In 1945, the US Public Health Service (PHS) conducted a study of 8 cities in North America (Grand Rapids and Muskegon, MI; Newburgh and Kingston, NY; Evanston and Oak Park, IL; and Brantford and Sarnia, Ontario, Canada) to test the hypothesis that dental caries (tooth decay) could be prevented by adjusting levels of fluoride in community water sources. After 15 years of surveys (intervention and control), the PHS reported that caries was reduced by 60% among children in communities with fluoridated water. The majority of the nation responded quickly by adding the recommended amount of fluoride (1.0 parts per million) to its water and dental caries declined precipitously during the second half of the 20th century. Mass marketers didn’t miss a beat, adding fluoride to their products (toothpastes, mouth rinses, etc.), which millions of Americans today continue to use, and twice a day! Those who have been educated about dental hygiene and can afford regular dental check-ups and supplies of fluoride certainly have an advantage over those simply exposed to fluoridated water. That said, according to the Center for Disease Control and Prevention, water fluoridation remains the most equitable and cost-effective method of delivering fluoride to all members of most communities, regardless of age, educational attainment, or income level. Today, 72 percent of Americans consume fluoridated water.
Yet even in 2012, the year the US Supreme Court ruled favorably for “Obamacare,” this kind of socialized preventive healthcare approach remains under attack by individuals who don’t want to be medicated without consent. The state that has fought the hardest against it is New Jersey, the most densely populated state in the country. (Only 14 percent of New Jerseyans drink it. NJ is also the state with the most dentists per citizen.) Several municipalities say it’s too expensive (costs range from a mean of 31 cents per person per year in towns greater than 50,000 persons to a mean of $2.12 per person in towns of less than 10,000). Some believe fluoridation causes cancer, Down syndrome, Alzheimer’s, and other health conditions although the National Academy of Science cannot find any scientific evidence of any links. Some individuals have sued their towns saying the water has made them sick, but to date, no federal or state court has found water fluoridation to be unlawful. Based on the 67 year history of water fluoridation, the debate will continue to find ways to continue. (During the “Red Scare” in the 1950s, right-wing activists claimed fluoridation was a communist plot to poison Americans.) Most English-speaking countries favor it: US, UK, Ireland, Canada, Australia, while continental Europe side-steps the issue (and costs) by adding fluoride to its table salt.