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Gains and Setbacks 1" GAINS AND SETBACKS Community experiences on efforts for acceptance of water fluoridation Committee to Protect Our Children's Teeth, Inc. 105 East 22nd Street, New York 10, New York COMMI'ITEE TO PROTECT OUR CIDLDREN'S TEETH, INC. 105 EAST 22ND STREET NEW YORK10, N. Y. CHAIRMAN Benjamin Spock, M.D. VICE CHAIRMEN Mrs. Mary W • Lasker Thomas Parran, M. D. Basi I O'Connor W • P • She pa rd, M • D • PRESIDENT Duncan W. Clark, M. D. VICE PRESIDENTS W i Ison G • Smi 11i e, M • D. C. Raymond Wells, D.D.S. SECRETARY TREASURER ASSISTANT TREASURER Winslow Carlton Robert W. Dowling Samuel L. Steinwurtzel OTJIER MEMBERS OF BOARD Leona Baumgartner, M. D. Merri s I ushew i tz Gordon Brown Joseph D. Mc Goldrick Arthur BusheI, D. D.S. Joseph J. Obst, D. D.S. Howard Reid Craig, M. D. George Reader, M. D. ~133 CONTENTS (2nd edition, November, 1958) lntroducti on Duncan W. Clark, M. D., President Committee to Protect Our Children's Teeth, Inc. I. Victories l. Progress through December, 1956 Public Health Reports 2. San Francisco; California, 1951 J . J o Wei ne r Co . 3. Baltimore, Maryland, 1952 H. Berton McCauley, D. D.S. 4. Milwaukee, Wisconsin, 1953 E. R. Krumbiegl, M.D. 5. St. Louis, Missouri, 1955 Mayor R. R. Tucker 6. Torrington, Connecticut, 1953-54 Harold Singer, DoD.S. 7. Philadelphia, Pennsylvania, 1954 James P. Dixon, M. D. 8. Chicago, Illinois, 1956 E o R. Me Ian i phy, Esq., 9. Hastings, New Zea Iand, 1954 Dr. C. N. Derek Taylor 10. Anglesey, England, 1954-55 Dr. Wynne Griffith lL Orlando, Florida, 1955 Florida State Board of Health 12. Atlantic City, New Jersey, 1956 Harry Saul, D.DoS. 13. Oroville, California, 1956 -------Editor & Publisher 14. Peoria, Illinois, 1956 Fred Long, M . D o 15. Green Bay, Wisconsin, 1957 J. M. Rose 16. Summary of Court Action 17. New Canaan, Connecticut, 1958 Wi I liam Attwood W. Harry Siemon, D.D.So 18. Concord, New Hampshire, 1958 Concord Monitor 11. Setbacks and De lays 1. Seattle, Washington, 1952 San ford Lehman, M. D . Barbara L. Kahn, M. P.H. 2. Williamstown, Massachusetts, 1953 John Ao Hutchison 3. Northampton, Massachusetts, 1953 Bernard & Judi th Mausner 4. Cincinnati, Ohio, 1953 Al Schottelkotte 5. San Diego, California, 1954 J • B . Askew, M. D . 6. Newark, New Jersey, 1956 Newark Star-Ledger 7. Long Beach, California, 1958 Douglas W. Stephens, D.D.S. 111. Discussion L How Communities Win Herbert Bain 2. Referenda for Fluoridation Professor Charles A. Metzner 3. Motivation and Health Education Homer N. Calver 4. Community Aid in Obtaining Fluoridation Pennsylvania Department of Health 5. Community Organization for Fluoridation California State Department of Health 6. Advice from Palo Alto, California California State Department of Health 7. Community Organization for Fluoridation of Public Water Supplies Maine Department of Health IV. Where to Get Materials INTRODUCTION This guide is released at a time when the issue of fluoridation of community water supplies has become a matter of national concern. The wisdom of proceeding with a health measure which has been proved beyond reasonable doubt to be safe and effective is contested in many communities throughout the nation. Many failures of public understanding and action have been experienced. From failure and from success, lessons are available for the learning and for this reason representative community experiences are presented. Through this opportunity for knowing something of the actions and methods of the opponents of fluoridation, the behavior of some persons and groups in your community may be anticipated. More important, through examination of localities where favorable action has been taken, the key to public and official education and understanding may be recog­ nized and used. Fluoridation is of national concern, on the basis of more than simply widespread geographic distribution of the debate. Medicine, dentistry, public health and engineering have overwhelmingly supported the practice of fluoridation on evidence within their competence to judge. But there is by virtue of the attack upon the integrity and authority of these profes­ sions the quite serious fact of a faith at risk which has long known public trust. When to this is added an identical attack upon officially constituted health bodies the situation borders on the absurd. The health of children is not the least reason why this is a matter of national as well as local concern. Three out of four American children fail to receive this valuable trace element in amounts sufficient for the normal development of healthy teeth resistant to decay. This failure can be ascribed to public and official apathy, inadequate community planning, and an opposition answered in the record but unanswered as far as the public understands. To the correction of such failure, this guide has been organized for the use of community lay and professional leaders in this effort toward the public health. DUNCAN W. CLARK, M.D. President Committee to Protect Our Children's Teeth, Inc. U. S. DEPARTMENTOFHEALTH, EDUCATION , ANDWELFARE Fr011Public Health Report• Public Health Service This second summa ry of the status of fluoridation includes the numbe r of commun ities adding fluorides to their water suppl ies, the num ber of water supply systems, the population served, and the percentage of towns in each popu lation category using this public health measure. Status of Controlle d Fluoridation in the United States, 1945-56 URING 1!)56 fluoride was added for the By the end of 1956 nearly 1,500 communities D first time to the drinking water of more with 31,500,000 people fluoridated their water . than 6,500,000people (table 1). This is nearly It has been estimated that about 110,000,000 twice the number of people who started drink­ people in the United States are served by com­ ing fluoridated water in 1955. The 1956 in­ munity water supply systems. At the present crease was exceeded only in 1952 when 8,600,000 time about 1 in every 4 of these peop le are people sta rted drinking :fluoridated water. drinking water with adjusted fluoride content . In 1956, 213 communities started :fluoridat­ I t seems apparent that the number of pe.ople ing their drinking water, a larger number using water with a contro lled fluoride content than in each of the pr eceding 2 years. Th e will contin ue to increa se at a substantial rate. number of water supp ly systems which these The year 1956 was the 12th year in which the communities represent was slightly fewer than the nurpber starting fluoridation in 1!)55 (92 practice of adding fluoride to the drinking compared with 96). water in optimal amounts has been practiced During the year, 12 water supply systems, as a cari es contro l measure. The proc edure was representing 16 communities and serving a pop­ sta rt ed in a few study communities in 1945. ulation of 185,000, discont inued fluoridation. More stucly communities were added in 1946 Four water supp ly systems, repr esenting an equal number of communities and serving Figure 1 . Population drinking water with ad­ 38,000 people, rein stituted the . practic e after justed fluoride content, 1949-56 . discontinuance. Although the annua l rate of increase in the number of water supp lies instituting fluorida ,­ tion remained about the same during the last 1/) t525 3 year s, there was a declb1e in the rate at which ·::; ~ water supplies discontinued fluoridation. · In :E 20 1954, 20 systems discontinued this public health measure. In 1956, 12 water systems stopped 15 fluoridating. Two systems reinstituted fluori ­ dation in 1954, four in 1956. 10 Prepared by the Division of Dental Public Health, Bureau of State Services, Public Health Service. 1~49 1950 1951 1952 1953 19!>4 1955 1956 464 Publi c Health Repor ts and 1947. By 1949 and 1950 a small number A.s adoption of the procedure gathered mo­ of places, convinced of the benefits to be de­ mentum, the number of people drinking fluori­ rived from fluoridation, instituted the measure dated water increased from about 1.6 million as a regu lar practice . Late in 1950 published in 1950 to 5 million in 1951, 13.6 million in 1952, reports confirmed the anticipated reduced in­ 17 million in 1953, 21 million in 1954, 24.8 mil­ cidence of denta l decay resulting from the addi­ lion in 1955, and finally reached 31.4 mill ion tion of fluoride to drinking water, and nationa l last year ( fig. 1). professiona l organizations endorsed the pro­ During the entire 12-year period,· 80 com­ cedure. As a result, 109 communities in 1951 munities, which at one time served fluoridated and 182 in 1952 decided to bring this health water to 1,900,000people, discontinued the pro­ measure to their people, and the trend in reduc ­ cedur e. Of these, 10 communities, serving 223,- tion of tooth decay by an observed two-third s 000 people, reinstated the practice ( tab le 2) . was well under way. According to the 1950 Census of Population, Table 1. Annua l cumulat ive finding s on the institution, discontinuanc e, and rei nstitution of controlled fluoridation show ing numbe r of communities , wa ter supply systems , and population served,1 1945-56 F luoridation status at end of Fluoridation institut ed whether or each year not discontinued Year N wnb er N umbe r Number Number of com- of water Populn- of com- of wate r Popu la- munitie s supply tion munities supply t ion syste ms systems 1945_ _________________________ 1946__ ________________________ 6 3 231,920 6 3 231,920 1947_______ ___________________ 12 8 332,467 12 8 332,467 1948___ _______________________ 16 11 458, 748 16 11 458,748 1949_
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