The Centers for Disease Control and Prevention calls community water fluoridation, “One of the 10 great public health achievements of the 20th century”. However, few realize that this remarkable effort had some of its beginnings in Wisconsin thanks to the efforts of former WDA President (1948-1949) Sheboygan city dentist Dr. Almore H. Finke, and the former superintendent of the Sheboygan Water Utility, Jerome C. Zufelt.
Dr. A. H. Finke had been closely following the research of Dr. Frederick McKay of Colorado who was studying the effects of naturally occurring fluoride in the water on tooth development.
About the same time, Dr. Francis Bull, the former dental director of the Wisconsin State Board of Health, started a study in 1937 which compared the rate of decay of seventh, eighth and ninth grade children in Sheboygan and Green Bay.
Green Bay drew its water from various wells with an average fluoride content of 1.3 ppm. Sheboygan obtained all of its water from Lake Michigan with a fluoride content of only 0.05 ppm.
Dr. Bull’s studies, published in 1943, showed 30 percent of the children in Green Bay with no apparent decay versus only 3 percent in Sheboygan. In addition, anterior decay was 15 times higher in Sheboygan than Green Bay. Given the geographic proximity and similar populations, his conclusion was that it was the natural fluoride in the water that made the difference.
As a result, Sheboygan’s health officials, Dr. G.J. Hildebrand, city health officer, Dr. A. H. Finke, city dentist; and J. C. Zufelt, water utility superintendent, persuaded the Sheboygan city council to authorize addition of fluoride to the water supply in September 1945. However, actual implementation did not take place until February 1946, because of the difficulty in obtaining materials and equipment post World War II.
In February 1948, Mr. Zufelt published the article, “Some Practical Aspects of the Addition of Sodium Fluoride to a Municipal Water Supply” in “Water and Sewage Works”. This seminal work on Sheboygan’s efforts to efficiently fluoridate the water supply influenced the world. Among his files were letters from Australia, Belgium, Columbia, Japan, New Zealand and South Africa as well as many U.S. cities asking either for a reprint of that article or for further advice based upon Sheboygan’s experiences.
Dr. Finke, who is credited naming the process “fluoridation”, wrote over one hundred papers and numerous progress reports on the process and outcomes.
Sheboygan was the first city in the country to start optimal water fluoridation as a community initiative. The other pioneering cities (Grand Rapids, Mich., Newburgh, N.Y. and Evanston, Ill.) were government subsidized or part of a research group.
Within the first few years of public water fluoridation, more cities in Wisconsin had community water fluoridation than the rest of the United States combined.
Mr. Zufelt’s personal files contained various antifluoridationist tracts and letters critical of fluoridation. Some were filled with outrageous claims (e.g., a Communist plot to poison Americans or collusion with the aluminum industry to dispose of their toxic waste for a profit).
In all examples, the superintendent politely referred the writer to the appropriate scientific evidence that was available.
Would public water fluoridation be as successful if it was introduced today? Would our elected officials be as courageous about making decisions based on scientific evidence, and not be unduly influenced by junk science and conspiracy theories spread through the internet and social media? I’m not so sure.
One thing I do know, the dental community is fortunate to have had Mr. Zufelt and Dr. Finke help pave the way for implementing a public health effort which has had a positive effect on the oral health of millions throughout the world.