January, 1975 Vol. Eight No. One FLUORIDE 0 FFlC IAL QUARTER LY JOURNAL OF 1 NTERNATIONAL
President Prof. A. H. Mohamed University of Missouri Kansas City, Mo. Secretary G. L. Waldbott, M. D. Warren, Mich. OFFICERS VicePresident Prof. G. W. Miller Department of Biology Utah State University Logan, Utah Second VicePresident H. M. Sinclair, M. D., D. Sc. Institute of Human Nutrition Oxon, England Treasurer P. E. Zanfagna, M. D. Lawrence, Mass. Prof. G. Frada Institute of Occupational Medicine University of Palermo, Italy Dr. G. Halbwachs Institute of Botany Vienna, Austria Prof. S. S. Jolly Medical College Patiala, India ADVISORY BOARD J. V. Marhold, M. D., Ph. D. Research Institute for Organic Synthesis Pardubice, CSSR Prof. J. B. Patrick Mary Baldwin College Staunton, Virginia Prof. F. Pinet Lyon, France Prof. Dr. Rosenberger Veterinary university Hannover, Germany Prof. A. H. Siddiqui Coon Rapids, Minnesota Prof. Rene' Truhaut FacuIte' De Pharmacie Universitg de Paris, France Prof. A. W. Burgstahler University of Kansas Lawrence, Kansas MUDr. G. Balazova CSc. Research Institute for Hygiene Bratislava, Czechoslovakia EDITORIAL BOARD Prof. G. Neil Jenkins The Dental School, Univ. of Newcastle Upon Tyne, England Prof. Frederick W. Oehme Kansas State University Manhattan, Kansas Dr. Ernest Bovay, Director Jetzy Krechniak, Ph. D. Federal Agric. Research Station Akademia Medyczna, Liebefeld Bern, Switzerland Gdafisk, Poland Prof. Albert Schatz Temple University Philadelphia, Pa. Dr. G. Halbwachs Institute of Botany Vienna, Austria John R. McLaren, M.D. Carlo Mangoni di S. Stefano, M. D. Robert Winship Memorial Clinic Institute-of Human Physiology Emory University University of Naples, Italy Atlanta, Georgia H. Hanhijarvi, D. D. S. Korpilahti, Finland Prof. S. P. S. Teotia, M. D. Department of Human Metabolism Medical College University of Meerut, India.
Vol. Eight No. One January, 1975 Pages 1-57 FLUORIDE Quarterly Issued THE INTERNATIONAL SOCIETY Reports by FOR FLUORIDE RESEARCH Editor G. L. Waldbqtt,.M. D. Warren, Michigan Co-Editors A. W. Burgstahlor, Ph. D. Lawrence, Kansas J. A. Yiarnouyiannir, Ph. D. Monrovia, California CONTENTS EDITORIAL REV I EW Fluoride and Down's Syndrome (Mongolism)... 1 ORIGINAL ARTICLES Treatment of Fluorosis in Humans - by S. R. Rao, K. J. R. Mum/, T. V. S. D. Murty, and S. S. Reddy, Hyderabad, India..... 12 Fluoride Emissions from Treatment of Natural Phosphates in the Production of Fertilizer - by R. Truhaut, P. Bourbon, and J. Alary, Paris, France..... 25 Dental Fluorosis in Areas with a High Natural Content of Calcium and Magnesium in Drinking Water - an Epidemiological Study by S. P. S. Teotia and M. Teotia, Meerut, India... 34 Fluorides in Drinking Water and Hair - by J. Krechniak, Gdairsk, Poland... 38 How Safe is Fluoridation? A Brief Review of Supporting Evidence by G. L. Waldbott, Warren, Michigan... 41 SPECIAL ARTICLE The Mutagenic Activity of Inorganic Fluorine Compounds - by E. A. Gileva, E. G. Plotko, and E. E. Gatiyatullina, Sverdlovsk, SSSR..... 47
ABSTRACTS Effect of Sodium Fluoride and Sodium Pyruvate on Palatal Development in Vitro - by G. S. Myers, Vancouver, British Columbia... 51 Sodium Fluoride as a Potential Mutagen in Mammalian Eggs - by G. Jagiello and J. Lin, New York, New York..... 52 Fluoride Concentrations in the Human Placenta in Maternal and Cord Blood - by Y. W. Shen and D. R. Taves, Rochester, New York... 54 Effects of Fluoride Supplementation from Birth on Human Deciduous and Permanent Teeth - by R. Aasenden and T. C. Peebles, Boston, Massachusetts.... 55 Fluorosis in a Dairy Herd - by W. G. Jones, Warwickshire, Great Britain... 56 CORRECTIONS... 57 FLUORIDE is published quarterly by THE INTERNATIONAL SOCIETY FOR FLUORIDE RESEARCH, INC., SUBSCRIPTION RATES - Price per annum in advance including postage $18.00; Single copies $5.00. MANUSCRIPTS for publication should be submitted in Englkh, daub- with generous margins. References should be arranged accding to the order in which they are cited in the text, and written as follows: Author, title, journal, volume, pages and year. Each paper must contain a summary of not more than 12 lines Contributon will receive copies of the iesue of FLUORIDE containing their paper, free of charge. FLUORIDE is listed in Current Contents Agricultural Food and Veterinary Sciences
Editorial 5 and gave an overall incidence rate of 0.89 cases per 1,000 live births - not very different from the upper end of Rapport's figures for his second Illinois investigation (11-13). Utilizing data previously collected by Fabia and Drolette (24), the authors of the Massachusetts study (22) determined the geographical distribution of 2,469 cases of mongolism born to resident mothers among a total of 1,833,452 live births from 1950-1966. The births were classified with respect to occurrence in 321 nonfluoridating communities with less than 0.3 ppm fluoride in their water supplies and 30 communities with a variable and sometimes brief history of fluoridation; of the latter, nine ceased to fluoridate during the 17-year study period. Although the authors state that all mongoloid births were included, it is unclear how those in rural areas were classified. The incidence rate for the cases in the nonfluoridating communities was 1.34 per 1,000 Eve births and 1.53 during periods of fluoridation in the fluoridating ones. The difference was attributed largely to a slightly higher maternal age in the fluoridating cities - stated to be 34.0 years compared to 33.2 years in the nonfluoridating ones - and to "a slight upward trend [of 'about 1 per cent per year overall'l in the rates of Down's syndrome" during the study period. The first of these suggestions must be questioned, however, since Fabia and Drolette (24) tabulated and commented on a mean maternal age of 33.9 years for the bulk (2,411) of these very same cses. (For 1,553 cases without other attendant malfoqnatians it was 34.1 years, and for 858 remaining cases with one or more defects besides the syndrome itself it was 33.5 years. ) Needleman et al. (22) do not indicate why their maternal age figures differ so markedly from those of Fabia and Drolette from whom they obtained most of the case records., It would appear, therefore, that the figures given by Needleman et al. are simply reversed, and that the mean maternal age for the 2,345 cases in the nonfluoridating communities was actually 34.0 years (not 33.2 years), whereas for the 124 cases in the fluoridating communities it was really 33.2 years (not 34.0 years). This point is most significant, for a trend toward lower maternal age in the fluoridating communities would actually corroborate Rapport's work Needleman et al. also suggested that the upward trend in annual incidence rates accounted for most of the small increase in incidence from 1.46 to 1.53 cases per 1,000 live births observed between the 36-month pre- and post-fluoridation periods in an unstated number of communities. On the other hand, the fact that this pre-fluoridation incidence figure exceeds that of the nonfluoridating communities as a whole might well reflect some factor other than simply a secular increase. It is especially regrettable, therefore, that data were not FLUORIDE
Statistics of Fluoridation 45 control city of Cameron. McClure et al. (19) studied the fluoride metabolism on only four healthy individuals for relatively short intermittent periods (up to 28 test periods of 8 hours a day for 5 days) on the basis of which he concluded that "elimination of absorbed fluoride via urine and sweat is practically complete" when intake does not exceed 4 to 5 mg daily. Such observations,interesting though they may be,cannot be extrapolated to the millions who are drinking fluoridated water for a lifetime, people with widely different food habits, those who are healthy and sick, young and old. Of even less value is the comparison of the autopsy findings in a single case, a woman who had been residing in Bartlett (8 ppm), with those of another from non-fluoridated Washington, D. C. (20). Both subjects died under similar circumstances of the same illness, namely arteriosclerotic heart disease. Even if adequate clinical data pertaining to the fluoride intake of the two individuals and their association with their symptoms had been available, it is doubtful whether, in retrospect, sufficient information could have been gathered to establish the role played by fluoride in the illness of the two individuals. Baselines In designing a statistical study on fluoridation, it is difficult to find a normal baseline with which to compare the findings. Many factors account for this dilemma, especially the ubiquitous occurrence of fluoride in the ecosystem and the extraordinary reactivity of the fluoride ion. Shambaugh et al. (21) expressed the prevailing view when they stated that soft tissue organs contain less than 1 part per million of fluoride. The Call study (22) of 127 autopsies in industrialized Utah revealed 258 ppm fluoride in the aorta of one individual. As stated previously, 8400 ppm were found in the aorta of two individuals who had been residing in Grand Rapids, fluoridated for 20 years. Such values deviate considerably from what must be considered normal. However, it should be borne in mind that no "normal" values of fluoride in bones, teeth, hair, and soft tissues which are not associated with ill effects, are available for comparison. In summary, statistics of this kind do not reflect the true conditions which become evident when a patient's illness is assessed individually and when his symptoms as well as the laboratory data, the respective autopsy and biopsy materials are related to his fluoride intake. Bibliography 1. Editorial: Fluoride Toxicity. The Lancet, 2:889, October 20, 1973. FLUORIDE