Our drinking water naturally contains small amounts of fluoride. In the middle of the last century, municipalities added extra fluoride to the water to protect teeth. Rebellious citizens managed to put a stop to this measure.
It is the late 1960s. Dentist Cappieri is on the phone to his assistant. “Can one of the ladies come by with information cards from 12-year-old school leavers?” he asks in a dignified, old-Dutch tone. A little later, Cappieri looks through the pictures of his young patients’ teeth. He starts counting. “1, 2, 3 … 16, 17, 18 affected elements.” On another card, the molars are coloured in – it turns out they’ve all been extracted. “It gives you a feeling of hopelessness,” he says, shaking his head.
This is a scene from ‘The perfect teeth’, an episode of Other Times. After the Second World War, the number of caries (cavities) in Dutch teeth skyrocketed. Often due to a lack of money, the Dutch brush their teeth poorly or not at all. Only the rich can afford a dentist. And they only go to the dentist if they are in pain or need to have a tooth extracted. Back then, no one had heard of a biennial check-up. Many municipalities decide to intervene: to protect their citizens’ teeth, they add fluoride to the drinking water.
The idea that fluoride might be good for our teeth came from the United States. In 1901 dentist McKay began looking into it. He found that in areas where drinking water naturally contained a lot of fluoride, patients were less prone to tooth decay and had stronger teeth. That is why in 1947 the Minister of Health asked the Health Council to advise on drinking water fluoridation this resulted in a major fluoride study in 1953 – also known as the Tiel-Culemborg project.
Fluoride was added to Tiel’s drinking water without informing the population, while Culemborg’s unfluoridated drinking water served as a control group. Dentists monitored children’s teeth in Tiel and Culemborg for 16.5 years. The research showed that while fewer dental treatments were needed in Tiel, there were almost as many cavities in Tiel as in Culemborg. Researchers concluded that fluoride inhibited the progression of tooth decay rather than its occurrence. In other words: it took more time for cavities to become large and deep.
On the advice of the Health Council – and supported by the professional association of dentists, the Dutch Society for the Promotion of Dentistry (NMT) – the ministry decided to allow drinking water fluoridation through a permit system under the Water Supply Act. Drinking water fluoridation was introduced locally, via municipalities. From Rotterdam to Groningen, from Amsterdam to Heerlen, many municipalities started adding fluoride to their drinking water.
In Haarlem, general practitioner Moolenburgh was shocked to read that his municipality also intended to add fluoride. “Then I immediately became very angry,” he recalls in Other Times. “Because I heard that fluoride has the same level of toxicity as arsenic. I didn’t think that was good for the population.” He objected in an open letter and demanded to know the long-term effects. In his practice, Moolenburgh saw patients every day who, according to him, were suffering from the effects of fluoridated water. “My patients experienced painful mouth sores, gastrointestinal complaints, and sore throat.”
In addition to reports about its possible negative side effects, water fluoridation encountered more resistance. There had been protests from religious and anthroposophical quarters for some time, but now this was more widely supported and a social debate arose. How safe was fluoride for our health? Lawyers also got involved in the discussion. They saw it as an enforced measure which people had not asked for and for which there was no alternative. Drinking water fluoridation was framed as an attack on freedom.
An anti-fluoride sentiment began to grow among the population, partly due to increased individualism and the desire for co-determination. Citizens wondered aloud how much power the government should have: “Why should the government decide what is good for us?” Action groups such as Vigilance Drinking Water and the committee Anti Fluoridation Drinking Water Amsterdam (AFDA) successfully challenged drinking water fluoridation through the Council of State and the Supreme Court. The latter ruled that the measure was “of such a drastic nature” that it did not fall under the Water Supply Act.
It was decided that municipalities should also offer unfluoridated water. When the municipality of Amsterdam installed a handful of taps where unfluoridated water could be tapped, the response was clear. Amsterdammers lined up to fill their bottles, watering cans and bags with pure water. Meanwhile, the measure divided politics. The Supreme Court decided that the House of Representatives should determine whether drinking water fluoridation was a good idea and that, if there was a majority vote, a new law would have to be made.
Ultimately, both the government and parliament lacked the political courage to adopt a new ‘fluoride law’ that would guarantee drinking water fluoridation in the Netherlands. After a memorable political debate, Partij van de Arbeid (PvdA) Minister of Health Irene Vorrink – previously in favour of the introduction – withdrew the bill. As a result, municipalities had to stop adding fluoride to their drinking water. In 1976, the last municipality stopped its water fluoridation. The population’s need for freedom to choose cleaner drinking water was thus answered.
Today we brush our teeth with fluoride toothpaste and are therefore better protected. However, this fluoride ends up down the drain, into sewage treatment plants, and into surface water. Drinking water companies pump our drinking water from there, which means that there is fluoride in our drinking water from natural sources and human activity. Fluoride concentrations differ per area: between 0.05 and 0.25 milligrams of fluoride per litre, which is below the legal standard of 1.1 milligrams per litre. Dental Netherlands calls for a reintroduction from time to time, but that seems to be out of the question for the time being.
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Timeline:
1901 – American dentist McKay discovers benefits of fluoride for teeth.
1947 – Minister’s requests advice from the Health Council regarding drinking water fluoridation.
1953 – Start of fluoride research with the Tiel-Culemborg project.
1954 – 20 million Americans get fluoridated tap water.
1968 – Start of drinking water fluoridation in several Dutch municipalities.
1972 – Action groups oppose drinking water fluoridation.
1976 – The last Dutch municipality stops drinking water fluoridation.
2020 – 77 percent of Americans still receive fluoridated water.
