Many dentists and physicians are concerned about the answer to this question as it regards fluoridation of public drinking water. They deplore lacunae* which are plainly visible in research on the effects of fluoride. Why, for example, should there be any doubt about the manner in which fluoride acts on teeth? Yet there is considerable controversy over whether the effect is achieved by contact with the exterior of the enamel, as was suggested by three Canadian scientists in SRI Research for January 1964, or by systemic entry through the blood stream. The latter alternative has been insisted upon by several writers of pro-fluoridation letters to SR. Its fundamental significance is discussed below by a 1940 graduate of Northwestern University Medical School 14.,ho interned at Cook County Hospital in Chicago and specialized in orthopedic surgery at Tulane before entering practice in Oregon.
What are mottled teeth?
At the turn of the century, Dr. J.M. Eager, a young American naval surgeon, observed and described them at Naples, Italy. About the same time a young dentist, Dr. Frederick McKay, after taking his dental training in Philadelphia, decided to practice in Colorado and there encountered and described them (mottled teeth).
Through persistent research by Dr. McKay, the advent of the spectroscope for microchemistry, and the technical abilities of chemist, H.V. Churchill of the Aluminum Company of America, fluorine was identified in 1929 as the cause of mottled teeth.
Simultaneously, without knowledge of the work of those researchers, two brilliant Arizona chemists, Howard Smith and Margaret Smith, using the reverse method of synthesis, produced mottled teeth by feeding fluoride to rats.
An objective description of mottled teeth shows the basic unit the mottle to be a chalky deposit on the surface of the enamel. If this mottle falls out, through the attrition of many washings of saliva and the mastication of food, a pit is left. When the mottling is severe, there is a brownish discoloration.
But how are the mottles formed? Are they the result of a local chemical reaction?
Mottles have not been described following application of very strong fluoride solutions to children in dental chairs. Nor are mottles described in experiments with mouth washes containing the fluoride ion.
Are mottled teeth perhaps due to a disturbance in vital function during the formation of the teeth?
Could they, therefore, represent evidence of systemic fluorine intoxication?
First, let us define systemic toxicity as injury to one or more of the body’s cells by an agent gaining access to the systemic circulation by absorption through the intestines or the skin or the lungs or parenteral (via the doctor’s needle) administration.
Next, let us consider some hard facts acceptable to all doctors, dentists and scientists concerned with fluoridation:
- The cells which form the enamel of the teeth, the ameloblasts, are a thin microscopic layer on the surface of the enamel. They are worn away almost immediately after the teeth erupt from the gums.
- For practical purposes, the first nine years of life is the time when the permanent teeth lie buried beneath the gums, excluded from any local effect of fluorides.
- Disregarding the very short interval after the teeth erupt with the enamel already formed, this is the only time the enamel has cells.
- The first nine years of life is the only time that children consuming fluoridated water develop mottled teeth. Mottled teeth do not occur in those who begin drinking fluoridated water later in life.
- Six to ten percent of children drinking the so-called absolutely safe concentration of fluoridated water (1 part per million) have very slightly mottled teeth.
- The fluoride ion-in contrast to the chloride ion-is anti-enzymatic, blocking chemical reactions in the body.
In the foregoing six established facts, we have very strong circumstantial evidence of systemic toxicity of the so-called absolutely safe concentrate of fluoridated water. What is needed is pathological confirmation.
I have asked appropriate persons in the American Medical Association what is the pathogenesis (mode of formation) of mottled teeth. At first I was told that the answer was not believed to be available, and that the question would be discussed at a meeting of the AMA Committee on Environmental Health on February 1, 1964. After the meeting I received advice that the AMA still supports fluoridation. Accompanying this news came a memo from the American Dental Association which answered my question only to the extent of saying that mottled teeth are a result of malfunctioning ameloblasts.
How is the malfunction produced?
I find this slight clarification on page 609 of Robbins Textbook of Pathology (Saunders, 1962):
“MOTTLED ENAMEL (FLUOROSIS). This is a specific type of enamel hypoplasia caused by ingestion of fluorine. It occurs endemically in areas with fluorine-containing water supplies, and the incidence and severity of the mottling correspond to the fluorine content Defective calcification and structure revealed microscopically accounts for the spotted, chalky white appearance of the affected enamel which undergoes secondary brownish discoloration. Degenerative changes in the ameloblasts induced by the systemic effect of the ingested fluorine are responsible…”
Degenerative changes due to the systemic effect are not simple chemical phenomena. A group of ameloblasts, not as strong as the rest or by the laws of chance situated to bear the brunt of absorption of fluoride ions, after a certain critical level of antienzymatic activity, are laying down incomplete biological and chemical products in a disorderly fashion to produce the future mottle.
We know that when a certain gray-blue halo is seen on the gums, we are dealing with systemic lead poisoning. There is little doubt in my mind that mottled teeth are evidence of mild systemic fluorine poisoning.
Fluoridation research really belongs on an interdisciplinary frontier of basic science: a meeting place for chemists, biochemists, embryologists, histologists, physiologists, toxicologists and pathologists.
This article was reprinted from Saturday Review.