Fluoridation Safety Studies
… Bartlett, Texas
Excerpts from The American Fluoridation Experiment, by F.B. Exner, M.D., and G. L. Waldbott, M.D., Edited by James Rorty, revised edition, Devin-Adair, 1961 (Library of Congress Catalogue Card No.: 56-12140)
George L. Waldbott, M.D. … 1957:
Another reason why fluorosis is not recognized is that physicians, like other people, are inclined to accept as normal the things seen frequently. This was illustrated by a study conducted by the Public Health Service at Bartlett, Texas, in 1943. X-rays were made of Bartlett residents, and read by a competent radiologist at the Scott White Clinic in Texas. He called them all normal. They were then sent to a radiologist in New England. He found abnormal bone density in 11 percent of the people. The findings were normal for Texas, where fluoride waters are common, and quite abnormal in New England, where they are rare.
For this reason, a statement by the physicians of Colorado Springs that they never see abnormal findings traceable to fluoride in the water is wholly without significance.
When I was in Minnesota, where many people drink from fluoride-bearing wells and springs, we saw cases of osteomalacia which would not respond to therapy. Frequently we saw cases of ankylosing spondylitis. We saw calcified ligaments and periarticular structures. We saw calcified excrescences on the bones of the pelvis, which my chief told me were age change, but I couldn’t help wondering why some people were so old at fifty while others weren’t at ninety.
I don’t know that these things were due to fluoride. I do know that they are seen much less frequently in Washington, where few people drink fluoride-bearing water. Moreover, since I have started questioning people I find that the cases I do see have lived where fluoride is common.
That brings up another reason why fluorosis is hard to recognize in this country. Americans, by and large, just don’t stay put, and relatively few have used the same water for twenty years, much less forty; and of those who have, very few know how much, if any, fluoride it contained.
The only way to determine whether findings resembling fluorosis are actually due to fluoride is by chemical analysis of a sample of bone, for example. You aren’t justified in doing this to people merely to satisfy your curiosity about something it is years too late to do anything about.
Beyond question, the things that fluoride can do to people occur frequently in the United States. What we don’t know is when or how often they are due to fluoride, and what, if any, other things can produce them. The Public Health Service, which should be interested in finding out, isn’t. On the contrary, it is determined to prove that fluorosis does not exist. People must be convinced, at any cost, that 1.0 part per million is perfectly safe.
In 1943, and again in 1953, the Public Health Service made what it likes to call complete examinations of people in Bartlett and Cameron, Texas. Again, there is far more in this than meets the eye.
The Public Health Service says Bartlett water contains 8 parts per million of fluoride. The Texas State Health Department says 6.6 parts per million. Neither says when, or what, changes have been made in the supply during the past thirty years. The U.S. Geological Survey doesn’t mention Bartlett.
The Public Health Service says Cameron water contains 0.4 part per million. The supply, however, is from the Little River, and such sources are notoriously variable in fluoride content. A single determination means absolutely nothing. Even from such a source as Lake Michigan, fluoride determinations on consecutive days vary by as much as fourfold at the same location.
Actually, as in the case of other Public Health Service studies, they are not comparing a fluoride city with a nonfluoride city. Both are fluoride cities, and within a range where some Cameron people will ingest more water-borne fluoride than some in Bartlett. Consequently, fluoride effects will be present in both places, and any differences will be in degree rather than in kind.
Moreover, although all those studied had lived in their respective communities at lest fifteen years, only eleven (14.5 percent) of those studied in Bartlett had been born there, or had lived there during the period of tooth and bone development. Consequently, when we are told that 11 to 12 percent of those studied in Bartlett showed evidence of osteosclerosis, it is somewhat misleading. Actually, at least 82 percent of those exposed to Bartlett water during the bone-forming period showed evidence of osteosclerosis.
The examinations included a test for syphilis, but did not include tests for such things as prolonged bleeding time, or disturbed thyroid function, which the Public Health Service knew might result from fluoride. Neither did they examine the few who had been born in Bartlett for post-rachitic changes.
They did test for acid and alkaline phosphatase, when indicated. They do not tell us what the indications were, how many people were so tested, or what was found.
We are told that:
When the data are reviewed critically, it is clear that the medical characteristics of the two groups, with the exception of dental fluorosis, do not differ more than would be expected of two comparable towns with or without an excess of fluoride in the water supply.
The trouble with that is there are no data to review.
Instead of recording what was found, we are merely told how many people were classified as abnormal in various respects in the two communities. Neither the quantitative nor qualitative criteria of normality are given: and there is no possible basis for correlating actual findings with probable fluoride intake or with other pertinent factors such as duration of intake or age at exposure.
There are numerous reports in the literature that fluoride causes an increased incidence and severity of periodontal disease, with resultant loss of teeth. This is reported both in experimental animals and among people.
This fact lends added interest to certain findings in Bartlett: Ten of 45 nonedentulous individuals in Bartlett, … and 1 of 64 in Cameron … had positive signs of fluorosis in 1953.
Otherwise, there was no mention of the fact that 40 percent of the people studied in Bartlett had lost all their teeth, whereas only 20 percent had done so in Cameron. This seems like a significant difference which might have been worthy of mention.
The difference, apparently, was not related to mottling. Only eleven Bartlett residents had lived there during the tooth-forming period, and ten people still had enough teeth to permit diagnosis of mottling. Granted that we don’t know how many had developed mottled enamel elsewhere, there is still reason to suspect that the teeth were lost from some effect of the fluoride produced after the teeth erupted.
In any case, and regardless of the time when the damage occurred, periodontal disease was far more common at Bartlett than at Cameron.