, from 1,806 to 3 subjects.[13]

Meanwhile, the Evanston study was described as "one of the most elaborate investigations" by the United Kingdom Mission, which came to the US in 1952 to witness the effects of artificial fluoridation.[14] The researchers, Hill and his colleagues, asserted that they had planned the study so as to measure every variable that might influence and obscure the findings. However as Philip Sutton pointed out:

"It soon became apparent that Oak Park could not be called the 'ideal control community', for Hill, et al (1951), stated that comparison of the caries rates of all children in the study area (Evanston, Illinois) and the control area (Oak park, Illinois) prior to the addition of sodium fluoride to the communal water supply of the study area, indicated a lower caries rate for school children of the control area:"

In addition the UK Mission had to admit that, compared with Oak Park, the economic and dental rate level in Evanston was very high. It also stated that:

"Before fluoridation started, a dental survey was made of 4,375 children in the selected groups in Evanston, and of 2,493 children in Oak park. Further examinations have been carried out each year since 1947 and will continue until 1962."[17]

However, the examinations in Oak Park did not begin until after the Evanston water supply had been fluoridated in February 1947. After the initial 1947 examination, no further Oak Park examinations were conducted until 1956, 9 years later.

An example of how the authors of the studies were able to affect the results is seen in the 'weighing' of results In the 1946 and 1048 Evanston examinations, the six, seven. and eight year old age groups were combined to give a caries rate for the children ranging from six to eight years. In Evanston in 1946 the DMF rate for these age groups was 46.85, l53.49 and 249.93 respectively. Thus clearly, depending on the number of children taken from each group, the average caries rate will be lower or higher than it would be if each group had been equally represented. In 1946, from the age groups of six, seven and eight years, 461, 759 and 771 children respectively, were examined. The corresponding numbers in 1948 were 756, 838 and 440.

Sodium fluoride was added to the Newburgh water supply in May 1945. D.B. Ast wrote in the American Journal of Public Health (1950) that with regard to Newburgh and the control city, Kingston, "water supplies at the outset of the study were comparable and have remained so, except for the addition of sodium fluoride to Newburgh's supply."[18] But in fact, both the source and the composition of the two water supplies were different. Especially important were the differences in composition. A 1952 analysis by the US Geological Survey found that for each or the items:

"magnesium, sodium, dissolved solids, specific conductance, hardness, and alkalinity - the values for the Newburgh water were at least four times as great as those obtained from analysis of the Kingston supply. In the very important matter of calcium content the Newburgh value 35 ppm (Ca) was more than five times as large as that of the Kingston one of 6.6 ppm (Ca)."[19]

As with the Evanston study, weighting occurred at the Newburgh trial. Although the authorities stated in 1951 that the DMF rates in the control city of Kingston showed no changes, each of the six, seven and eight year old groups studied showed a decrease in the caries rates between 1946 and 1949.[20] This occurred despite the fact that Kingston "remained fluoride deficient throughout the study period".[21] Meanwhile the claim for no change in the Kingston rates had been based on a method which computed a caries rate for the combined age groups or six to twelve years.[22]

In Brantford, Canada, two independent trials were conducted. In one of these there was no control group. Instead, two prefluoridation surveys were carried out by the school dental officer and his assistant.

The other study, carried out by the Canadian Department of National Health and Welfare, was begun in January, 1948, nearly three years after fluoridation of the Brantford water supply. Brantford's "dental care was outstandingly good", according to the UK Mission Report (1953). H.K. Brown, one of the authors of this study, wrote in the Journal of the Canadian Dental Association (1952) that:

"the recordings so far obtained indicated both a high treatment and an apparently better oral hygiene status of the Brantford children when compared with the controls, and it is therefore suggested that caution should be exercised in the interpretation of the rates shown. The lack of a prefluoridation survey on a comparable basis is a further limiting factor in interpreting the results."[23]

The control towns were Sarnia, a 'fluoride-free' city, and Stratford, a city with water containing a natural fluorine concentration of 1.3 ppm.

In the 1955 Division of Medical Statistics, Ontario Department of Health, Report to the Minister of Health, Province of Ontario, Canada, any fall in the dental caries rates of deciduous teeth in the control city of Sarnia was omitted, yet the percentage reduction there was 16 per cent, an compared with 18 per cent in the test city.[24]

Average DMF Per Child (54 per cent Average)

Group A0.523.556.5
Group B0.
'Reduction' %10075433023

K.K. Paluev, a Fellow of the American Institute of Electrical Engineers and an analyst of experimental data, describes how misleading the whole method of expressing 'reductions' in percentages is. He gives the following example:

In the words of the PHS and the American Dental Association, "reduction up to 100 per cent with the average of 54 per cent is demonstrated." The following chart displays the rate of increase in DMF teeth between two groups of children, where group B has received fluoridated water. From this chart the above claim can be made and justified, yet it is clear that the differences between the groups A and B rapidly vanish as the children get older.[25,26]

Full Scale US Promotion

The USPHS gave official approval of artificial water fluoridation in June 1950. It was shortly followed by approval from the American Dental Association, and many other professional bodies, including the American Medical Association (which, as noted, limited its approval to an endorsement of the 'principle' of fluoridation). Such approval was, nonetheless, a turn around for the AMA, since in October 1944, the Journal of the American Medical Association published an editorial stating:

"We do know that the use of drinking water containing as little as 1.2 to 3 parts per million or fluorine will cause such developmental disturbances in bones as osteosclerosis, spondylosis, and osteoporosis, as well as goitre, and we cannot afford to run the risk or producing such serious systemic disturbances in applying what is at present a doubtful procedure intended to prevent development of dental disfigurements among children."[27]

Yet, pressure to join in the promotion or fluoridation was coming from high places, and in a paper read before the Massachusetts Dental Convention in 1952, Assistant Surgeon General Knutson demanded to know "why are we quibbling, delaying, pigeon-holing, in the face of exhaustive research and overwhelming proof?"[28]

This was at a time when the outcry against sugar and sugar products was growing within the ADA and the American public. The research and propaganda arm of the sugar industry, the Sugar Research Foundation, was one of the earliest advocates of water fluoridation. It gave generous support for research designed to show that America's annual average 100 pound-per-person consumption of sugar was not excessive. In 1949 the Foundation's scientific director, Dr Robert C. Hockett, acknowledged that the dental-caries research was designed "to find out how tooth decay may be controlled effectively without restriction of sugar intake."[29]

As potential suppliers of the fluoride wastes used to fluoridate water supplies, the aluminium industry was an eager promoter. At one point in the 1950s, the Aluminium Company of Canada printed a full-page advertisement, recommending the use of 'Alcan sodium fluoride'. The adverts stopped when fluoridation opponents began to use them as proof of commercial involvement.

The 'Fluoridation Campaign' was under way, with millions of dollars and many reputations resting on its success. Professor Albert Schatz of Temple University, a leading researcher in dentistry as well as in cancer, who claimed to have lost his share of the Nobel Prize as co-discoverer of streptomycin because of his outspoken opposition to fluoridation, had this to say about the fluoride controversy:

"Ever since US dentistry 'created' fluoridation it has been forced to defend it in the face of increasing worldwide opposition from many responsible scientists. As a result, the reputation of US dentistry has become irrevocably bound to the fate of fluoridation. A stage has now been reached where the rejection of fluoridation will irreparably discredit the American Dental Association and the National Institutes of Dental Research of the US Public Health Service."[30]

That may not be far from the truth. After the 1950 endorsements of fluoridation, "state and local dental societies were mobilised in support of fluoridation, and dissenters were silenced by an unprecedented gag rule that penalised by expulsion any public criticism of fluoridation.[31] The House of Delegates of the ADA had to invoke Section 20 of its Code of Ethics in 1951 to prohibit dentists opposing fluoridation, on pain of loss of licence to practise."[32]

W.B. Hartsfield, Mayor of Atlanta, Georgia, merely noted in 1961 that "the general public does not realise the gigantic power structure which is pushing fluoridation." [33]

Instances of the professional community's commitment to, and enthusiasm for, fluoridation abound. National Fluoridation News published this description of a 'Fluoridation Campaign' effort:

"Mason City, Iowa ... was the scene of an interesting fluoridation campaign ... The fluoridation drum beaters descended on Mason City with the usual misleading literature. The hometown paper was enlisted in the crusade. Endorsements by experts were introduced. Civic groups joined up with the parade. Local doctors issued statements about the deplorable state of children's teeth. The decay rate was so appalling that the local dentists couldn't handle the terrible situation. Dr Charles Henshaw, employee of the Iowa Department of Health, came to town to display his charts and graphs to show how 1 ppm could lower the decay in Mason City children's teeth by 65 per cent.

Then someone tested the Mason City water supply and found that it already contained 1.25 ppm - a little more than the magic amount of fluoride. Almost the same thing happened at Ottawa, Illinois, only the water there contained 1.3 ppm of natural fluoride."[34]

By 1967 six million in Canada and 72 million in the US were drinking fluoridated water, "and in the latter country, a further ten million people were living in areas where the natural water contained sufficient fluoride."[35]

United Kingdom Joins the Campaign

In 1953 the UK Mission to the US returned and reported on the benefits of fluoride, and made their recommendation to begin pilot programmes in the UK.

"The mission found no scientific evidence of danger to health from the prolonged consumption of water containing fluoride in low concentration. The mission concluded that fluoridation of water supplies was a valuable health measure through its effect in reducing the incidence of dental caries"[36]

It was decided that three communities should be fluoridated as trials. Fluoridation began in Anglesey in 1955, in Kilmarnock in 1956, and in Watford the same year. Fluoridation was terminated in Kilmarnock on October 10, 1962. Prior to the Town Council vote, which brought it to an end, the Medical Practitioners' Union, in London, wrote to express its support for continuing fluoridation. "We believe", it said, "that any change in policy in Kilmarnock could seriously prejudice the Government's decision on a national policy. This is our only reason for intervening."[37]

Town Treasurer, W. Wallace, an opponent of the experiment had this to say:

In the three British study areas - Anglesey, Kilmarnock, Watford - on the figures given, it is claimed that at age three dental decay is reduced by 66 per cent. It is also admitted that at age seven the reduction is only 14 per cent. In plain English, at age seven before fluoridation the average child had seven bad teeth whereas, after five years of fluoridation, six bad teeth. Does any member here consider that achievement of fluoridation outstanding or worthwhile?"[38]

Wallace had also been put off by a remark in the Medical Officer's Report of 1957 (page 42); it read: "As far as possible the same children are examined every year."[39]

Meanwhile the Department of Health and Social Security gave full backing to fluoridation in Report No 105 and did so again in 'Report No 122', published in l969.[40]

The 'Fluoridation Campaign' was under way in the UK, and soon had professional support equal to that in the US and Canada. In the October 1970 issue of the British Dental Journal, Gordon M Williams, chairman or the British Dental Association Dental Health Committee, wrote:

"As soon as dentists recognise their responsibility to the politics or fluoridation, their performance will be outstanding. In politics, the emphasis is on propagandising rather than on educating. In politics, the emphasis must be on commitment rather than detached objectivity ... In other words, a dentist does not need to know all the vast scientific background to fluoridation - all he needs is the knowledge that fluoridation is safe, effective, and practical, and enough enthusiasm to convince other people that this is so."[41]

In fact, the difference in decay associated with fluoridation is one, or less than one tooth per child. 'Report No.122' claims that decay or the permanent teeth had been reduced by 43 per cent at age 8, by 36 per cent at age 9, and by 31 per cent at age 10. When improvements in the control areas are deducted, the percentages become 35, 33 and 26 respectively. The reductions claimed represent one or less than one tooth per child.

By 1980, approximately four and a half million people in Britain were receiving artificially fluoridated water.

The United Kingdom's Royal College of Physicians (RCP) took up the question in 1976, and published its findings in a booklet entitled Fluoride, Teeth and Health.

In placating those who fear the environmental consequences of adding fluoride to the water, the College asserts that "most of the fluoride used would be derived from sources that would otherwise have been discharged to the sea as waste. Fluoridation does not harm the environment"[42] It has been suggested that this explains "why fluoridationists do not carry their efforts to replicate nature to the extent of using calcium fluoride for the process of fluoridation. Calcium fluoride is not, of course, a waste product of industry"[42]

On the basis of past data such as that described here the RCP came to the conclusion that:

"The statement is sometimes made that fluoridation merely postpones and does not prevent caries. Several factors contribute to the development of caries and the removal of one factor (a relative lack of fluoride) cannot be expected to prevent the others from having an effect in the course of time. This is the case in many diseases. The elimination of one factor among several may, nevertheless, be worthwhile. It is certainly so in the case of fluoride intake and dental caries, since adequate provision of fluoride reduces the prevalence or the disease throughout life"[44]

The report cites the support of the World Health Organisation (WHO) Committee on Trace Elements, and states that this committee has included fluorine in their list of trace elements believed to be essential for animal life. The WHO report states:

"Since only trace amounts of the element are required by the organism, animals and human beings are probably rarely in acute need of it. It is also possible that our present state of knowledge concerning optimal levels and essential functions may be quite inadequate."[45]

Nevertheless, the Who report does support fluoridation in the areas where fluoride concentration is below the 'optimal level' of 1.0 ppm. We may note that no scientist who spoke out against fluoridation was asked to contribute, and the report's editor. Yngve Ericsson, is well known for his pro-fluoridation stance.

The RCP report makes several references to Dean's work, and to the original US and Canadian studies. All of these references seem to ignore any evidence which might question the validity or conclusions of these studies. The report cites the US Food and Drug Administration as listing fluorine among the essential nutrients. This may have been the case in 1976, but in March 1979, fluorine classification was changed from 'Essential' to 'Non-essential' and now rests in the FDA category of "not generally recognised as safe".

Today we are faced with growing quantities of fluoride in the environment regardless or whether it is added to the water supply. Sodium fluorosilicate is a component of chemical fertilisers, whose use is on the rise. Fluorides are used in insecticides, pesticides and herbicides. Fluorides are still released into the air by the steel, ceramic, superphosphate fertilizer, aluminium, copper, coal, oil and atomic energy industries.

In the US, after over 25 years of fluoridation, Grand Rapids, Newburgh and Evanston have almost twice as many dentists per unit population than the average figure for the whole country. Granted this proves very little; but maybe Professor J.C. Muhler of the University of Indiana was more than pure cynic when he said in 1963 that "the great benefit of fluoridation to dentists was the fact that the enamel became so brittle that dentists needn't waste time on ordinary fillings but could concentrate on the more profitable work of fitting crowns."[46]

In the UK the British Dental Association now suggests that pressure be put on education authorities to include pro-fluoridation projects in school. In the US, sugar and sugar products account for more than $8 billion in sales annually. In 1985 the Sugar Association sponsored a $2 million sugar campaign. Per capita annual consumption in the US is up to 118.1 to I26.8 pounds.

None of the professional endorsers of fluoridation, not the AMA, ADA, USPHS, IRMA, IRDA or RCP have done any comprehensive research into the safety of the free fluoride ion in a living organism. Fluoride is everywhere in our environment. It is in this food, air and water, and now in gels, toothpastes, tablets and other drugs. Today fluoride has a positive image, built up over just a few decades; to oppose artificial fluoridation is to attack the health or our children's teeth, and to raise objections by bringing in any other considerations is to be guilty of layman ignorant stubbornness.

Arguments against artificial water fluoridation can come from several angles. The economic argument: the small decrease in decay does not warrant the cost of fluoridating an entire water supply, especially when fluoride has no effect after the teeth have formed. The moral argument: Fluoridation is a form of compulsory mass medication. The health argument: The safety of artificial fluorides has in no way been proven, and there is increasing evidence to the contrary.

Thomas Outerbridge


1. DeEds, Floyd, 'Chronic Fluorine Intoxication', Medicine 12, 1-60, 1933.
2. Exner, Fred 'Economic Motives Behind Fluoridation'. Seattle, Washington, 1961. p.6.
3. Wilde, Major C.N.G., The Truth: Regarding the Campaign for the Artificial Fluoridation Experiment of Public Water Supplies, p.4.
4. Exner, Fred (1961) op.cit. p.7.
5. op.cit. p.6.
6. Exner, Fred and G.L. Waldbott, The American Fluoridation Experiment, The Devin-Adair Company, new York, 1957, p.124.
7. op.cit. p.124.
8. op.cit. pp.124-5.
9. op.cit. p.108.
10. Cox, G.J., 'New Knowledge of Fluoride in Relation to Dental Caries', J.A.W.W.A., 31, 1926-30, 1939.
11. Exner, Fred (1957) op.cit. pp.5-6.
12. op.cit. p245.
13. Sutton, Philip R.N., Fluoridation: Errors and Omissions in Experimental Trials, Melbourne University Press, Victoria, Australia, 1960.
14. United Kingdom Mission Report, 'The Fluoridation of Domestic Water Supplies', Brit. Med. J., 1, 1953, pp.584-5.
15. Hill, I.N., Blaney, H.R., and Wolf, W., 'The Evanston Dental Caries Study, IV', J. Dent. Res., 29, 1950, pp.534-40.
16. Sutton, Philip (1960) op.cit. p.16.
17. op.cit. p.20.
18. Ast, D.B., Finn, S.B., and McCaffrey, I., 'The Newburgh-Kingston Caries Fluorine Study, I. Dental Findings After Three Years of Water Fluoridation', Amercian J. Pub. Hlth., 40, 1950, pp.716-27
19. Sutton (1960) op.cit. p.49.
20. Ast, D.B., and Chase, H.C., 'The Newburgh-Kingston Caries Fluorine Study, III. Further Analysis of Dental Findings Including the Permanent and Deciduous Dentitions After Four Years of Water Fluoridation', J. Amerc. Dent. Ass., 42, 1951, pp.188-95.
21. Ast, D.B., Smith, D.J., Wachs, B. and Cantwell, K.T., 'The Newburgh-Kingston Caries Fluorine Study, XIV. Combined Clinical and Roentgenographic Dental Findings After Ten Years of Fluoride Experiences', J. Amerc. Dent. Ass., 52, 1956, pp.314-25.
22. Sutton, Philip (1960) op.cit. p.56.
23. Brown, H.K., 'Mass Control of Dental Caries by Fluoridation of a Public Water Supply', J. Canadian Dent. Ass., 18, 1952, pp.200-4.
24. Sutton, Philip (1960) op.cit. p.56.
25. Exner, Fred (1957), op.cit. p.247.
26. Nesin, B.C., 'A Water Supply Perspective of the Fluoridation Discussion'., J. Maine Water Util.. Ass., 32, 1956, pp.33-47.
27. Anne-Lise Gotzsche, The Fluoride Question, Davis-Poynter Ltd., London, 1975, p.38.
28. Knutson, John W., Paper read before the Massachusetts Dental Convention, Jan. 17, 1952.
29. Gotzsche, Anne-Lise (1975) op.cit. p.36.
30. op.cit p.35.
31. Exner, Fred (1957) op.cit. p.8.
32. Wilde, Major C.N., letter to John Chadwick Esq., Senior Dental Officer, Dental Department,May 6, 1985.
33. Gotzsche, Anne-Lise (1975) op.cit. p.40.
34. op.cit. p.24. National Fluoridation News (Nov-Dec).
35. Reports of Public Health and Medical Subjects No.122, 'The Fluoridation Studies in the United Kingdom and the Results Achieved after Five Years', Ministry of Health, 1962, p.1.
36. Reports on Public Health and Medical Subjects, No.16, 'The Conduct of the Fluoridation Studies in the United Kingdom and the Results Achieved after Five Years', Ministry of Health, 1962, p.1.
37. Kilmarnock Standard, October 13, 1962.
38. op.cit.
39. op.cit.
40. Report No.105 (1962) op.cit. pp.9-10.
41. Gotzsche, Anne-Lise (1975) op.cit. p.25.
42. The Royal College of Physicians, Fluoride, Teeth & Health. Pitman Medical, 1976, pp.11- 12.
43. National Pure Water Association, 'Indictment of the Reprt by a Committee of the Royal College of Physicians', 168, February 1976, p.10.
44. RCP (1976) op.cit. p4.
45. Gotzsche, Anne-Lise (1975) op.cit. p.71.
46. op.cit. pp.32-33.

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