Health & Fitness

The Fight Over Fluoride

The 50-year battle over Dallas’ water supply.

Jim Williams hated to see children in pain. Back in 1965, when he was a 30-year-old dentist, he was astounded by the condition of his young patients’ teeth. Before they left his chair, he’d usually end up pulling a rotten molar and fixing a “barrel” of cavities. The experience they associated with his office was rarely positive.

“When I see a kid with a swollen jaw, who’s been up all night hurting like the devil, you can’t take those teeth out without hurting them,” he says. “They never get over that. They’re scared of dentists for the rest of their lives.”

And that meant something to Williams, the scion of a proud Dallas dental dynasty. If one were to assign a family crest to the Williams clan, it probably would contain a tartar scraper and mouth mirror. His father, H.J., his brother, Chuck, even his brother-in-law, James—all dentists.

To Williams, fluoride looked like the panacea for what ailed his patients. After all, every dentist in the country had heard of the little Panhandle hamlet of Hereford, dubbed “The Town Without a Toothache.” The water supply, it was discovered, contained naturally occurring, elevated levels of fluoride. In 1945, Grand Rapids, Michigan, became the first American city to add to its water what Hereford’s already possessed in abundance. Among children born after that year, researchers with the National Institute of Dental Research documented a 60 percent decline in cavities. The evidence was convincing. Why, then, Williams wondered, couldn’t Dallas do the same thing and ease the suffering he saw in his office every day?

In the mid-’60s, Williams and a few other Dallas dentists started spreading the gospel of community fluoridation to any group that would listen, from PTAs to Baptist churches to the Rotary Club. Most people were receptive to the idea. But no matter where Williams went, he always ran into someone who thought adding fluoride to water was mass poisoning, an affront to freedom, or both. There was even a rumor going around that claimed fluoride was a communist mind-control plot. On one occasion, he ran into Larry Stephens, a member of the Dallas Cowboys’ “Doomsday Defense” and a staunch opponent of Williams’ cause. Try as the dentist might, he couldn’t bring the defensive end around to his way of seeing things. 

“He’d have made three of me,” Williams says. “He was pleasant, but he was pretty forceful.”

Williams was apparently more persuasive with the City Council, which approved the addition of fluoride to Dallas’ water supply in 1965. The victory, however, didn’t last long enough for Williams to savor. A group opposed to the measure succeeded in forcing a referendum. On January 29, 1966, the polls opened that morning to bitter cold; by midafternoon, the temperature had stalled at 20 degrees. In this weather, turnout was expected to be low. City officials projected 35,000 voters at best, and that was on a pleasant day.

But much to Mayor Erik Jonsson’s shock, nearly 38,000 Dallasites braved the chill, making theirs the first city in the country with a population of more than 500,000 to defeat an anti-fluoride referendum. It was the largest single-issue referendum turnout in Dallas history—and also one of the most lopsided. The anti-fluoride group lost by a two-and-a-half-to-one margin. DeWayne Dallas, leader of the Greater Dallas Association for Pure Water, was reportedly stunned.

The Centers for Disease Control called the proliferation of fluoride in municipal water supplies one of the 10 greatest public-health achievements of the 20th century. But the backlash against it was already building.

It started with a University of Texas biochemist named Alfred Taylor, who dosed mice with sodium fluoride to test its cancer-fighting properties. Disappointingly, the results showed no reduction in cancer incidence. The dosed mice actually developed cancer earlier than their counterparts. Taylor’s students leaked the alarming results to the press. Anti-fluoride activists made hay with the news, never mind that a subsequent investigation found that the mice had been fed Purina lab chow, which contained concentrations of fluoride dozens of times higher than that found in fluoridated water. The damage was done. Over the years, the opposition would secure victories in small towns like Ford City, Pennsylvania; in big cities, like Portland, Oregon; and in midsize ones, like Wichita, Kansas.

Yet nearly half a century would pass before another activist would attempt to reverse what Jim Williams and his fellow dentists had set in place here in Dallas. Regina Imburgia, a former Ron Paul organizer who describes herself as a “private cook,” began attending City Council meetings in 2013. She had recently founded a group called Activists for Truth, which associated variously with 9/11 truthers, birthers, JFK conspiracists, and chem-trail believers. But she aligned most closely with those who believed Dallas was poisoning its water supply. Imburgia realized quickly that she would get nowhere decrying the health risks of fluoride during the public comment portion of the meetings. Nor could she count on drumming up enough signatures for a referendum, as DeWayne Dallas had in 1965.

So Imburgia changed her message. Dallas Water Utilities, she told the Council, could save $600,000 a year by not adding fluoride to the water. Even though the savings amounted to a small fraction of 1 percent of Water Utilities’ enormous budget, the argument found a receptive ear in Councilman Sheffie Kadane in April last year. He spoke out in support: “We don’t need it and can save a million dollars and use it for something else, like libraries and recreation centers.”

Imburgia could hardly believe what she’d just heard. “I’m an animated person and probably gave a little scream,” she says. If she could wean Dallas—with more than 2 million served by DWU—off fluoride, it would mark the movement’s greatest victory yet.

And the more Kadane studied it, the more he became convinced that fluoride wasn’t solely a fiscal issue—he saw a public-health risk. Imburgia was pointing council members to her evidence: an oft-criticized article in the journal The Lancet Neurology, which underscored the difficulty of dismissing outright her deepest fears when they found support in a Harvard scientist. The study identified brain deficits in children exposed to elevated levels of fluoride. One of its authors, Philippe Grandjean, however, noted in an email that the findings had been “widely misinterpreted by both sides.” If anything, he said, they proved fluoride exposure in children merited closer study.

Councilman Scott Griggs seemed receptive at first. When he did a little research, though, he discovered that the natural levels of fluoride in Dallas’ water (between .35 and .5 parts per million), and the levels to which it was enhanced (.7 parts per million), were quite close. “We’re arguing over .3 parts per million,” he said.

Council member Jennifer Staubach Gates, a registered nurse, was skeptical. She remembered when she was in nursing school in San Antonio at Incarnate Word and gave birth to her daughter. San Antonio didn’t fluoridate its water supply back then, and her pediatrician urged her to supplement the infant’s diet with the chemical. “It was an extra cost,” Gates said. “And John and I were starving college students.”

Either way, there was little the Council could do until January, when the city’s contract with its provider for hydrofluorosilicic acid was up. In the meantime, both sides went to work, including the Dallas County Dental Society’s former president, John Findley, also a past president of the American Dental Association. As he visited with council members, he found there were some dubious scientific facts out there. “We use something called peer-reviewed science,” he says. “It’s not just the opinion of one person. When I presented the solid evidence for fluoride, most council members understood the concepts and said, ‘You’re right.’ ”

On January 28, the Council convened to vote on the city’s $1 million fluoridation contract. Per resident, it amounted to somewhere between 25 and 50 cents per year. Only Kadane and Councilman Adam Medrano voted against it. Imburgia was disappointed, but she didn’t give up the fight. She sued the council members individually in small claims court, but the judge quickly tossed the cases. In short order, Imburgia found her allies dwindling. Kadane, her chief supporter, was term-limited out. Still, the odds aren’t terrible that she finds another receptive ear down the road, when the Council turns over again. The fluoride contract only lasts three years.

Jim Williams is 80 years old now and no longer practices at his office on Hampton Road and Loop 12, in Oak Cliff. That the fighting over fluoride didn’t end 50 years ago comes as little surprise to him. But he made sure to explain that it wasn’t for adults like Imburgia that he fought for fluoride. It was for the kids who came into his office with swollen jaws and rotten teeth.

He points out that before the first molar erupts, fluoride is absorbed during the process of calcification, and that tooth becomes stronger for it. Williams must have fixed thousands of kids’ cavities over his nearly 40 years in practice. 

Getting fluoride in the water, he says, “was the most important thing I ever did in dentistry.” 

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