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Water Fluoridation History – How Fluoridation Started

Water fluoridation is a public health measure designed to reduce the amount of dental decay in populations.  In fact, the CDC has praised water fluoridation as one of the ten great public health achievements of the 20th century.

How water got to be fluoridated in a majority of the United States is an interesting story.  It all started over 100 years ago with a recent dental graduate in Colorado Springs, Colarado.

Water Fluoridation History

Brown, Stained, and Pitted Teeth

Upon graduating from dental school at the University of Pennsylvania, Frederick McKay moved to Colorado Springs, Colorado to practice dentistry in 1901.

He was immediately troubled by an interesting phenomenon — a lot of his patients had teeth with unsightly brown stains and pits.  In fact, he found that over 80% of the people in Colorado Springs had a defect with their enamel.

In 1905, McKay moved to St. Louis for three years.  He didn’t see one case of stained teeth there.  Upon returning to Colorado, he suspected that there was an environmental factor in play.  He had the drinking water tested in areas with the brown stain, but nothing turned up.

Frederick was puzzled.  He had no idea what was causing the brown teeth, but his curiosity led him to continue to search for an answer.

Frederick McKay Gets Some Publicity

Frederick Mckay noticed that the brown stains occurred without regard to sex, race, or the amount of money people had.  He also noticed that it was isolated to whole communities throughout the United States.

Mckay and Black Investigate Colorado Brown Stain in 1909A prominent dentist caught wind of McKay’s observations and came out to Colorado to write about them.  They even took a picture of themselves analyzing the teeth of a young Coloradan boy.  As you can see in the picture to the right, everybody seems to be thoroughly enjoying themselves!

As stated above, McKay suspected the culprit was something in the water, but since his initial tests didn’t turn up any significant clues, he was still without answers.  As a result, other theories as to the origin of the brown stains began to develop.  Some of the theories included a nutritional deficiency, too much iron, radiation exposure, and genetics.  One researcher even found an association between freckles and stained teeth.

Something In the Water

McKay could not let go of his suspicions that the water was the source of the brown stains.  The small town of Oakley, Idaho was one of the many towns that had an epidemic of brown stained teeth.  However, people living on the outskirts of Oakley who drank from a spring (a different water source than the rest of Oakley) had beautiful, pearly-white teeth without any of the brown staining.

McKay persuaded the town to change its water supply to the spring water.  To make a long story short, when McKay returned years later, he found that the children who had been born after the water supply switch had beautiful teeth that were  free from brown stains and pits!

To see before and after pictures of Oakley, Idaho children and for more information, read this article published in 1939 (PDF).

Naturally Fluoridated Water is Found All Over the World

It’s not just Colorado that has naturally fluoridated water.  Since then, research has found many areas in the world with naturally fluoridated water.

To find out which areas in the world have naturally fluoridated water, view this world map that shows naturally fluoridated water.

The Fluoride In the Water Made the Teeth More Resistant to Cavities

Right about now, you’re probably wondering what this has to do with teeth.  Don’t worry, that’s what we will discuss next!

Along with the brown staining, McKay also made other observations about the teeth of the people affected by the staining.

In 1916 McKay said, “Contrary to what may be expected [the brown staining] does not seem to increase the susceptibility of the teeth to decay.”

Then in 1925 McKay asked the question, “How do we explain the comparatively high immunity to decay of mottled enamel when its structural elements lie wrecked and disorganized?”

Finally, in 1928 McKay proclaimed that mottled teeth exhibit “a singular absence of decay.”  In other words, there were no cavities in the people with stained teeth.

People started thinking that if mottled teeth exhibit greater resistance to cavities, maybe if we got a small enough dose of whatever was in the water, it could protect us from cavities without making our teeth look too ugly.

After a lot of testing and numerous studies, it was eventually discovered that the fluoride in the water was what caused the brown, ugly teeth and also the resistance to cavities.

What Is the Optimal Fluoride Concentration In Water?

Throughout the 1930’s, researchers set out to find the “optimal fluoride concentration” in water that would both reduce the amount of cavities and minimize the cosmetic effects of enamel fluorosis.

A man by the name of H. Trendley Dean came up with a scale to record the severity of fluorosis.  After weighing the cons of fluorosis versus the pros of teeth more resistant to decay, the “optimal fluoride concentration” was deemed to be 1 ppm (part per million) of fluoride.

Curious about how much 1 PPM of fluoride really is?  Read the article How Much Fluoride is in a PPM?

The Idea to Add Fluoride to Water Supplies

Gerald J. Cox is the man who usually gets the credit for suggesting water fluoridation as a public health measure.  He was a biochemist from the University of Pittsburgh School of Dental Medicine.  In a published article, he stated that adding fluoride to the water supply would be the “most practical means of approaching the goal of sound teeth for all children.”

He also thought that adding fluoride to the water  should be less controversial than adding chloride to sanitize water.  Judging by the polarized fluoride debate that rages on today, I think it’s safe to say that he was wrong regarding that second assumption!

Artificial Water Fluoridation Begins in 1945

Artificial Water Fluoridation System
Artificial Water Fluoridation System in Minnesota in 1987

Grand Rapids, Michigan was selected as the first city to test artificial water fluoridation.  Muskegon, Michigan would be the control city.  That way, the researchers could evaluate whether or not water fluoridation was effective.

In January of 1945, fluoride was added to a public water supply in Grand Rapids for the first time.  The initial trials showed an improvement in oral health.  After that, cities across the nation were clamoring to get fluoride in their water supplies.

Since then, the number of people receiving artificially fluoridated water has steadily increased.  As of 2008, nearly 200 million United States citizens were receiving fluoridated water.  Here’s a map that shows the increase in water fluoridation between 1992 and 2006.


To read a much more detailed history of water fluoridation, check out the book The Fluoride Wars.  It is the most balanced book I’ve read yet on the topic; although you wouldn’t think it’s balanced by reading the reviews from the many anti-fluoridationists!

What do you think about water fluoridation?  Let us all know by leaving a comment below.  Thanks for reading!



  1. I just lost a great friend to colon cancer at 49yrs of age. My mom has it as well as another 40 year old friend. If flouride is so great for the few milliseconds that it crosses the teeth, what does it do while it settles in our organs? kidneys, liver, bowls, etc.

    We are spending billions on toothpaste and brush and swallow two,three times a day. Isn’t this enough?

    There is flouride in our waters at present – Why do we need more?

    I am against government medicating the public. What next? Vaccines in our water?


    • Hi Mary – I am really sorry to hear about your friends and mother. Fortunately, over 50 studies have been carried out to determine if fluoride causes cancer and no evidence was ever found.

      In all honesty, if you are brushing 2-3 times per day and eating a good diet, then fluoridated water probably isn’t helping you at all.

      Thank you for pointing out the “slippery slope” that we get ourselves onto when we start adding anything to the water. Where should the line be drawn? Thanks for your comment, Mary!

      • Tom,
        Hey…I hope you don’t use Mercury in your amalgams, even though the ADA still endorses the concept despite the scientific finding concerning such materials (off gassing, your health & hygienists health).

        There’s no scientific peer reviewed study that shows any benefits of ingesting fluoride, yet it’s put in our City Municipalities….actually, the later is found and it causes Harm to the body.

        Proper dental health starts with nutrition, look to the Indians or Aboriginals. No tooth brush, no dental floss, no tooth paste, no cavities.

        Research a Dr. Weston Price, implement his techniques in your practice. The bottom line will not be as rich, but your patients teeth & health will benefit far beyond any monetary gain you could have make. The ADA was given full disclosure of Price’s work, but forgotten.

        Realize as well Tom, over 90% of the Peer Reviewed Journals are owned by just 6 Corporations. No different than our MSM & Major papers. The Scientific Method has been having a very hard time being Scientific for quit some time & even more so these days. Food for thought if you think for yourself.

  2. No mention was made that socio-economic factors were actually accounted for.

    “Frederick Mckay noticed that the brown stains occurred without regard to sex, race, or the amount of money people had.”

    Only the rich could afford dental treatment in those days.
    Also, nutrition would play a role in tooth decay as well as whatever other minerals may have been in the water that may have contributed to holding the teeth together: these are not detailed.

    It can certainly be stated that since the structure was affected, as reported, the teeth would eventually break down as has been observed time and time again in many animal studies.

    In the same way, after 20 to 30 years of exposure to fluoridated water, in spite of all other factors, teeth begin to crack and break because they are too crystalline after continued re-mineralization to hold together and they begin to wear down to the point where people become edentulous.

    Otherwise, fluoridation would be the panacea it is touted to be.

    If fluoridation really worked as the claims say it does, then tooth decay should have long ago been eradicated where it has been practiced for over 25 years, yet look at the rate of toothlessness prevalent where fluoridation has a long standing and nearly ubiquitous history:

    Verifiable and indisputable examples:
    The following states have high fluoridation rates yet still have among the highest
    tooth loss rates – above the U.S. national average (median 18.4%):
    92% fluoridated West Virginia 37.8 toothless
    94% fluoridated Tennessee 31.5% toothless
    80% fluoridated Missouri 26.2 toothless
    83% fluoridated Alabama 26.0 toothless
    100% fluoridated Kentucky 23.7 toothless
    96% fluoridated Georgia 23.1 toothless
    95% fluoridated South Carolina 22.7% toothless
    80% fluoridated Georgia 21.9 toothless
    95% fluoridated Indiana 21.7 toothless
    88% fluoridated North Carolina 21.3 toothless
    89% fluoridated Ohio 20.8 toothless
    96% fluoridated North Dakota 20.1% toothless

    Compare the above rates of toothlessness to Hawaii which is 8% fluoridated- 9.6% tooth loss.

    • Why is Georgia listed twice and with different percentages?

      Another question, what is the percentage of the poor and under educated in all of these states? Fluoride in the water still doesn’t make up for lack of brushing and flossing. Periodontal disease is the #1 cause of tooth LOSS and can only be prevented by properly maintaining oral health.

      If you look at the main source of income for these above states, you’ll likely find jobs like coal mining or other manual labor occupations which don’t require high education. Other than education level, look at poverty level and diet.

      These percentages don’t exactly include all factors that contribute to toothlessness.

  3. The more fluoride, the more sugar you can eat. Us humans always think that we can make things better than what nature gave us on a silver platter.

  4. Benefits from fluoridation are just another medical myth the way cigarette smoking was once touted by doctors paid for endorsements. It’s a battle between the ADA and common sense, driven by fear mongering from their highly paid shills on Madison Ave. Unfortunately though, there are casualties and dentists are all too eager to profit from others misery.

  5. After the second world war there was an abundance of flouride due to the manufacture of aircraft. What better way to dispose of it than strain it out through our kidneys. Thus the push was on to fluoradate our water supplies.


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