Acknowledgments ix
1 A Story of Our Times 1
Grand Rapids, Michigan, Four O’Clock Eastern Wartime 1
The Longest-Running Circus in Town 3
Pro or Con? 6
References 8
2 A Clash of Absolutes 9
Dueling Websites 9
Quack, Quack 14
The $100,000 Cash Offer 16
As One Voice 19
Who Drinks Fluoridated Water and Who Doesn’t 25
Fear and Loathing 30
Fluoridation Facts, Dr. Y, and the Lifesaver’s Guide 32
What We Have Here Is a Failure to Communicate 36
References 40
3 A Tale of Two Cities 44
Spokane, Washington 46
Cumberland, Maryland 52
Fluoridation, 2000 56
The Push for Statewide Mandates 59
On the Phone and in the Booth 60
The Early Studies: Social Dynamics and Pop Psychology 61
The Later Studies: Just Plain Politics 64
Spokane and Cumberland: Reprise 67
References 68
4 Two Women 71
Darlene Sherrell: The Canary in the Mine 72
Jackie Speier and the Legacy of Jonestown 78
The California Mandate 83
San Diego, Escondido, and the Golden Fleece 87
References 90
5 The Road to Fluoridation 92
Beautiful Women and Black Teeth 92
Frederick McKay and the Mystery of the Colorado Stain 94
H. Trendley Dean and the Towns without Toothaches 98
Lathered Up to Go 102
Little Girls in Gingham Dresses 106
Fluoride on Trial 111
Blind Examiners and Confounding Factors 116
The Mavericks Emerge 120
References 122
6 Fluorophobia 127
Satan’s Metal 128
ALCOAnoia 133
Toxic Coup? 137
The Donora Death Fog 138
Project F 141
The Far Side 145
Let There Be Light: An Assessment of Anti-fluoridation Conspiracy Claims 146
The Perils of Obsession 164
References 165
7 Look, MA. No Cavities: Fluoride and Teeth 170
Teeth 172
The People’s Disease 175
Reversal of Misfortune 178
The Fluoride Cycle: From Apatite to Apatite 185
How Fluoride Works 187
More Studies and Diminishing Returns 191
The Halo Effect 197
Flossers and Cheeseheads 201
The Back of the Coin: The Increase in Dental Fluorosis 204
The Bottom Line on Fluoride and Teeth 209
References 212
8 Fluoride and Health 219
Exposure, Intake, and Dose 219
The Roots of Contention 221
Acute Fluoride Poisoning 223
Kaj Roholm’s Legacy 224
The Tragedy of Crippling Skeletal Fluorosis 225
Fluoride as Medicine: The Osteoporosis Experiments 227
Bone Health and Hip Fractures: Legitimate Questions and Equivocal Answers 228
The Special Case of Kidney Dialysis 230
Allergic Reactions and Psychological Distress 231
Affairs of the Heart 234
Fluoride and Genetics 235
Fluoride, Cancer, and Credibility 238
The Osteosarcoma Controversy 242
Alzheimer’s, Intelligence, Crime, and Addiction 245
References 248
9 EPA and the MCLs 255
Fluoride as Jekyl and Hyde 256
Brinksmanship 259
Amicus Curiae 263
The Marcus Affair 266
A Question of Allegiance 269
A Question of Motive 271
References 275
10 Riding the Tiger: The Dosage Issue 278
The Concept of a Maximum Acceptable Daily Dose 279
Fluoride Intake in Our Diet 282
Do Not Swallow 285
Contesting Conventional Wisdom 287
Too Much of a Good Thing? 290
References 294
11 Science and Not Science 298
Junk Science: Values and Bias in Scientific Research 299
Single-Minded Science: The ISFR and the Journal Fluoride 302
The Shunning of Phyllis Mullneix 307
John Colquhoun Falls Off the Wagon 310
Science, Funding, and Self-Interest 312
Fluoridation in the Courts: The Anti-fluoridationists’ Last Stand 315
The Congressional Pulpit 321
References 325
12 Money, Motive, and Risk 329
The Uneasy Science of Risk–Cost–Benefit Analysis 329
The Cost of Fluoridation 331
The Wrangle Over Benefits 333
The Ultimate Battleground 338
Engineered Systems and Human Error 340
The Concept of Acceptable Risk 344
The Precursors 346
Public Health or Home Remedy? 349
The Bottom Line on the Economics of Fluoridation 351
References 352
13 the Light at the End of the Tunnel 356
Teeth 356
Health Risk 357
Dosage 360
Credibility 361
The Need for Civil Discourse 364
Index 365