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Fluoridation of Drinking Water in Switzerland

English: Putting toothpaste on a toothbrush. T...

English: Putting toothpaste on a toothbrush. The toothpaste is Crest Pro-Health Clean Cinnamon, 0.454% stannous fluoride, 0.16% w/v fluoride ion. Deutsch: Zahnpasta auf eine Zahnbürste auftragen. Русский: Выдавливание зубной пасты из тюбика на зубную щётку (Photo credit: Wikipedia)

I was in general practice as a dental practitioner from 1954 to 1984 and during this period witnessed the enormous and dramatic gains in oral health. Before the Second World War, it was very rare for anyone over 40 to have any teeth left. Everyone over 40 was toothless. Dentists were having to pull the remaining teeth and make full dentures. My best friend, in England, lost all his upper teeth before the age of 20, which was not unusual.

In some countries, even after the war, young women would have healthy teeth removed and full dentures made, as these were inevitable, in order to save their future husbands dental expenses, and thus be more attractive! Today dentists are filling few teeth and are now in the cosmetic business, working in “Smile Clinics”, with patients having beautiful teeth, well into old age.

There are no federal laws forbidding the practice fluoridation of drinking water Switzerland, however it is impossible to fluorinate the public drinking water.  The reason for this is that the water supply in Switzerland is extremely diverse, from lakes, rivers and especially springs and is not centralized.

As an older dentist I feel that fluoride was mainly responsible for the rapid and dramatic advance in oral health. As water fluoridation was not feasible in Switzerland, fluoride was added to salt as well as to milk.

English: Photo of mild dental fluorosis, or ev...

English: Photo of mild dental fluorosis, or evidence of trauma to deciduous teeth while permanent teeth were still forming. (Subject never had braces, which can be another cause for white dots or rings in the center of the teeth.) The condition appears here as white spots on both central incisors (front teeth) and upper left canine tooth, and less noticeably in the upper left lateral incisor. (Photo credit: Wikipedia)

Pregnant mothers and young children were given fluoride pills. Systemic fluoride was considered most important as the fluoride is thus incorporated into the developing tooth enamel making it more resistant to tooth decay rather than fluoridation of the tooth surface.

Dental clinics for school children were set up. Dental hygienists visited schools and gave toothbrush instruction with fluoridated toothpaste, rinsing instruction with fluoridated mouth washes and distributed fluoride pills. In addition dentists gave regular fluoride treatment. Inspite of the considerable amount of fluoride given in various forms to the public, in my 30 years of practice I never saw a case of dental fluorosis, mottled enamel or skeletal fluorosis or any condition that would suggest that the fluoride given was detrimental to health. Academic support was given by the University of Zurich which became well known for its preventive research. In fact the systematic, statistical research on the effects of the preventive measures in Switzerland received international acclaim in the field of caries prevention.

Today, fluoridated salt and non-fluoridated salt are available, fluoride is no longer added to the milk and pregnant mothers and children are no longer pressurized into taking fluoride pills.  Although Switzerland did not, in contrast to it’s neighbors have fluorinated drinking water, the population was certainly subjected to far more fluoride than any of the surrounding countries. The amount of fluoride could be huge as it was uncontrolled.  At the same time research showed that dental health in Switzerland increased dramatically and was superior to that of the surrounding countries.

To summarise; my practice experience has led me to believe that fluoride administered in the recommended dosage does not have a negative effect on health and that fluoride, together with other factors was responsible for the dramatic advances in dental heath.