How I Feel about Fluoridation

Benjamin Spock, M.D.
June 1980

You might guess that I would be opposed to fluoridation of the water supply (to prevent tooth decay) on several counts. I've been against pollution of the diet of children and adults with extra sugar and salt, and with additives and preservatives. I've always disagreed with those health professionals who assumed, without solid proof, that they knew more than Nature—when, for example, some physicians used to prescribe tonsillectomy on a wholesale basis or tried to change growth patterns of normally short or tall children by means of growth hormones. I'm also against imposing regulations on people in an arbitrary and undemocratic manner.

The fact is that I started out as somewhat skeptical and cautious about fluoridation in the 1940's and early 1950's. But then I became a firm believer as proof was assembled by scientists in the 1950's and afterwards that fluoridation of a water supply will reduce the production of tooth cavities (our most prevalent disease) by 60%, and, just as important, that no disease or defect is caused by this procedure. What particularly allayed my early doubts about adding a chemical to public water supplies was learning that fluoride has always occurred naturally in water supplies—in concentrations from several parts per million in some regions of the southwest to a mere twentieth of a part per million in the northeast. Obviously, it is a natural, though varying, ingredient of water. Because of this, any long-term bad effect could be—and was—searched for in those people who had drunk water with a moderate or high concentration all their lives.

In the late 1950s and the early 1960s, I was chairman of a national committee to educate the public and public officials about the value and safety of fluoridation. As such I received hundreds of letters, some politely explaining that I was mistaken, others abusing me as intentionally evil. (One was an indignant letter from one of my sisters, a vigorous environmentalist and organic farmer.) But I've also received favorable mail, and awards from two national dental associations, so it wasn't all painful. My book Baby and Child Care has advocated fluoridation since the 1950s.

The many endorsements of fluoridation by professional organizations are certainly impressive. After careful review of all scientific evidence, including claims of opponents, fluoridation has been recommended as safe and effective by the American Dental Association, the American Medical Association, the American Public Health Association, the American Academy of Pediatrics, the National Institute of Dental Research (an arm of the U.S. Department of Health, Education and Welfare), the Royal Society of Physicians in Great Britain , and the World Health Organization. In fact, no major health organization or recognized scientific body has ever differed with these conclusions.

The story of how fluoridation's value was discovered is not only fascinating, but should also be reassuring to some doubters since it reveals that the early researchers had no bias, no axe to grind. They were simply looking for answers to certain dental problems. Dr. Frederick S. McKay, a practicing dentist in Colorado with an extraordinary curiosity and dedication to human betterment, spent the first 30 years of this century tracking down the cause of a certain type of tooth stain which has always been prevalent in Colorado and several southwestern states. He first found, strangely enough, that this staining occurred in people whose teeth had a high resistance to decay. He finally discovered, in 1931, that the staining and resistance to decay were both due to the high concentration of fluoride which occurred naturally in that region.

Then Dr. H. Trendley Dean and a team from the U.S. Public Health Service spent 10 years evaluating the dental health of 7,000 children in 4 southwestern states with moderate to high concentrations of naturally occurring fluoride to find what concentration gave the best protection without staining. They found it to be one part fluoride in a million parts of water.

A crucial test was begun in 1945 in Newburgh, New York, to see whether deliberate addition of fluoride to a water supply which had very little natural fluoride would provide the same benefit. Over a 10-year period, the children of Newburgh developed nearly 60% fewer cavities than the children of the comparable city of Kingston, where the water was not fluoridated. Since then, thousands of studies of the effectiveness and safety of fluoridation have been made with consistent results.

The natural occurrence of moderate to high concentrations of fluoride in certain regions has made it possible for scientists to search without delay for possible bad effects by carefully comparing rates for such diseases as cancer, heart disease, birth defects and allergies in regions with high, medium and low concentrations of fluoride. All studies have agreed: the only adverse effect is staining of the teeth when the fluoride concentration is several times as high as that recommended for artificial fluoridation.

You've probably heard the accusations against fluoridation—that it is a poison; that it may cause cancer, heart disease, birth defects, allergies and other diseases; that its use in a public water supply is an invasion of people's constitutional rights unless they consent. Other, wilder, claims are that it is a communist plot to weaken our country (even though the Soviet Union uses fluoridation), or that it is simply a money-making scheme of the aluminum companies who produce the fluoride as a by-product. All adverse claims and accusations which had the slightest plausibility have been scrupulously investigated by scientists and government officials and have been found to be baseless. But nothing seems to keep the more determined opponents from repeating old accusations and making new ones.

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Dr. Spock, who retired from his pediatric practice in 1967, was best known for his authorship of Baby and Child Care, which sold 28 million copies between 1946 and 1980. This article was excerpted from the foreword to The Tooth Robbers: A Pro-Fluoridation Handbook, edited by Stephen Barrett, M.D., and Sheldon Rovin, D.D.S, and published in 1980 by the George F. Stickley Co. of Philadelphia.

This article was posted on December 10, 1996.

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