The Journey to a Healthy Smile – Finding Fluoride

Preventing Tooth Decay Can Lead to Overall Wellness

After the common cold, tooth decay is said to be mankind’s second most common disease. Because the mouth is a primary entryway into the body, bacteria caused by poor oral health, can easily enter the bloodstream and cause infection and inflammation wherever it spreads. Arthritis to dementia and cardiovascular disease to diabetes, all these ailments and many more, have been associated with poor oral health.

Tooth AnatomyEven so, that millimeter of enamel making up the outer part of the tooth is the hardest substance of the human body and can outlast even the human skeleton when interred.  In fact, the oldest vertebrate fossil relics going back 500 million years are teeth. Despite these details, teeth can be surprisingly fragile and prone to decay.

Our teeth and gums, we so often take for granted, has until as recently as the mid-twentieth century, a very interesting and painful past.

A Toothless History

Tooth decay is not merely a modern disease, scientists have discovered mankind has suffered from dental disease throughout history. During the early years of human history, evidence shows ancient hunter-gathers didn’t suffer too greatly from tooth decay. Rather, the shift in poor oral health occurred with the transition to agricultural societies and the introduction of crops that were high in carbohydrates and sugars.  The consumption of these bacteria causing foods destroyed tooth enamel.

That change in diet was the beginning of centuries of barbarous dentistry and a mouthful of pain.

Young or old, rich or poor—no one was immune to the ravages of toothaches, swollen bleeding gums, and tooth loss. It wasn’t until the reign of Louis XIV in the early 17th century, when fashionable society demanded—more for appearance than for eating—solutions for missing teeth. With that, Pierre Fauchard, who was to be called the Father of Dentistry, introduced a new era of dental care. He not only practiced more humane tooth extraction, he developed the first dental drill and methods for filling cavities, learned to fill a root canal, and introduced a spring to the upper portion of his ivory carved dentures to keep in place.

false teethDentures were a rich man’s luxury until the mid-1800’s when vulcanized rubber was discovered. Strong and flexible, vulcanized rubber revolutionized the second phase of the industrial age by ushering in innovation and prosperity to the masses. It also made a good base for making dentures.

Finally, common people had access to false teeth.

Still, with these advances in dentistry, tooth loss and decay persisted.  Since ancient times, it was widely thought that toothaches were caused by worms that destroyed teeth. It wasn’t until 1890, when a dentist named Willoughby Miller identified that tooth decay was caused by a certain type of bacteria that thrives on sugar, creating an acid that ate away at tooth enamel.

But preventing tooth decay was still a mystery.

Brown Stained Teeth

That is until dentists in Colorado, who were puzzled for decades, wondered why their patients had mottled, discolored teeth.  The cause of the brown stained tooth enamel, it was discovered, was from high levels of fluoride in the water supply. Dr. Frederick McKay, the dentist spearheading this research, found that teeth afflicted by the Colorado Brown Stain, as it was called, were surprisingly resistant to decay.

Dr. McKay
Dr. Frederick McKay

Fluoride, which is a component of tooth enamel, is also found naturally in many foods we eat, and, like the small Colorado towns of Dr McKay’s research, is detected in water supplies around the world. At low concentrations, fluoride can be beneficial to healthy teeth. However, too much exposure can have adverse effects, such as dental fluorosis, which causes tooth enamel to become mottled and stained.

Further research found that people, who had inadequate amounts of fluoride in their drinking water, had higher incidences of tooth decay. At last, after more than thirty years of studies, Dr. McKay made the connection to fluoride and tooth decay.

This accidental discovery lead to dramatic changes in dental care… and the introduction of fluoride in modern drinking water supplies.

A Preventable Disease

By the early 1930’s, Dr. H. Trendley Dean, head of the Dental Hygiene Unit at the National Institute of Health (NIH) began investigating the prevalence of dental fluorosis, and exposure to fluoride in drinking water. He made a significant discovery.  Low levels of fluoride of up to 1.0 ppm in drinking water did not cause enamel fluorosis in most people and only mild dental fluorosis in a small percentage of people.

Fluoride in water
Scientists testing bacteria samples during the Grand Rapids water fluoridation study.

Dr. Dean took his hypothesis further and wondered whether purposefully adding fluoride to drinking water at safe levels would help fight tooth decay without causing negative cosmetic or bodily effects. In 1945, after years of debate and discussion, Dr. Dean convinced the City Commission of Grand Rapids to become the first city in the world to fluoridate its drinking water. On the afternoon of January 25, 1945, powdered sodium fluoride was added to the City’s municipal water supply.

During the fifteen-year experiment, Grand Rapids children born after fluoride was added to the water supply, had fewer cavities by more than more than 60 percent. The results were so successful that neighboring cities and communities across the country demanded fluoridation of its public water. By the 1960’s, more than 50 million people in the US had fluoridated treated drinking water in their public water systems.

For the first time in history, this scientific breakthrough revolutionized dental care and proved that tooth decay can be a preventable disease.

One of the Top Public Health Achievements

Fluoridation of pubic water supplies has shown to be a major factor in the decline of tooth decay.  Although there are other fluoride-containing products available, water fluoridation in public water systems remains the most cost-effective way of delivering fluoride to many communities, regardless of age, income, or gender.

The Center for Disease Control (CDC) declared that fluoridation of drinking water to be one of the top ten great public health achievements of the 20th century1.

With tooth decay now a preventable disease, scientists are making the case that poor oral hygiene leads to other health ailments, including coronary disease.  Studies show that the bacteria found in periodontal disease including Streptococcus sanguis, which plays a role in strokes—can spread through the bloodstream to the heart.2  

Dentists stress that fluoride strengthens the tooth enamel, making it more resistant to tooth decay and thereby can greatly help dental health. And, most people now associate the fluoride in their drinking water and in other dental products, such as toothpaste, gels, and mouth rinses, with advanced tooth protection and strong bones.

Worldwide Fluoride Treatment

After years of extensive scientific analysis, The U.S. Department of Health and Human Services (HHS) recommends a ratio of fluoride to water of the amount of fluoride people receive from all sources, at 0.75 parts per million (ppm). These recommendations “will help ensure an effective level of fluoride to reduce the incidence of tooth decay, while minimizing the risk of cosmetic fluorosis in the general population.”3   As a result, Public Water Systems can add optimal concentrations of fluoride to the local drinking water to prevent cavities.

Today, approximately 372 million people worldwide (in 25 countries) receive treated fluoridated drinking water. Most public water supplies in the United States are treated and about 57.4 million worldwide received water that was naturally fluoridated to recommended levels.4



My Water's Fluoride

The public can search the CDC’s My Water’s Fluoride website to research fluoride levels in their drinking water.