Fluoride use for cavity prevention - how it got started

In 1901 Dr. Fredrick McKay, a recent dental school graduate from the east coast arrived in Colorado Springs, CO and immediately noticed a molted brown permanent stain on the teeth of the residence in the area. He also noticed the individuals that were afflicted with this molting and stain did not have cavities. Through investigation, primarily done by himself, he discovered that:

1. Only the people in Colorado Springs and a few surrounding areas were affected.
2. 87.5% of school children were affected and all of them had lived in and around Colorado Springs and vicinity.
3. Students at Colorado College who had the stain where from the area. Those that did not were born elsewhere.

From fellow dentists he learned that some other areas had the identical stain were Franklin, Virgina, Amarillo, Texas and areas of Arizona

There were many theories on what caused the brown stain including to much pork in diet, milk from local cows, lack of calcium and too many freckles. These causes were eliminated by careful analysis of the accumulated information.

In the meanwhile, another area was identified with the Molted brown stain in Britton, South Dakota by Dr. O.E. Martin, accept that this time he reported that before 1898 the towns water supply was from individual surface wells but now got their water from a deep artesian well. At this point, anyone born before this change had normal enamel but individuals born shortly after the change had the brown stain.

This solidified the belief that it was something in certain water supplies causing the brown stain.

In 1925, as further confirmation, the town of Oakley, Idaho started to use a hot spring as their water source. Shortly after this switch the children born showed signs of the brown stain. Dr. McKay convinced the town to switch to a cold spring instead and here is what happened:

“…and an examination eight years later showed the absence of mottling [brown stain] in the children born at or about the time that water was changed. There was no change in the mottling [brown stain] already present on persons who has been raised on the former warm water supply”

A similar story unfolded in Aluminum Company of America (ALCOA) town of Bauxite Arkansas. The water supply came from 3 deep wells that had been drilled for sanitary purposes and from this time forward every child born in the community has mottled enamel with brown stain. But neighboring town 4 miles away that got their water from a river was not affected.

When the Bauxite towns people blamed the company for the problem. Alcoa’s chief chemist. H.V. Churchill ordered the water to be tested for rarer elements and it was found that the wells in Bauxite, AR contained fluoride in a concentration of 15 ppm.

Churchill ask McKay to send water samples from other effected areas for testing and it was found that the fluoride concentration ranged from 2 to 13ppm. The mystery had been solved! And Alcoa could not be blamed for the problem.

Further, the water supply of Bauxite Arkansas, was changed the brown molted stain went away and cavities came back.

The United States Public Health Service appointed Dr. H. Trendley Dean to determine what level of fluoride started to “blemish teeth”. Comparing Colorado Springs and Pueblo Colorado (fluoride of 2.6 ppm and 0.57 ppm respectively) along with other towns in South Carolina, Illinois and Texas he determined that 1ppm concentration caused mottling in its “very mildest form” in only 10 percent of the population.

Grand Rapids, Michigan was the first water fluoridation program and began 1945 at 1 PPM. Fifteen years later in 1965, the children that had grown up using fluoridate water had 50% less cavities. And now you know that fluoride works!