Flyer used by opponents to water fluoridation in Seattle 1952

If you’re of a certain age, you probably remember the fluoridated water controversy of the 1950s and early 1960s. I’m old enough to remember it and the other day I came across a brief discussion of the controversy in the book I was reading which whetted my appetite to see how accurate my memory of the issue was. What I found, I think, is that my memory of the controversy was only partially correct and incomplete. I thought I’d write about here at Ricochet because the actual story is 1) more interesting than the cartoon version I remembered, 2) I believe the story has been somewhat mythologized and distorted, and 3) the fluoridated water wars continued long after the early 1960’s and to a certain extent still exists.

Before I start, let me provide links to wikipedia articles for water fluoridation and for the fluoridated water controversy for your reference.

Initial Studies and Investigations

How did the idea of adding fluoride to our drinking water start? The genesis for this started in 1901 when a young dentist, Dr. Frederick McKay (1874-1959) opened his dental practice in Colorado Springs, CO and noticed that many of his patients had permanently stained teeth – a condition known locally as “Colorado Stain.” This began a 30-year search on his part to find the cause for this condition. By 1916, he’d come to the conclusion that “something in the drinking water” was the agent, and he had long ago realized that those with the mottled teeth displayed “a singular absence of decay.” Eventually, his search led him to Bauxite, AR where he found that people born after 1909, when the town had changed its’ water source, had badly mottled or stained teeth while those born earlier did not thus confirming his hypothesis regarding drinking water. He published his findings in 1931, which led H. V Churchill, the chief chemist of ALCOA (which had a large plant in Bauxite) to investigate and test the local water and discover that it contained elevated levels of fluorine (13.7 ppm). H. Trendley Dean, a research scientist with The U. S. Public Health Service (USPHS) would see if he could confirm these findings – he would test drinking water sources across the country and determine that at fluoride levels above 1 ppm (1 mg per liter) the mottling would start and children drinking such water had lower rates of dental caries (tooth decay).

Dentist Frederick McKay and a young patient 1952

At this point, the USPHS decided to have a test program for the addition of sodium fluoride to the drinking water for Grand Rapids, MI using the nearby town of Muskegon as a control all with the blessings of the local officials. The test program began in 1945 in Grand Rapids with additional test cities (each with their own control city) following shortly thereafter in Newbourg, NY, Sheboygan, WI and Marshall, TX. The plan by the USPHS was for the tests to run for 10 to 15 years and, if the results were satisfactory, to pursue a fluoridation project on a nationwide basis. This deliberate wait and see process would be derailed when several Wisconsin dentists became aware of the test program and began touting the benefits of fluoridated drinking water throughout their portion of the country. Thus in the late 1940s and early 1950s a number of cities began adding fluoride to their water supply and shortly thereafter a backlash would ensue.

The Great Fluoridated Water Wars of the 1950s and Early 1960s

By the early 1950s both the USPHS and the American Dental Association endorsed the use of fluoride in water supplies as a safe, effective and inexpensive procedure. In 1951, two councils of the American Medical Association (Pharmacy and Chemistry, and Food and Nutrition) issued a joint statement declaring that there was no evidence of toxicity in adding fluoride to drinking water. A committee of the National Research Council (known today as National Academies of Sciences, Engineering and Medicine) came to the same conclusion. Despite this, there was extensive resistance to the idea by the public. This seems unique and incredible to me. These organizations and professions were at the time and are still today given great respect and deference by the public. Yet, that was surely was the not the case with fluoridated water. And, the fact that the chief beneficiaries of this proposed practice were to be children only adds to the uniqueness of the opposition. This would be a red-hot and on-going issue throughout the rest of the 1950’s and into the 1960’s.

Let me start by providing a few statistics. From 1950-1966 there were a total of 994 referenda in American cities and locales with only 41% passing and 59% failing water fluoridation proposals. In the same time span, sixty-six water supply systems for which fluoridation had been approved or passed were subsequently halted although in twenty-six of these, fluoridation was subsequently reinstituted. See the table below.

Local Fluoridation Referenda 1950-1966

Year Tot Yea Nay Pct Y

1950 01. 00.. 01.. 00.0

1951 11. 08.. 03.. 72.7

1952 51. 23.. 28.. 45.1

1953 63. 28.. 35.. 44.4

1954 106. 47.. 59.. 44.3

1955 60. 19.. 41.. 32.7

1956 96. 37.. 59.. 38.5

1957 54. 18.. 36.. 33.3

1958 68. 20.. 48.. 29.4

1959 47. 22 ..25.. 46.8

1960 67. 25.. 42.. 37.3

1961 59. 20.. 39.. 33.9

1962 48. 20.. 28.. 41.7

1963 61. 27.. 34.. 44.3

1964 101. 36.. 65.. 35.6

1965 50. 28.. 20.. 56.0

1966 51. 25.. 26.. 49.0

The question becomes: why? Why was there such resistance for water fluoridation? Well, I don’t really know the answer to that question. Many reasons were presented by opponents to fluoridation, some of which were reasonable or plausible to some extent and others of which were fantastic and downright silly. It is not clear to me that the locales that rejected fluoridation did so for the same or any one issue. Many arguments were made against fluoride. One was just the basic fact that a chemical was being added to the water supply regardless of its’ efficacy. A fact that attracted support for the antis was that sodium fluoride in large doses was employed in rat and insect poison. Many people had a difficult time making sense of how a compound used in such poison could be added to the water supply without posing a health risk. Also the argument was made that adding fluoride to the public water supply was an imposition on personal freedom. After all, it wasn’t required to provide a safe drinking water; rather, it was being added to improve the water beyond that level such that it would aid the consumer’s dental health – shouldn’t this be left to the discretion of each citizen? Especially since there were other ways available to get fluoride to assist in dental health. Another argument against water fluoridation was that it was a wasteful expense since the majority of the treated water will not be ingested by people and again there are other ways available to get fluoride.

Anti-fluoridation flier 1955

One thing the opponents of fluoridation looked to do was add credentialed people to make arguments for their side. And some physicians, dentists, and scientists were opposed to fluoridation. One of those was Dr. Alfred Taylor, a University of Texas biochemist who tested fluoridated water on lab rats and announced in 1950 that the rats who drank the fluoridated water developed cancer earlier than those who had not. When these results were announced USPHS’s Dean went to investigate the study. What he found was the rats had been fed Purina Chow that contained 42 ppm of fluoride (recall that human consumption would be limited to 1 ppm). The test was invalid but the damage had been done. This study and the idea that there was a connection between fluoridated water and cancer would be cited by opponents for the foreseeable future. Another confederate was Dr. George L. Wallbott, a Detroit allergist, who made regular pronouncements tying fluoride to a variety of ailments and allergies. Also, for some reason, chiropractors were some of the most steadfast opponents of fluoridation. The International Chiropractic Association announced their opposition to fluoridation and sent out anti-fluoridation data to any and all wishing it, although what authority they possessed to make any proclamations on the subject is difficult to discern.

The most outlandish of the anti-fluoride arguments may have been that adding it to the public water supplies would somehow lead to radioactive contamination of said water supply. Then again, maybe the most outlandish claim was the fluoridation was a communist plot to kill or weaken Americans. This anti-fluoride argument was most famously parodied in the 1964 movie Dr. Strangelove.

I mentioned earlier that my memory of the water fluoridation controversy was that the opponents were cartoonish. I suppose the Dr. Strangelove clip is most in line with that viewpoint, that being that the opponents consisted mainly of country bumpkins of various sorts and mostly right-wing in their political outlook. And while there were anti-communists (especially among the John Birchers) and right-wingers among and prominent in the antis, I don’t think their opposition was why there was so much opposition on this issue, and there simply weren’t enough of them to carry the day in so many elections. No, I think people of all political proclivities and social backgrounds were necessary for the success of the antis. Whether or not this was so, much elite opinion thought so. Scientific American presented an argument in their February 1955 issue by Bernard and Judith Mausner that the difficulties being experienced by fluoridation proponents were due to an increasing anti-intellectualism and a rejection of science. They came to their conclusion based on interviews with the citizens of Northampton, MA who had just rejected water fluoridation by a 2-1 margin. They noted that the citizens of Northampton had made their decision even though the 10-year tests of Grand Rapids and Newbrough had been completed with favorable results.

My memory was also incomplete. Somehow I was under the impression that the issue had resolved itself sometime in the mid 1960s; but, that is not so. Resistance to fluoridation continued although at a greatly reduced temperature.

After the 1960s

Although there was still significant resistance to fluoridation after the 1960s, the public fluoridation process was slowly gaining despite all of the electoral setbacks. In 1951, more than 360 communities had adopted the process; this increased to more than 1,000 with a population of 17.7 million by 1953; more than 2,000 with a population of 41.2 million by 1960; and more than 4,000 with a total population of 74.6 million by 1968. The Center for Disease Control (CDC) estimated that approximately 130 million Americans or 60.5% of the population consumed fluoridated water as of 1988. The most recent CDC statistics indicate that approximately 75% of Americans consume fluoridated water. I should also note that the fluoridation statistics understate to some extent the number of people receiving fluoridated water since some source waters have fluoride levels above the required levels and so do not need to add fluoride.

That said there was still opposition to the program and those people and places varied from the 1950s antics. The people now in opposition tend to be left of center – radical environmentalists, health food advocates especially of the more exotic type as well as some of the same types from the earlier era – chiropractors and quack scientists. Take for example Los Angeles. In 1974, the LA City Council voted to fluoridate the water. In 1975, the citizens of Los Angeles were able to get a referendum on the ballot to override the council vote. To aid in their effort they enlisted the new go-to scientist for the anti-fluoride crowd – John Yiamouyiannis, a University of Texas biochemist who was a triple-threat quack ( he was also opposed to polio vaccination and milk pasteurization) who gave speech after speech alleging a link between fluoride and cancer. The anti-people easily repealed the previous year’s City Council vote 213,573 to 166, 549. The city of Los Angeles did not get fluoridated water until over twenty years later in large part to comply with a 1995 California law (AB 733) as per this timeline prepared by the Los Angeles Department of Public Health. Well, at least they beat San Diego which did provide water fluoridation until 2011.

Another location that fought a rear-guard action against water fluoridation is that den of right-wingers otherwise known as Santa Cruz. This article from the SF Gate mocks their defeat of a 1999 water fluoridation measure.

In a situation similar to that of LA in the mid-1970s, Portland, OR citizens overrode their city council on the question of water fluoridation in 2013 in a romp 60%-40%. Portlandia and San Jose, CA (another city full of the woke) are the two largest cities still resisting the communist plot to sap our strength with fluoridated water.

Summary

It’s time to wrap this up. Let me first provide two charts and two more links. This first link is to the CDC webpage regarding water fluoridation, while the second link is to a Chemical & Engineering News article reviewing the various scientific controversies associated with the fluoridation of public water supplies. Now, the two charts.

Fluoridation Growth in the United States 1940-2012

Finally, just for the record, I should note that I’m fine with water fluoridation. If it ever came up for a vote in my neck of the woods I’d vote for it without hesitation. That said, after studying this issue, the battles over the issue, especially in the early years but also currently strike me to a certain extent as much ado about nothing. The stakes were and are nowhere near as cataclysmic as the remaining opponents stridently claim and although the CDC and the ADA are right about the benefits (and risks) of water fluoridation, the people living in those places that do not provide public water with sufficient fluoride have not and will not be doomed to a life of dental misery.