A once-practising dentist of almost sixty years’ standing and living in the Northwest since 1960, one of my earliest, pre-fluoridation experiences was as a student at the United Dental Hospital in Sydney.
The mission: to carry out treatment for a young, migrant boy by attempting to reduce the rapid rate of his rampant caries. After he received cleaning, oral hygiene instruction and dietary advice, his teeth were painted with silver nitrate and peroxide from which the teeth emerged coated with a black slime.
This had been continuing for several weeks with little if any improvement of the condition, and since no fluoride products were available at the time it was quite depressing for all involved. Sensing this, young Con offered me a roll of “Lifesavers” (It’s not for nothing that they became known as the “candy with the hole”!). When he saw how shocked I was, but still not making the connection between sugar and tooth decay, Con proudly announced that they had a lot more boxes at home!
In final year we students were able to trial the effect of imported American stannous (tin) fluoride toothpaste by testing the acidity of saliva generated by chewing paraffin wax before and after cleaning with the new material. There was certainly much less decay…but the teeth stained easily!
In those days one could be quite envious of those American dentists who practised in naturally fluoridated areas, because low decay rates are so easily managed…yet even before fluoridation of water supplies. Gunnedah with its low level of natural fluoride had relatively low caries rates, provided the home-care was adequate. My own children, growing up with F-tabs in tank-water, experienced very little decay…but a small degree of white flecking – undesirable but might it have been partly due to some additional fluoride from foods grown in fluoridated areas?
I noticed also that patients from non-fluoridated Barraba with its rather unpalatable town water suffered higher decay rates than Gunnedah – where several moves to increase concentration from 0.3parts per million to 1ppm had been abandoned on account of the multiple points of application that would render the accurate monitoring of dosages more difficult. On the other hand, fluoridated patients from Manilla (first fluoridated town in NSW) and Tamworth did not show a strikingly greater reduction in caries exposure compared to ours, with Boggabri’s caries rate in between.
I put this positive advantage for the Gunnedah population, many who claim not to be partakers of the local piped water product, to relate partly to the existing fluoride levels but possibly it is in part subconsciously driven by our attitudes of town pride in our readiness to pursue civic improvements.
This I witnessed initially in the universal kerbing and guttering that made Gunnedah the envy of smaller (and larger, like Moree) places. There is also our enthusiasm for health initiatives such as the currently-reviving Rural Health Centre, the multiple fitness establishments (for one, the very first Australian branch), plus a wide range of ancillary health services and choices for retirement accommodation and care…on top of excellent facilities every sport short of snow-skiing, all pointing to self-help values, actively seeking health in preference to fatalistic acceptance of infirmity.
Now to my belief, the fluoride story has advanced since those good old days related above! We know that the Fluoride ion of the most reactive of all the elements, is itself the protective element, because upon contact with a tooth, it is instantly absorbed. Only a minute particle, less than five millimetres of concentrated paste is necessary, provided it is thoroughly applied at gum level – the brush to stimulate the support structures…but without excessive force to cause wear of the hard tissues (enamel, dentine and cementum), thus avoiding sensitivity. Such technique will form an outer protective shell that shields each tooth by holding salivary acidity at bay… while re-depositing any partly dissolved tooth structure – thus preventing it from escaping into the saliva. It is also important that the fluoride is not swallowed because the benefits end on the tooth surface and it is no longer believed that teeth are only adequately shielded if formed through and through with fluoride. Our bodies certainly do not benefit from a fluoride build-up to engender hard, but brittle bones!
Here comes the controversial conclusion!
If only minute quantities of not even highly concentrated fluoride, constantly maintained, produce maximum resistance to tooth decay, why have Fluoride in the drinking water at all?
And, why risk fluoride-embrittled bones by eating vegetables grown in fluoridated water or by consuming meats from animals drinking fluoridated water?
The original argument for mass fluoridation was to help the disadvantaged proportion of the population who could not afford dental treatment. The disadvantaged do not want brittle bones either! But even though prevention is still being better than cure, fluoridation will not cover for neglect and slow cavities can form despite diligent, self- applied cleaning, so some professional overview is still essential if the aim of “teeth for life” is to be realised.
To conclude, Council will save ratepayers from the costs and risks of an over-dosing of water supplies where Megalitres of water are loaded with tonnes of a toxic substance (an industrial waste product, actually) for the dubious beneficial reaction of one part per million – but only from the minute portion that is consumed as drinking water – and that benefit is lost through cumulative deposit in hard tissues of the body, unless it is spat out …so then what do we drink?
Gerald L Bartlett, B.D.S. Univ.Syd.; B.A.,U.N.E., Armidale