Epigraphs Note on Terminology Acknowledgments Introduction

Hardy Limeback dated May 15, 2003, from Myron Coplan, of Natick, MA,
who explained that he had received the comments directly by mail from
the office of Paul DePaola at the Forsyth Center in the early 1980s.
5. See especially J. D. B. Featherstone, “Prevention and Reversal of Dental Caries:
Role of Low Level Fluoride,” Community Dent. Oral Epidemiol., vol. 27
(1999), pp. 31–40. Also, “Recommendations for Using Fluoride to Prevent
and Control Dental Caries in the United States,” Fluoride Recommendations
Work Group, CDC (August 2001).
6. Linking fluoride to better teeth was not a new idea. As early as 1892 there had
been medical speculation that because fluoride was found in dental enamel,
it was necessary for strong teeth. In 1925 scientists at Johns Hopkins University
tested that theory by feeding rats fluoride. They were disappointed;
the fluoride made the teeth weaker, not stronger. They found, “contrary to
our expectations, that the ingestion of fluorine in amounts but little above
those which have been reported to occur in natural foods, markedly disturbs
the structure of the tooth.” E. V. McCollum, N. J. E. Simmonds, and
R. W. Bunting, “The Effect of Addition of Fluorine to the Diet of the Rat
on the Quality of the Teeth,” J. Biol. Chem., vol. 63 (1925), p. 553. In 1938 the
biochemist Wallace Armstrong of the University of Minnesota may well
have contributed to the confusion. He reported that teeth with fewer cavities
had more fluoride in them. W. D. Armstrong and P. J. Brekhus, “Chemical
Composition of Enamel and Dentin. II. Fluorine Content,” J. Dent. Res., vol.
17 (1938), p. 27.
That data was, in turn, cited by Gerald Cox (whom we will meet in the
next chapter) along with Dean’s work and his own, permitting him to conclude
that “the case for fluoride should be regarded as proved.” That was not
the conclusion of the editorial writers at the Journal of the American Medical
Association (JAMA), who noted after reading Dean’s study that “the possibility
is not excluded that the composition of the water in other respects
may be the principal factor.” Dean also said that other differences in the
mineral composition of the water in the study cities—especially calcium
and phosphorus—were a factor that should not be overlooked. H. T. Dean,
“Endemic fluorosis and Its Relation to Dental Caries,” Public Health Reports,
vol. 53 (August 19, 1938), p. 1452. Cited in G. L. Waldbott, A Struggle with
Titans (New York: Carlton Press, 1965), p. 13. But in 1963 one of the three
planks in Cox’s argument collapsed when Wallace Armstrong realized that
he had gotten it wrong—increased fluoride in the teeth was a function of age
and his earlier simple equation of fewer cavities and greater fluoride content
was therefore invalid. “Age as a factor in fluoride content was not then (in
1938) appreciated.” W. D. Armstrong and L. Singer, “Fluoride Contents of
Enamel of Sound and Carious Teeth: A Reinvestigation,” J. Dental Res., vol.
42 (1963), p. 133. Cited in Waldbott, A Struggle with Titans, p. 119.
7. As we shall see, fluoride’s ability to poison enzymes has long been fingered
by scientists as a main pathway of its various toxic effects.