Health Info Publications Clinical Trials Data & Statistics Finding Dental Care The Story of Fluoridation NIDCR dentists examined these Grand Rapids schoolchildren once a year to document the effects of fluoridation It started as an observation, that soon took the shape of an idea. It ended, five decades later, as a scientific revolution that shot dentistry into the forefront of preventive medicine. This is the story of how dental science discovered-and ultimately proved to the world-that fluoride, a mineral found in rocks and soil, prevents tooth decay. Although dental caries remains a public health worry, it is no longer the unbridled problem it once was, thanks to fluoride.A Mysterious Disorder Dr. Frederick McKay (right) and Dr. Green Vardiman Black (left) Fluoride research had its beginnings in 1901, when a young dental school graduate named Frederick McKay left the East Coast to open a dental practice in Colorado Springs, Colorado. When he arrived, McKay was astounded to find scores of Colorado Springs natives with grotesque brown stains on their teeth. So severe could these permanent stains be, in fact, sometimes entire teeth were splotched the color of chocolate candy. McKay searched in vain for information on this bizarre disorder. He found no mention of the brown-stained teeth in any of the dental literature of the day. Local residents blamed the problem on any number of strange factors, such as eating too much pork, consuming inferior milk, and drinking calcium-rich water. Thus, McKay took up the gauntlet and initiated research into the disorder himself. His first epidemiological investigations were scuttled by a lack of interest among most area dentists. But McKay persevered and ultimately interested local practitioners in the problem, which was known as Colorado Brown Stain.A Fruitful CollaborationMcKay's first big break came in 1909, when renowned dental researcher Dr. G.V. Black agreed to come to Colorado Springs and collaborate with him on the mysterious ailment. Black, who had previously scoffed that it was impossible such a disorder could go unreported in the dental literature, was lured West shortly after the Colorado Springs Dental Society conducted a study showing that almost 90 percent of the city's locally born children had signs of the brown stains. When Black arrived in the city, he too was shocked by the prevalence of Colorado Brown Stain in the mouths of native-born residents. He would write later:"I spent considerable time walking on the streets, noticing the children in their play, attracting their attention and talking with them about their games, etc., for the purpose of studying the general effect of the deformity. I found it prominent in every group of children. One does not have to search for it, for it is continually forcing itself on the attention of the stranger by its persistent prominence. This is much more than a deformity of childhood. If it were only that, it would be of less consequence, but it is a deformity for life."Black investigated fluorosis for six years, until his death in 1915. During that period, he and McKay made two crucial discoveries. First, they showed that mottled enamel (as Black referred to the condition) resulted from developmental imperfections in children's teeth. This finding meant that city residents whose permanent teeth had calcified without developing the stains did not risk having their teeth turn brown; young children waiting for their secondary set of teeth to erupt, however, were at high risk. Second, they found that teeth afflicted by Colorado Brown Stain were surprisingly and inexplicably resistant to decay. The two researchers were still a long way from determining the cause of Colorado Brown Stain, but McKay had a theory tucked away in the back of his head. Maybe there was, as some local residents suggested, an ingredient in the water supply that mottled the teeth? Black was skeptical; McKay, though, was intrigued by this theory's prospects.The water-causation theory got a gigantic boost in 1923. That year, McKay trekked across the Rocky Mountains to Oakley, Idaho to meet with parents who had noticed peculiar brown stains on their children's teeth. The parents told McKay that the stains began appearing shortly after Oakley constructed a communal water pipeline to a warm spring five miles away. McKay analyzed the water, but found nothing suspicious in it. Nonetheless, he advised town leaders to abandon the pipeline altogether and use another nearby spring as a water source.McKay's advice did the trick. Within a few years, the younger children of Oakley were sprouting healthy secondary teeth without any mottling. McKay now had his confirmation, but he still had no idea what could be wrong with the water in Oakley, Colorado Springs, and other afflicted areas. The answer came when McKay and Dr. Grover Kempf of the United States Public Health Service (PHS) traveled to Bauxite, Arkansas-a company town owned by the Aluminum Company of Amer...