This morning Dr. Spira indicated that as a result of his examinations and experiments which he conducted earlier he discovered that there were fluorine indications in those persons with whom he was experimenting and further drew the conclusion that the signs and symptoms that he discovered indicated that these fluorine indications were derived from sources other than the drinking water.

In your experience, does the average human being actually receive fluorine through sources other than drinking water, that is, through the intaking of food and so forth in his daily life?

Mr. DEAN. Practically all the food we eat has some fluorine in it. Studies conducted by Dr. Armstrong at Minnesota, who will be down tomorrow, show, I think, around two or three-tenths of a milligram per day in the average diet you eat. He could give you some particular information on that.

Mr. WARBURTON. I see. Am I correct in saying, then, that we can start out with this factor that as an ordinary matter all of us take in fluorine in some unknown quantity in our daily life?

Dr. DEAN. Two or three milligrams a day, I think.

Mr. WARBURTON. In some areas of the country there are also water supplies used normally which will also contain fluorine?

Dr. DEAN. Yes, sir.

Mr. WARBURTON. You further suggest, then, in this fluoridation program, the injection of a constant amount, or to treat the water supply with a constant amount of fluorine?

Dr. DEAN. No. No. I said: Bring the concentration up to the optimal level. You may have a fractional part in the water, and you bring it up to one. If you have three-tenths, you will only need seventenths. If you have zero you will need one. If you vary from threeto five-tenths on a seasonal switch you would adjust again, so that you have no more than one in the water supply.

Mr. WARBURTON. It is your conclusion, then, that the optimal amount for the particular locality, based upon that which is already normally in the water supply from natural sources, is still sufficient to cause no danger, regardless of the amount that we take in normally from sources other than the water supply?

Dr. DEAN. The amount we have been taking in as food is probably so low as to be relatively of no value in protecting against dental caries.

Mr. WARBURTON. Let me ask you this the other way around. It it of such a low value, together with that which is naturally contained in the water supply and that which is added to the water supply, that no danger is created?

Dr. DEAN. No. You would see it in a place like Denver or Aurora, where they have it naturally, and they still eat the same type of food that we do.

Mr. WARBURTON. In your experiments, which you indicate here on page 4 of your report, you indicate that the studies of the National Institutes of Health culminated in an examination of 7,257 continuous resident white children of 21 cities, and you drew from those studies 2 conclusions with respect to the beneficial effect that water treated naturally or otherwise with fluoride concentration has. In the tests

were there any groups which were incorporated in the whole test who received no benefit?

Dr. DEAN. These studies had to do with cities where they contained the fluoride in various amounts, either under natural conditions or where it was relatively absent.

Mr. WARBURTON. I see.

Dr. DEAN. This was the evidence upon which we took the next step. We went through the 7,200 studying this thing quantitatively in detail under natural conditions.

Mr. WARBURTON. The point I am trying to get at is this—and I am possibly not getting to it because of my lack of knowledge on this subject-in any particular city under the conditions under which these studies were made did you have, for example, 500 children whom you had examined and who showed a lack of dental caries which could be attributable to the fact that they had been drinking over whatever the required period of time was water containing naturally fluorides; and were there any children, for example, in that same city in the same age group who had received no benefit, although they had been there for the same length of time and had been taking the same kind of water?

Dr. DEAN. It is quite probable you would have a few. Any time you take a large group for any biological study of people, 300 or 400, there may be some who will still have a fair amount of caries; but if you stated mathematically the average for the group you would find it is probably down 50 or 60 or 65 percent. We studied that on the basis of what you call the multiple attack rates, in which the number of children who had no caries, the number who had one tooth, the number who had two teeth, and so forth up to 20 were involved. You could see quite a marked difference.

You could have the case of a sporadic type, where you may have had 12 or 15 carious teeth, but it was very unusual; hwere as on the other side you have quite a distribution.

Mr. WARBURTON. Let me ask you this: In a study of this type when you are selecting the group of children to examine and study over some extended period of time do you just take a group of children selected at random?

Dr. DEAN. I will tell you how we did these 21 cities. We took all 12-, 13-, and 14-year-old white children in every seventh, eighth, and ninth grade in every public school in the community.

Mr. WARBURTON. So it was comprehensive across the whole community within those particular limits?

Dr. DEAN. Yes.

Mr. WARBURTON. Thank you.

The CHAIRMAN. Any further questions?

Mr. WILLIAMS. Dr. Dean, have you read the testimony of Dr. Exner? Dr. DEAN. Yes, sir.

The CHAIRMAN. Any further questions of Dr. Dean? We thank you, Doctor.

Dr. DEAN. Thank you, sir.

The CHAIRMAN. May I inquire as to the length of time that Dr. Doty would take to deliver his testimony?

Mr. GARVEY. About 15 minutes is prepared for, Mr. Chairman, absent questions.

The CHAIRMAN. Does Dr. Doty intend to be here tomorrow, or is he leaving tonight?

Mr. GARVEY. He can be here tomorrow.

The CHAIRMAN. I would appreciate it, then, if we would be able to adjourn, because we have some people waiting to see members of the committee on committee business. We would like to talk to them. They have been waiting since an hour ago.

The committee will adjourn until 10 o'clock tomorrow, when the first witness will be Dr. J. Roy Doty.

(Thereupon, at 4: 40 p. m., Wednesday, May 26, 1954, an adjournment was taken until 10 a. m., Thursday, May 27, 1954.)

FLUORIDATION OF WATER

THURSDAY, MAY 27, 1954

HOUSE OF REPRESENTATIVES,

COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D. C. The committee met, at 10 a. m., pursuant to adjournment, in Room 1334, New House Office Building, Hon. Robert Hale presiding.

Mr. HALE. The committee will be in order. We will resume this morning, hearings on H. R. 2341, to prohibit water fluoridation, and the first witness is Dr. J. Roy Doty of Chicago, Ill. Dr. Doty.

STATEMENT OF DR. J. ROY DOTY, SECRETARY, COUNCIL ON DENTAL THERAPEUTICS, AMERICAN DENTAL ASSOCIATION, CHICAGO,

ILL.

Dr. Dory. Mr. Chairman and members of the committee. May I say for the American Dental Association, it wishes to express its appreciation to the Public Health Service representatives for allowing the American Dental Association's representatives to appear first.

I am J. Roy Doty of Chicago, Ill., secretary of the council on dental therapeutics of the American Dental Association, in which capacity I have for several years studied and evaluated the scientific literature relating to fluoridation of community water supplies as a method of diminishing the incidence of dental caries. I hold the degree of bachelor of science from Monmouth College, Monmouth, Ill., and doctor of philosophy from the University of Illinois. From 1928 to 1930 I taught inorganic and analytical chemistry at Monmouth College, from 1933-after obtaining my doctor's degree-to 1935 I did research on the effect on animals of the ingestion of spray residues on plant products; and from 1935 to 1943 I was first instructor and subsequently assistant professor of physiology at Louisiana State University School of Medicine at New Orleans. Since 1943 I have been associated with the council on dental therapeutics of the American Dental Association.

My purpose in appearing before you today is to discuss some of the biochemical aspects of community water fluoridation programs. The fluoridation of drinking water is a simple, natural, and straightforward procedure for insuring to millions of children the opportunity to obtain the optimum amount of an important trace element in nutrition. During the period of tooth development it is essential that children receive adequate but limited amounts of fluoride in order that their teeth may become more resistant to those forces which lead to tooth decay and its resultant potential for further ill healh.

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