October 4, 2010

Fluoride in Water – First in a Series of Five

The history of fluoridated water is like many of the great scientific findings throughout the ages. It started with an observation.

Archeologists have long known that tooth decay is a modern problem that was rare until the Renaissance, when refined sugar became available to wealthy people. The problem reached epidemic proportions during the industrial revolution, when income levels grew to the point that sugar could be purchased by nearly everyone in an industrialized society.

During the 1870s, scientists and physicians began to notice that people living in some areas of the world seemed immune to tooth decay. Many of these same people also had brown-stained teeth. One of the first cities where this was observed was Naples, Italy. Medical examiners on Ellis Island also noticed many Italian immigrants with this same phenomenon. Similar observations were made in the American West, especially amongst miners in the gold fields of Colorado. It was eventually determined after many years of study that the water these people were drinking contained very high levels of naturally-occurring fluoride, which found its way into groundwater wells via the mineral deposits of the local area.

Researchers determined that these people were getting too much fluoride, and this caused the brown staining which is now known as dental fluorosis. The water they were drinking contained as much as 30 parts per million (ppm) of the element. Studies eventually determined that the optimum drinking water concentration which delivered protection from cavities but did not produce fluorosis was about 1 ppm.

Water intentionally fluoridated at the 1 ppm (parts per million) level was first produced in four cities in 1945: Grand Rapids, MI; Newburgh, NY; Evanston, IL; and Brantford, Ontario. These trials were overseen by an eminent scientist of time, H. Trendley Dean. The results were profound: a 40% reduction in cavities in four years, and up to 57% within 15 years.

It was near the end of this 15-year study, in 1959, that Des Moines Water Works (DMWW) began fluoridating water delivered to Des Moines and surrounding areas. Natural levels of fluoride are supplemented during treatment so that water leaves the treatment plants with the optimum level of 1 ppm.

This article is the first in a series of five articles addressing the subject of fluoride in City water. Please leave a comment, and come back to read the next articles in the series. Thanks for reading!

Posted by: Chris Jones 8 Comments
Labels: , , , , , , Posted in Fluoride, Health, Water Treatment

8 Responses to “Fluoride in Water – First in a Series of Five”

  1. November 02, 2010 at 11:19 am, nyscof said:

    Fluoridation began with the mistaken belief that ingested fluoride reduced tooth decay. Modern science proves that ingesting fluoride does lead to discolored teeth but that it is the topical application alone that strengthens the outer enamel.

    The early studies were done on healthy wealthy people in Colorado where dentists, as they do today, migrate – to where the money is.

    Early researchers neglected to factor in other now-well-known tooth builders such as calcium which was also present in the water. They thought that, since fluoride was the tooth discoloring culprit, then it must also be the cavity preventer.

    The proof that early researchers were wrong is in the current literature which shows that after 65 years of water fluoridation, instead of spreading less tooth decay across the land, dental fluorosis now afflicts up to 48% of children – 4% of it severe. While tooth decay is a national epidemic with children dying from the consequences of untreated tooth decay.

    for more info http://www.fluorideAction.Net

    Reply

  2. November 03, 2010 at 2:27 pm, Chirs Jones said:

    From Chris Jones, Des Moines Water Works Laboratory Supervisor

    Thanks for your comment, NYSCOF! My thoughts on your comments follow:

    “Fluoridation began with the mistaken belief that ingested fluoride reduced tooth decay. Modern science proves that ingesting fluoride does lead to discolored teeth but that it is the topical application alone that strengthens the outer enamel.”

    The first sentence here is partially true. Early researchers did believe that the cavity-prevention benefits were mostly due to systemic ingestion. We now know that the primary mechanism of cavity prevention is topical, i.e. on the surface of the tooth. Current research does indeed show that early researchers were correct in assuming at least some systemic benefits. A very recent paper in the American Journal of Public Health (1) reports a strong relationship between fluoride levels in a resident’s county at the time of their birth, with tooth loss as an adult. The author of the paper, a Columbia University professor, states “Your fluoridation exposure at birth is affecting your tooth loss in your 40s and 50s, regardless of what your fluoridation exposure was like when you were 20 and 30 years old.” This argues strongly for a systemic benefit.

    There is also some truth to the second sentence in NYSCOF’s comment. Modern science (and science performed nearly 100 years ago) does indeed show that excessive ingestion of fluoride, well beyond the amounts delivered via conventional water fluoridation, can cause tooth discoloration.

    “The early studies were done on healthy wealthy people in Colorado where dentists, as they do today, migrate – to where the money is.”

    The first professional dentist who made the Colorado observations was Frederick McKay. He arrived in Colorado Springs in 1901. McKay was frequently taken aback by the number of patients, rich and poor alike, who showed up in his dental chair with stained teeth (2, 3, 4, 5). It is true that McKay was a wealthy and cultured man, and that Colorado Springs was a boom town cashing in on prosperity generated by gold mining.

    “Early researchers neglected to factor in other now-well-known tooth builders such as calcium which was also present in the water. They thought that, since fluoride was the tooth discoloring culprit, then it must also be the cavity preventer.”

    I am not aware of evidence supporting this statement. Two things are known relevant to this statement: 1) archeologists know tooth decay was rare in human beings prior to the availability of refined sugar, regardless of access to calcium; and 2) calcium is precious to human health and is critical for many bodily processes.

    Many people have indeed thought about calcium, and its role in tooth decay. From an evolutionary perspective, a resistance to tooth decay would appear to be a highly advantageous trait, because it can be shown that dental caries will reduce the survival odds of any individual or species. The body providing extra calcium to the teeth to prevent cavities presumably would be a great thing. All things being equal, an individual with good teeth will live longer than an individual with rotten teeth. But all things are not equal. Calcium is not free in nature and the body has a “calcium economy”—calcium is needed for all sorts of bodily processes, so taking more for the teeth would mean some other (and perhaps more critical) bodily process would have to do with less. The truth of the matter is that nature did do a pretty good job in designing decay-resistant teeth for us, until we intervened with the modern sugary diet.

    “The proof that early researchers were wrong is in the current literature which shows that after 65 years of water fluoridation, instead of spreading less tooth decay across the land, dental fluorosis now afflicts up to 48% of children – 4% of it severe. While tooth decay is a national epidemic with children dying from the consequences of untreated tooth decay.”

    The statistics in the comment are not referenced, so I can’t directly comment on their accuracy. Literature is legion that shows tooth decay rapidly declining in the U.S. following the onset of fluoridation. The prevalence of dental fluorosis in communities with a public water supply has been quantified (6). “Mild Fluorosis” is considered to be cosmetic, with a clinical description of opaque white areas scattered over as much as 50% of the tooth surface. There are virtually no documented cases of crippling skeletal fluorosis in the modern era of U.S. history.

    As to the comment about the early researchers being wrong is not well-supported when considering the entire weight of evidence. If fluoride were truly harmful to our health, surely this would be indicated in our national health statistics. There is simply no statistical evidence that fluoridation has caused a significant decline in societal health. On the contrary, the very period in which fluoride exposure has been increasing has been a period of steady health improvement and increased lifespan. And improved dental health is indisputably a factor in our improved overall health as a society.

    References
    (1)M. Neidell, K. Herzog, and S. Gleid, The Association between Community Water Fluoridation and Adult Tooth Loss, American Journal of Public Health, 100:10, 2010.
    (2)F.S. McKay, Investigation of mottled enamel and brown stain, J. Natl. Dent. Assoc., 4, 273-278, 1917.
    (3)F.S. McKay. Mottled enamel, a fundamental problem in dentistry, Dent. Cosmos, 67, 847-860, 1925.
    (4)F.S. McKay, Do water supplies cause defects in tooth enamel? Water Works Eng. 79, 1321-1335, 1926.
    (5)F.S. McKay and G.V. Black, An investigation of mottled teeth, Dent. Cosmos 58 (various), 1916.
    (6)J.A. Brunelle and J.P. Carlos, Recent trends in dental caries in U.S. children and the effect of water fluoridation, J. Dent. Res., 69, 723-727, 1990.

    Reply

  3. December 17, 2010 at 3:50 pm, Fluoride in Water – Fourth in a Series of Five | Des Moines Water Works said:

    […] Fluoride in Water – Part 1 […]

    Reply

  4. January 03, 2011 at 9:40 pm, Fluoride in Water – Final in a Series of Five | Des Moines Water Works said:

    […] Fluoride in Water – Part 1 […]

    Reply

  5. May 02, 2011 at 2:53 pm, Tasha said:

    As much as I appreciate that the city was trying to look after my health, I now live with discolored teeth which is embarrassing and has been a constant source of embarrassment for many years. Was discoloration not taken into account when the city decided to start putting fluoride in the water?

    Reply

    • May 04, 2011 at 1:00 pm, Randy Beavers said:

      Thanks for your comment, Tasha. This is Randy Beavers, CEO & General Manager from DMWW. Dental professionals locally and nationally have found that the 1.0 part per million (ppm) fluoride concentration we have maintained in our drinking water up to this year is optimum for cavity prevention. We know there is well water near Des Moines and other parts of Iowa which contain fluoride levels above 4.0 ppm which can cause mottling of tooth enamel and discoloration. Our water sources are shallow groundwater and river water which we sample daily and know they contain levels in the 0.1 ppm range, which is why we add fluoride to achieve the optimum recommended amount.

      Reply

  6. June 01, 2012 at 5:42 pm, Lori said:

    I am hypothyroid from a lifetime of drinking water with added fluoride in it. The body can only get rid of half the fluoride it takes in. So over the years your body has more and more fluoride built up in it. Fluoride displaces iodine, and iodine is needed to make thyroid hormone. Maybe you should lower or eliminate adding fluoride to our water.

    Reply

    • June 04, 2012 at 2:29 pm, Laura Sarcone said:

      Thank you for the comment, Lori. Des Moines Water Works lowered the fluoride level January 2011 – http://www.dsmh2o.com/new-fluoride-concentration-levels-for-dmww-finished-water/. Final fluoride concentration in finished water is 0.7 parts per million (ppm). Natural levels of fluoride in DMWW’s source water (Raccoon & Des Moines Rivers) range from 0.2 to 0.5 ppm.

      Thank you,
      Laura
      Des Moines Water Works

      Reply

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