WEBVTT - Ep 178 Fluoride 1: The real tooth fairy 0:00:00.120 --> 0:00:03.360 It is now twenty five years since the late Trenley 0:00:03.480 --> 0:00:06.559 Dean and I journeyed by train from Washington, d C. 0:00:06.880 --> 0:00:10.440 To Grand Rapids, Michigan, to be joined by Philip Jay 0:00:10.600 --> 0:00:13.080 for a meeting with the mayor to gain his approval 0:00:13.200 --> 0:00:18.000 for a water fluoridation experiment. There were no signs of apprehension, 0:00:18.480 --> 0:00:22.640 of daring or of pioneering. There was no suggestion that 0:00:22.680 --> 0:00:26.079 we were being foolhardy in subjecting a population of one 0:00:26.120 --> 0:00:29.760 hundred and sixty thousand people to a procedure which might 0:00:29.880 --> 0:00:34.120 have either short or long range hazards. We were merely 0:00:34.159 --> 0:00:38.400 replicating Nature's best based on an extensive background of study 0:00:38.479 --> 0:00:43.080 data in Nature's laboratory. In the United States alone, some 0:00:43.320 --> 0:00:47.360 seven million people in one thousand, nine hundred communities had, 0:00:47.560 --> 0:00:52.080 throughout life used drinking water which was naturally fluoridated with 0:00:52.159 --> 0:00:56.200 a fluoride concentration of zero point seven parts per million 0:00:56.400 --> 0:01:00.640 or more. We knew what too much floride did, We 0:01:00.760 --> 0:01:04.120 knew what too little did. We knew what the optimum 0:01:04.160 --> 0:01:07.960 amount was, and we had reassurance that one part per 0:01:08.000 --> 0:01:11.720 million fluoride in the drinking water had the same biological 0:01:11.760 --> 0:01:15.440 effect whether it got there from flowing over rocks or 0:01:15.480 --> 0:01:19.560 from a feeding machine. Twenty five years ago, there were 0:01:19.600 --> 0:01:23.920 no anti fluoridationists to becloud the issue or distort our efforts. 0:01:24.520 --> 0:01:28.840 The opponents of fluoridation act collectively as merchants of fear 0:01:29.080 --> 0:01:34.480 and doubt, implicating fluoride as either causing or exacerbating virtually 0:01:34.640 --> 0:01:40.160 every disease and biologic malfunction known to mankind. They discovered 0:01:40.200 --> 0:01:44.960 early that the public referendum method afforded them excellent opportunities 0:01:45.000 --> 0:01:49.160 to exploit fear and doubt while posing as protectors of 0:01:49.240 --> 0:01:54.640 human rights and religious freedom. The anti fluoridationists sought opportunities 0:01:54.680 --> 0:01:57.560 to engage us in debate on the platform. 0:01:57.280 --> 0:01:59.240 On radio, and on television. 0:02:00.040 --> 0:02:02.680 In retrospect, it is clear that it took us much 0:02:02.720 --> 0:02:06.760 too long to learn that these public debates, these confrontation dialogues, 0:02:07.240 --> 0:02:12.040 increased confusion rather than understanding, and thereby helped serve the 0:02:12.080 --> 0:02:16.520 cause of the anti floridationists. On July twenty seventh, nineteen 0:02:16.600 --> 0:02:20.320 sixty nine, the Assembly of the World Health Organization, at 0:02:20.360 --> 0:02:26.200 its annual meeting in Boston, endorsed water fluoridation. This endorsement 0:02:26.280 --> 0:02:31.480 adds another asset of great potential use that potential will 0:02:31.520 --> 0:02:36.240 not be activated, however, unless it engenders commitment and political 0:02:36.320 --> 0:02:40.799 action by the proponents of water fluoridation. It has been 0:02:40.840 --> 0:02:43.920 said that only a fool learns from his own mistakes. 0:02:44.600 --> 0:02:48.079 You are invited to escape that classification by learning from 0:02:48.120 --> 0:02:51.440 the mistakes committed by me and my colleagues during the 0:02:51.480 --> 0:02:53.240 past twenty five years. 0:03:38.640 --> 0:03:42.840 Aaron, Yeah, that's very interesting, isn't it. 0:03:43.080 --> 0:03:46.520 Yeah, so that is a like a reflection article about 0:03:46.880 --> 0:03:49.520 fluoridation after twenty five years by one of the people 0:03:49.520 --> 0:03:53.960 who led the charge, John Knutsen, and that paper was 0:03:53.960 --> 0:03:55.360 published in nineteen seventy. 0:03:56.000 --> 0:03:56.640 Oh wow. 0:03:56.960 --> 0:04:01.240 Yeah, sometime it's just it's fastating to me. I think 0:04:01.320 --> 0:04:05.080 also the reflection of like, we made mistakes. 0:04:05.160 --> 0:04:08.160 We made mistakes by not being by by just. 0:04:08.080 --> 0:04:17.160 Assuming that the public would accept facts and science, right yeah, Like, yeah, we. 0:04:17.120 --> 0:04:19.880 Have science on our side, but that doesn't. 0:04:19.800 --> 0:04:21.960 Really do mean all that much, right Yeah. 0:04:22.160 --> 0:04:24.640 So it's so it was really interesting the whole the 0:04:24.640 --> 0:04:26.240 whole paper is very interesting to read. 0:04:26.760 --> 0:04:29.360 I also I love that I tell my five year 0:04:29.360 --> 0:04:31.279 old that all the time, I'm like, you could learn 0:04:31.279 --> 0:04:33.240 from our mistake. We're just trying for you to learn 0:04:33.240 --> 0:04:35.000 from our mistakes. So that you don't have to make 0:04:35.040 --> 0:04:38.039 the same way. It doesn't work with the five year old. 0:04:38.080 --> 0:04:39.680 I don't know if it works with grown ups either. 0:04:39.839 --> 0:04:47.560 No, certainly, not rarely. Hi, I'm Aaron Welsh. 0:04:47.000 --> 0:04:48.760 And I'm Aaron Aman updight. 0:04:48.480 --> 0:04:50.560 And this is this podcast will kill you. 0:04:51.120 --> 0:04:55.760 Welcome to episode one of two on fluoride. 0:04:55.880 --> 0:04:57.960 Fluoride. There's a lot there. 0:04:58.160 --> 0:05:01.000 We wanted to get it all, you know, out in 0:05:01.040 --> 0:05:03.640 the open, the full story. 0:05:04.960 --> 0:05:10.279 I am really excited about this. We split this episode 0:05:10.520 --> 0:05:13.280 into two episodes, this series. We're making a series out 0:05:13.320 --> 0:05:16.320 of it, very much like we did with raw milk. 0:05:16.360 --> 0:05:19.920 So today I just get to listen. I'm so excited 0:05:19.920 --> 0:05:23.200 about that. I mean, well, you tell us all about 0:05:23.240 --> 0:05:27.240 the history of fluoridation and how we got to where 0:05:27.240 --> 0:05:29.599 we are today, and then next week I'll go through 0:05:30.520 --> 0:05:32.520 what the heck is a cavity anyway? 0:05:32.800 --> 0:05:33.480 What is? Yeah? 0:05:34.360 --> 0:05:36.760 And what do we know about the like biological effects 0:05:36.800 --> 0:05:37.600 of fluoride? 0:05:38.040 --> 0:05:38.640 Yeah? 0:05:39.040 --> 0:05:42.200 Yeah, wait, I am really excited. 0:05:42.240 --> 0:05:44.920 I mean, like it's it's very funny to me because 0:05:45.040 --> 0:05:47.120 when I was doing this and I'll tell you more 0:05:47.120 --> 0:05:49.960 about this like in the actual episode. Yeah, but the 0:05:50.160 --> 0:05:53.719 parallels between raw milk and fluoride are just off the 0:05:53.839 --> 0:05:55.240 charts where I'm like. 0:05:55.400 --> 0:05:56.640 I expect nothing less. 0:05:56.880 --> 0:06:00.280 Yeah, I feel also very anti vaccine too, Like it's 0:06:00.279 --> 0:06:03.160 all the things and it's all the same playbook. 0:06:03.240 --> 0:06:06.160 Like we've talked about you and I a lot, Yes. 0:06:05.920 --> 0:06:08.400 The playbook. That's what I think reading that paper. 0:06:08.440 --> 0:06:10.320 It's funny because like we talk about this in our 0:06:10.400 --> 0:06:14.440 in our presentations, where we're like, this is how disinformation spreaders. 0:06:14.440 --> 0:06:19.080 This is the strategies they use a debate equal sides 0:06:19.200 --> 0:06:21.400 or equal time to both sides, And I'm like, oh 0:06:21.480 --> 0:06:24.120 my gosh, there were so many other things, just like 0:06:24.240 --> 0:06:27.720 fear and doubt, and then I think the other scientists. Yeah, 0:06:27.760 --> 0:06:31.080 the other thing being in action that like people don't 0:06:31.080 --> 0:06:33.680 feel well informed enough about fluoride because it is a 0:06:33.720 --> 0:06:37.400 really complex scientific topic to vote at all. So then 0:06:37.920 --> 0:06:40.320 even if they might be pro fluoridation, they're like, but 0:06:40.320 --> 0:06:42.840 it feels safer to not vote, feels safer to not 0:06:42.920 --> 0:06:47.120 vaccinate despite what we know anyway, Right, there's something because. 0:06:46.920 --> 0:06:50.039 It feels like not doing something is like not for 0:06:50.440 --> 0:06:52.560 taking a side, when in. 0:06:52.440 --> 0:06:54.599 Fact it is a side. 0:06:54.760 --> 0:06:59.559 So yeah, it's and getting people to like be pro 0:06:59.640 --> 0:07:03.719 flora and not just like you know, indifferent is really 0:07:03.760 --> 0:07:07.960 like pulling teeth, is it? Eric? 0:07:08.080 --> 0:07:10.560 Did you like that? I was really good. 0:07:10.600 --> 0:07:12.640 Your face was so straight when you said it. 0:07:14.640 --> 0:07:17.240 I was trying to find the best transition to quarantiny dime. 0:07:17.600 --> 0:07:19.800 Oh yeah, it's quarantine It's quarantina dime. 0:07:20.440 --> 0:07:29.680 We're drinking, pulling teeth. I love it, pulling teeth, pulling teeth. 0:07:29.760 --> 0:07:34.240 It is what's in it? It's delicious, it is. It's 0:07:34.280 --> 0:07:40.600 got elderflower, liqueur mint, prosecco mint because like you know, freshness. 0:07:40.280 --> 0:07:41.880 Persecution paste, soda water. 0:07:41.960 --> 0:07:45.560 Yeah, bring a little toothpist. Don't consume toothpaste? 0:07:45.920 --> 0:07:46.400 Do you not know? 0:07:46.480 --> 0:07:54.520 It's a great little summary, refreshing bev and we'll post 0:07:54.560 --> 0:07:57.560 the full quarantini recipe as well as the non alcoholic 0:07:57.560 --> 0:08:00.440 placey Berrita on our website This podcast will kill You 0:08:00.480 --> 0:08:02.119 dot com, as well as on all of our social 0:08:02.120 --> 0:08:05.040 media channels, which if you're not following us on those. 0:08:04.960 --> 0:08:07.440 You should be shuck it out. We're there. 0:08:07.680 --> 0:08:08.040 We are. 0:08:09.120 --> 0:08:12.800 Also, if you haven't yet rated, reviewed, and subscribed on 0:08:13.000 --> 0:08:17.400 whatever platform that you love to listen where you're listening 0:08:17.480 --> 0:08:18.440 right now, do so. 0:08:18.520 --> 0:08:21.160 We'd love it. It would appreciate We would appreciate it. 0:08:22.400 --> 0:08:25.440 If you're not already subscribed to the exactly right YouTube channel, 0:08:25.560 --> 0:08:27.000 you could do that as well too. 0:08:28.400 --> 0:08:29.640 We're there, We're there. 0:08:29.520 --> 0:08:32.640 We're also we have a website, but you listened to 0:08:32.760 --> 0:08:34.360 episodes before you know what's there. 0:08:34.679 --> 0:08:35.840 Let's just get still, hap it. 0:08:36.200 --> 0:08:37.560 This podcast will kill you dot com. 0:08:37.559 --> 0:08:45.040 Goodbye, goodbye, goodbye, and hello. Well we'll get started just 0:08:45.120 --> 0:09:02.240 after this short break. Born in eighteen seventy four, Frederick 0:09:02.320 --> 0:09:05.800 McKay had spent his childhood, like many others, in his 0:09:05.920 --> 0:09:10.440 hometown of Milford, Massachusetts. He worked in his father's dry 0:09:10.440 --> 0:09:13.640 goods store. He played in bands, he went to school. 0:09:14.480 --> 0:09:18.840 But when he turned sixteen, he noticed that something felt off. 0:09:19.360 --> 0:09:22.840 Maybe it was a lingering cough, maybe it was night sweats, 0:09:23.080 --> 0:09:30.160 persistent fever. The diagnosis tuberculosis. Like many others at this time, 0:09:30.240 --> 0:09:33.520 I mean tuberculosis, was rampant. He sought to cure his 0:09:33.559 --> 0:09:37.240 disease with a better climate, dry air, so he traveled 0:09:37.240 --> 0:09:40.480 to Colorado Springs, where he recuperated for a while until 0:09:40.520 --> 0:09:44.720 he felt well enough to move back to Massachusetts. Upon 0:09:44.800 --> 0:09:47.960 returning to the northeast, he decided on a life of dentistry, 0:09:48.559 --> 0:09:52.600 and just as he was completing his education, McKay's tuberculosis 0:09:52.600 --> 0:09:55.960 flared up again, driving him back west, where he set 0:09:56.040 --> 0:09:59.439 up his dental practice in Colorado Springs in nineteen oh one. 0:10:00.000 --> 0:10:01.720 I think he was like, there's no point in me, 0:10:01.880 --> 0:10:04.840 Like I should just stay out west forever, right, okay? 0:10:05.679 --> 0:10:08.520 And before long after his arrival there, he began to 0:10:08.640 --> 0:10:12.000 notice an unusual pattern in the teeth of some of 0:10:12.000 --> 0:10:15.640 his patients. And even just like talking to people around town, 0:10:15.720 --> 0:10:18.400 he noticed this something on their teeth, and this was 0:10:18.440 --> 0:10:21.439 not anything that he had come across in his dental training. 0:10:22.360 --> 0:10:26.800 Their teeth were streaky with brown or yellow spots, something 0:10:26.840 --> 0:10:30.440 that he called modeled enamel and that the locals called 0:10:30.679 --> 0:10:35.200 Colorado stain or Colorado brown stain, which was a term 0:10:35.559 --> 0:10:38.559 not entirely welcomed by city officials who were trying to 0:10:38.600 --> 0:10:41.720 get people to come to the Springs, not repel them. 0:10:44.280 --> 0:10:46.800 And so McKay got kind of obsessed with the mystery 0:10:46.840 --> 0:10:49.400 of modeled enamel, like what the heck was causing it? 0:10:49.480 --> 0:10:51.080 And why did no one know about it? 0:10:51.120 --> 0:10:53.199 Why was this not in any dental textbook that he 0:10:53.280 --> 0:10:57.199 had come across. Other local dentists knew about it, and 0:10:57.440 --> 0:10:59.920 they weren't all that interested, and they just kind of 0:11:00.000 --> 0:11:02.520 figured well, specific to the Colorado region. It was kind 0:11:02.559 --> 0:11:03.720 of like, yeah, we've seen it before. 0:11:05.040 --> 0:11:07.800 How interesting to not to just be like, yeah, this 0:11:07.920 --> 0:11:10.280 is how it is here. But I guess if you 0:11:10.360 --> 0:11:12.240 have no other frame of reference, so it makes sense. 0:11:12.320 --> 0:11:14.319 He like trained in one place, came to somewhere else 0:11:14.320 --> 0:11:15.520 and was like this is different. 0:11:15.760 --> 0:11:18.160 Yeah, yeah exactly. He was like, what do you mean. 0:11:18.240 --> 0:11:20.560 This is not like, this is not what people this 0:11:20.640 --> 0:11:26.440 is not just like yeah. 0:11:26.760 --> 0:11:29.720 But when he so he briefly moved Mackay briefly moved 0:11:29.720 --> 0:11:32.520 to Saint Louis, and that's when he was like confirmed 0:11:32.559 --> 0:11:37.079 for him, Okay, this is not like a nationwide issue. 0:11:37.120 --> 0:11:39.600 This is something that is specific to the Colorado region. 0:11:40.760 --> 0:11:44.400 And so when he moved back to Colorado again tuberculosis driven, 0:11:44.880 --> 0:11:47.160 he was like, Okay, someone's got to get to the 0:11:47.160 --> 0:11:49.320 bottom of this. I guess it has to be me. 0:11:49.600 --> 0:11:51.480 I think secretly he was like, oh my gosh, I 0:11:51.520 --> 0:11:54.520 really want to know what's happening here. Yeah. 0:11:54.559 --> 0:11:55.679 And so the first. 0:11:55.360 --> 0:11:58.800 Steps too solving this puzzle were raising awareness, which he 0:11:58.840 --> 0:12:02.800 did by attending various regional and state dental meetings, sometimes 0:12:02.800 --> 0:12:05.720 with a patient in tow to be like Colorado bound, 0:12:05.720 --> 0:12:07.040 these teeth open up. 0:12:07.240 --> 0:12:08.600 Yeah. 0:12:08.640 --> 0:12:11.079 And also just by getting a sense of the incidents 0:12:11.120 --> 0:12:14.480 and the geographical scope of the issue, which he did 0:12:14.520 --> 0:12:19.000 by examining children in Colorado Springs public schools, eighty seven 0:12:19.080 --> 0:12:21.760 point five percent of the kids had modeled teeth. 0:12:22.080 --> 0:12:25.479 Wow, okay, huge. 0:12:24.760 --> 0:12:25.720 That's a huge proportion. 0:12:26.760 --> 0:12:29.440 McKay's efforts made it clear that there was a real 0:12:29.480 --> 0:12:31.800 issue here that was worth looking into. It wasn't just 0:12:31.840 --> 0:12:35.680 like a local curiosity. This was affecting a great number 0:12:35.679 --> 0:12:39.800 of people's lives. And as McKay cast a wider net, 0:12:40.240 --> 0:12:43.120 traveling around the state to look for more cases and 0:12:43.280 --> 0:12:46.959 receiving help from dentists across the country, he realized that 0:12:47.000 --> 0:12:50.120 the Colorado stain was not at all limited to Colorado 0:12:50.440 --> 0:12:53.160 or even the US. I think there was like another 0:12:53.240 --> 0:12:55.440 term for it. I wish I'd written this down in Texas. 0:12:55.480 --> 0:12:57.800 It was like maybe like Texas teeth or something like that. 0:12:58.320 --> 0:13:02.080 There are for some communities that models yeah, or modeled enamel. 0:13:02.920 --> 0:13:05.400 And so this this finding that it was like much 0:13:05.400 --> 0:13:07.599 more widespread, and he was like, okay, there's got to 0:13:07.640 --> 0:13:10.640 be what is driving this. It led him to team 0:13:10.720 --> 0:13:14.720 up with a the dean of Northwestern University's dental school, 0:13:14.760 --> 0:13:18.240 whose name was doctor Green Black, which is hilarious to 0:13:18.240 --> 0:13:21.920 me that it's Yeah, and they wanted to partner to 0:13:22.000 --> 0:13:25.400 systematically study, like what was happening with the stain at 0:13:25.400 --> 0:13:26.320 the tissue level. 0:13:26.520 --> 0:13:28.240 You know, what is the stain. 0:13:28.640 --> 0:13:32.160 Coming, where's it coming from, what is it in there? Yeah, 0:13:32.160 --> 0:13:35.400 and then try to find its root cause. As they 0:13:35.720 --> 0:13:39.600 collected more samples and more data on where and how 0:13:39.640 --> 0:13:41.600 the staining occurred, one. 0:13:41.559 --> 0:13:43.000 Thing stuck out to them. 0:13:44.080 --> 0:13:48.520 Even though the enamel on modeled teeth was rough and uneven, 0:13:48.880 --> 0:13:51.880 that didn't seem to make the teeth more susceptible to decay, 0:13:52.000 --> 0:13:55.320 which is what they would have predicted. In fact, what 0:13:55.440 --> 0:13:59.560 they noticed after examining thousands of patients was that decay 0:13:59.640 --> 0:14:03.520 was much lower in people with modeled enamel than it 0:14:03.679 --> 0:14:07.520 was in other populations. I mean this could be huge, 0:14:07.559 --> 0:14:12.079 Like this finding had huge implications, except they still didn't 0:14:12.120 --> 0:14:16.920 know what caused the modeling. Okay, but they had a suspicion. Okay, 0:14:17.000 --> 0:14:17.720 it was in the water. 0:14:19.080 --> 0:14:20.000 Yeah. 0:14:20.040 --> 0:14:23.840 In his investigations, McKay had seen that children who lived 0:14:23.880 --> 0:14:26.080 elsewhere for the first two to three years of their 0:14:26.120 --> 0:14:29.760 life before moving to a modeled teeth area were not affected. 0:14:30.240 --> 0:14:30.520 Okay. 0:14:30.920 --> 0:14:34.840 So he also noticed that basically all members of a community, 0:14:34.960 --> 0:14:37.880 regardless of their diet, whether they were rich or poor, 0:14:37.920 --> 0:14:39.320 where their house was, they. 0:14:39.280 --> 0:14:40.680 All had modeled teeth. 0:14:41.920 --> 0:14:45.480 He added stronger evidence to the water hypothesis when he 0:14:45.560 --> 0:14:48.520 visited a dentist in South Dakota who had reached out 0:14:48.680 --> 0:14:51.480 asking for McKay's advice on the modeling that he saw 0:14:51.520 --> 0:14:54.200 in his own town. And it turned out that the 0:14:54.200 --> 0:14:57.880 town had switched their water supply eighteen years prior. And 0:14:57.920 --> 0:15:00.760 you could draw a sharp line between those born before 0:15:00.800 --> 0:15:04.280 the switch, no modeling, and those born after lots of modeling. 0:15:04.480 --> 0:15:07.240 Ooh right, really. 0:15:09.240 --> 0:15:12.080 And so over the next fifteen years, McKay continued his 0:15:12.120 --> 0:15:15.240 search for the answer and had by the late nineteen 0:15:15.280 --> 0:15:19.720 twenties accumulated ample evidence that the water held the key. 0:15:20.200 --> 0:15:20.680 Okay. 0:15:21.040 --> 0:15:23.960 The final piece of the puzzle fell into place when 0:15:24.040 --> 0:15:27.040 McKay was sent by the US Public Health Service to 0:15:27.080 --> 0:15:30.920 a small town in Arkansas called Box Site. And this 0:15:30.960 --> 0:15:34.640 is a mining community built for employees of the Aluminum 0:15:34.720 --> 0:15:39.960 Company of America ALCOA. In nineteen oh nine, Box Site 0:15:39.960 --> 0:15:43.280 had switched their water from shallow wells to a deep 0:15:43.320 --> 0:15:49.960 well and kids born after the switch had extremely modeled enamel. Okay, 0:15:50.040 --> 0:15:53.760 this was not welcome news for Alcoa, the company, the 0:15:53.800 --> 0:15:57.040 aluminum company, who was already under fire from claims that 0:15:57.080 --> 0:16:00.920 their aluminum cookwaar was toxic. They were like, this is 0:16:00.960 --> 0:16:02.680 going to be used as evidence that we're poisoning the 0:16:02.720 --> 0:16:03.240 water too. 0:16:03.280 --> 0:16:05.240 Now, like everyone's gonna hate us even more. 0:16:06.640 --> 0:16:09.960 And so the chief chemist of Alcoa examined the water 0:16:10.040 --> 0:16:14.920 for rare elements using sophisticated tech not readily available, and 0:16:15.000 --> 0:16:18.280 he wrote to McKay about what he had found. Quote, 0:16:19.240 --> 0:16:23.760 we have discovered the presence of hitherto unsuspected constituents in 0:16:23.840 --> 0:16:28.040 this water. The high fluorine content was so unexpected that 0:16:28.160 --> 0:16:32.280 a new sample was taken with extreme precautions, and again 0:16:32.520 --> 0:16:36.760 the test showed fluorine in the water. They detected fluorine 0:16:36.880 --> 0:16:40.160 at a level of thirteen point seven parts per million. 0:16:40.920 --> 0:16:42.440 That's very high. 0:16:42.480 --> 0:16:42.960 Very high. 0:16:43.040 --> 0:16:43.240 Yeah. 0:16:43.280 --> 0:16:47.080 For context, the recommendation today is point seven parts per million, 0:16:47.160 --> 0:16:49.120 and it used to be one, but then it was 0:16:49.200 --> 0:16:53.360 revised downward so that point seven recommendation is enough to 0:16:53.440 --> 0:16:57.040 protect against decay but too low to cause fluorosis. 0:16:57.280 --> 0:17:03.600 Right, yeah, and seven that's quite quite. 0:17:03.320 --> 0:17:07.480 A lot higher, very very high. Yeah. 0:17:07.560 --> 0:17:10.600 So but this was also this was not necessarily it's 0:17:10.680 --> 0:17:12.760 kind of interesting I came across this leader, but this 0:17:12.800 --> 0:17:14.920 is not necessarily the first time that florine had been 0:17:14.960 --> 0:17:15.679 linked to this. 0:17:16.160 --> 0:17:17.240 But for some reason. 0:17:17.040 --> 0:17:21.520 McKay either like missed, like missed the memo on those 0:17:21.680 --> 0:17:24.160 or just like didn't it didn't seem as compelling as 0:17:24.280 --> 0:17:28.440 this example here, And so then McKay like this really 0:17:28.520 --> 0:17:33.800 was like whoa, this seems like this seems pretty strong, 0:17:34.440 --> 0:17:37.199 right at least like suggestive, right right, right, Like we 0:17:37.240 --> 0:17:40.159 should look look into this, and so that's that's what 0:17:40.200 --> 0:17:43.480 he did. He sent additional samples from other endemic areas 0:17:43.560 --> 0:17:47.760 where there was a lot of modeled enamel, and yes, 0:17:47.840 --> 0:17:51.240 the results were like okay, this every single one of 0:17:51.240 --> 0:17:55.120 these places where there is high teeth like high modeling, 0:17:56.320 --> 0:17:59.720 the fluorine levels are high either, you know, ranged from 0:17:59.760 --> 0:18:04.000 two parts per million in Colorado Springs to twelve in Kidder. 0:18:03.720 --> 0:18:04.640 South Dakota. 0:18:04.720 --> 0:18:05.200 Okay. 0:18:05.840 --> 0:18:09.720 The US Public Health Service was pretty excited and worried 0:18:09.760 --> 0:18:12.320 about these results, which like historically they were not they 0:18:12.359 --> 0:18:15.480 didn't seem that interested in it. Ok But now this 0:18:15.720 --> 0:18:17.960 was finally like, okay, we have we have something to 0:18:18.000 --> 0:18:18.760 go on here. 0:18:18.640 --> 0:18:20.520 Right way, way, we have some data here and not 0:18:20.640 --> 0:18:22.520 just like observational stuff. 0:18:22.680 --> 0:18:23.680 Yeah, yeah, yeah. 0:18:23.800 --> 0:18:27.919 And so they sent a young dental officer, doctor H. 0:18:28.040 --> 0:18:31.240 Trendley Dean, to get a clearer picture of the relationship 0:18:31.280 --> 0:18:35.720 between fluoride and modeling, and in his investigation he found 0:18:35.800 --> 0:18:38.679 that not only was there a clear relationship between the 0:18:38.760 --> 0:18:43.800 degree of modeling and fluorine concentration, which was like kind 0:18:43.840 --> 0:18:46.119 of like a dose, like there was like a continuous 0:18:46.160 --> 0:18:52.119 relationship essentially, he also observed the striking connection between florine 0:18:52.160 --> 0:18:56.000 and dental carries. In children who lived where the water 0:18:56.080 --> 0:18:58.840 supply had zero point six to one point five parts 0:18:58.880 --> 0:19:03.120 per million, only four to five percent were carries free, okay, 0:19:03.200 --> 0:19:06.520 Whereas in areas where the water was one point seven 0:19:06.600 --> 0:19:09.800 to two point five parts per million, twenty two percent 0:19:09.960 --> 0:19:10.840 were carries free. 0:19:10.960 --> 0:19:13.520 So like five times got it more carries. 0:19:13.600 --> 0:19:19.440 So the higher the concentration of fluorine than the more 0:19:19.600 --> 0:19:21.800 kids had no cavities whatsoever. 0:19:21.600 --> 0:19:24.320 Right, the higher the protective ability. Yeah okay. 0:19:24.920 --> 0:19:27.000 And then there was a study of twenty one cities 0:19:27.000 --> 0:19:29.919 that showed that children age twelve to fourteen that had 0:19:30.000 --> 0:19:32.399 grown up in a city with point five parts per 0:19:32.440 --> 0:19:37.320 million or less had on average more than seven decayed, 0:19:37.560 --> 0:19:39.480 missing and filled permanent teeth. 0:19:39.600 --> 0:19:41.240 These are kids age twelve to fourteen. 0:19:41.640 --> 0:19:43.439 Wow. Yeah. 0:19:43.800 --> 0:19:47.920 Further studies showed that the carries protection provided by fluoride 0:19:47.960 --> 0:19:51.200 plateaued around one part per million, which is a level 0:19:51.200 --> 0:19:54.520 that only led to quote sporadic instances of the mildest 0:19:54.600 --> 0:19:58.800 forms of dental fluorosis of no practical esthetic significance. So 0:19:58.840 --> 0:20:00.680 it was like, Okay, we don't need to add more, 0:20:00.760 --> 0:20:02.040 and we're not going to add We're not going to 0:20:02.119 --> 0:20:03.600 get more protection if we add more. 0:20:04.080 --> 0:20:06.240 If we add more, we're just going to get dental staining. 0:20:06.680 --> 0:20:07.080 Got it? 0:20:07.440 --> 0:20:11.880 And so Dean concluded in nineteen thirty eight, quote inasmuch 0:20:11.920 --> 0:20:14.800 as it appears that the mineral composition of the drinking 0:20:14.840 --> 0:20:18.040 water may have an important bearing on the incidence of 0:20:18.119 --> 0:20:22.680 dental carries in a community, the possibility of partially controlling 0:20:22.840 --> 0:20:28.320 dental carries through the domestic water supply warrants thorough epidemiological 0:20:28.400 --> 0:20:34.480 chemical study and yeah, on board. So, nearly four decades 0:20:34.640 --> 0:20:38.640 after a tuberculosis flare up sent doctor Frederick Mackay back 0:20:38.680 --> 0:20:42.280 West where he embarked on unraveling the mystery of model teeth. 0:20:42.600 --> 0:20:46.119 Dentistry in the US and around the globe was about 0:20:46.119 --> 0:20:52.560 to undergo a massive transition where prevention now occurred alongside 0:20:52.760 --> 0:20:58.040 restoration as the primary goal. Previously, it wasn't really possible, 0:20:58.080 --> 0:21:02.040 like there wasn't enough known about what causes tooth decay 0:21:02.680 --> 0:21:05.920 to interest and to enact any sort of preventative measures. 0:21:06.040 --> 0:21:10.040 So this also, like this finding also allowed for just 0:21:10.080 --> 0:21:13.639 like preventive dentistry period period which is now like the 0:21:13.720 --> 0:21:15.480 cornerstone of dentistry. 0:21:15.520 --> 0:21:21.320 Absolutely, yeah, yeah, But as we'll see, not everyone welcomed 0:21:21.359 --> 0:21:24.440 this change, and some actively fought against it. 0:21:24.840 --> 0:21:26.120 Classic classic. 0:21:27.720 --> 0:21:29.400 So next week erin you're going to take us through 0:21:29.440 --> 0:21:32.159 more of the nitty gritty biology of how dental carees 0:21:32.320 --> 0:21:38.000 forms and what floride does to reduce decay. But I 0:21:38.040 --> 0:21:40.480 want to take some time here to talk about dental 0:21:40.520 --> 0:21:42.520 carries over history, because what else am. 0:21:42.480 --> 0:21:43.480 I going to get to do this? 0:21:43.600 --> 0:21:46.600 And plus, like any opportunity to talk about paleopathology, even 0:21:46.920 --> 0:21:48.000 the littlest. 0:21:47.560 --> 0:21:49.000 Bit is fun. 0:21:49.680 --> 0:21:52.600 So humans and many other species have been impacted by 0:21:52.680 --> 0:21:56.320 dental caries since well before we were humans. Of course, 0:21:57.240 --> 0:22:01.199 fish hundreds of millions of years ago, dinosaurs tens of 0:22:01.200 --> 0:22:02.120 millions of years ago. 0:22:02.480 --> 0:22:05.200 Stop it, wait wait, wait, wait, we have like fossil 0:22:05.359 --> 0:22:06.960 dinosaur teeth with cavities. 0:22:10.560 --> 0:22:11.840 Oh I love that, I know. 0:22:11.960 --> 0:22:17.359 I know also our hominid and relatives and ancestors. Wild 0:22:17.440 --> 0:22:22.439 animals today like bears get carries. Are domestic animals like dogs. 0:22:22.480 --> 0:22:25.800 I mean carries for all right, So let me just 0:22:25.840 --> 0:22:27.960 take a second here to define what carries is. 0:22:28.160 --> 0:22:31.040 Essentially, it's tooth decay. So the hard. 0:22:30.920 --> 0:22:32.880 Enamel on the surface of a tooth begins to wear 0:22:32.960 --> 0:22:36.840 down and the inner soft dentin gets exposed and slowly decays, 0:22:36.920 --> 0:22:41.120 sometimes reaching the pulp cavity. The initial hit that enamel 0:22:41.200 --> 0:22:44.480 loss is helped along by bacteria in our mouth producing 0:22:44.600 --> 0:22:49.320 acid fluoride, by the way, acts to help strengthen that enamel. 0:22:49.359 --> 0:22:51.680 And so that's how it protects us from carries and 0:22:52.000 --> 0:22:55.040 a cavity. Just to distinguish, because I was like, what 0:22:55.160 --> 0:22:55.400 is the. 0:22:55.359 --> 0:22:58.080 Difference cavity versus carry? In fact you're doing this, I 0:22:58.080 --> 0:22:59.320 don't have two next week, okay. 0:23:00.119 --> 0:23:02.040 I mean the cavity is essentially when that tooth decay 0:23:02.080 --> 0:23:02.960 turns into a hole. 0:23:04.080 --> 0:23:05.840