A Not-Whatsoever-Topical Look at the History of Fluoride in the Water

Apropos of absolutely and totally nothing, I’ve been thinking about the fluoridation of water recently. As someone whose teeth, by all accounts, should look like something out of an X-Files episode, I’m pretty confident it’s been a positive for me. 

Others in the country, however, don’t share that sentiment. Which is weird, because we’re such a level-headed and scientific country. I figured, though, that it still might be worth visiting why and when it got introduced, and what the science says. Again, not that it’s going to come up in conversation anytime soon.

Funnily enough, fluoride’s effect on teeth was first discovered when the effects of far too much of it showed outward signals of dental strangeness. Specifically in the town of Colorado Springs, a dentist named Frederick McKay noticed that children who had grown up in the area, drinking the local water, had strange, brown-speckled teeth, which would be great information to attach to an email and send to other members of your family who have probably marked your emails as spam, if the story ended there. But in 1909, McKay roped in a researcher named G.V. Black to help him crack the mottled mouth mystery of Colorado Springs.

While researching, they found something very interesting: While these less-than-pearly whites weren’t great to look at, they were remarkably resistant to any form of decay — an accidental, oral sort of function over form. The cause, however, eluded them, and Black would pass away before ever figuring out. McKay continued on, however, and caught a break when the town of Oakley, Idaho, started reporting identical mottling after switching water sources. Suspecting the water, McKay advised them to avoid the new water source, and the mottling stopped. Now sure the water itself was the cause, he had it evaluated by a then-advanced process known as photospectrographic analysis, which revealed high levels of fluoride.

Brown teeth is a high price to pay for a lack of cavities, but the latter was an intriguing benefit, so research continued. They wondered if there was an amount of fluoride that would support these super-teeth but, you know, in their original color. As they found out, the math was blissfully cooperative. Fluorosis, as the condition was now known, began around 1 parts-per-million of fluoride in drinking water. At the same time, the dental benefits increased, up to 1 parts-per-million. 

At these small concentrations, the fluoridation of water was tested first in Grand Rapids, Michigan — a trial that lasted 15 years, because, despite public opinion, medical and scientific testing is pretty thorough.

One thing really sped up the adoption of fluoridated water as the standard. It was, of course, the one thing that can get the government off their ass to make something happen: war. During the draft for World War II, over one-fifth of the men drafted were rejected due to dental issues. The government couldn’t afford to lose so many valuable meat-shields to a couple cavities, so they became very interested in fluoridation. Grand Rapids had shown stellar results as well, with fully white teeth that were 60 percent more resistant to decay. With this information, the decision to increase the fluoridation of public water was increasingly adopted.

The word “increased” is used very intentionally there, because water has low levels of fluoride in it by nature. The amount is increased, by adding the equivalent of three drops per 55-gallon barrel. It brings the fluoride content up to 0.7 mg/L of water, equivalent to 0.7 parts-per-million, safely below the brown-tooth threshold, but plenty to show a very clear increase in dental health. 

Now, 77 percent of the country fluoridates their drinking water. The remaining 23 percent do not, because, as plenty of people seem not to understand, fluoridated water is not mandated by the CDC. It’s something decided on a local level, and something people can vote against and have successfully eliminated. Obviously, that would involve getting involved in local politics. Which is less fun than going nuclear on Twitter.