Public water fluoridation was implemented in the United States in 1954 and was recommended by the World Health Organization (WHO) as the main delivery method of fluoride to improve oral health.
Fluoride is unique in that it’s the only preventive chemical that most in the United States don’t have a choice about taking because it’s added to approximately 75 percent of the public water supply.
Although the Indiana Department of Health argues that the courts have ruled that “fluoride is a nutrient ... not a medication” and that “mandating fluoridation is a valid use of police power,” it also notes that nobody is forced to drink fluoridated water and one could employ reverse-osmosis or distillation.
Before 1945, health authorities had sought only to remove fluoride from water, according to “The Fluoride Deception,” a book by investigative journalist Christopher Bryson.
So how did fluoride go from being a toxic chemical that molted teeth, causing a range of health issues, to being the magic bullet said to cure tooth decay? Here are some key milestones and notable figures.
The Cavity Epidemic
Tooth decay and cavities don’t seem like a big deal today—although they remain the most prevalent preventable chronic disease in both children and adults. In the mid-1900s, however, tooth decay was a major health issue.
In her paper published in the American Journal of Public Health in 2015, historian Catherine Carstairs noted that during the mid-1900s, if not treated, cavities led to tooth loss, mastication problems, malnutrition, and infectious complications. Carstairs also noted that a contributing factor may have been the significant shortage of dentists in the United States at that time.
In the early 1950s, two public health researchers said that on average, young men between the ages of 20 and 35 years had already lost an average of 4.2 teeth, and 90 percent of them required bridges or full or partial dentures, Carstairs wrote.
Leaders such as Wisconsin’s state dental director, Frances Bull, “argued that cavities could be decreased by practicing good oral hygiene, restricting sugar consumption, and improving diet.” He also didn’t believe that the public was likely to do these things.
“Fluoride, in his view, offered the first real preventive for dental caries,” Carstairs wrote.
The war also brought the extent of dental disease in the United States into sharp focus. A 2016 American Water Works Association article notes that in 1938, the military had a rule that you had to have six teeth touch to get into the service
“When the war came, they dropped that rule because they needed more people. Forty percent of new inductees into the service had to have immediate treatment for dental pain,” the article reads.