Lessons from Brown teeth

When Dr. Frederick McKay began his dental practice in Colorado Springs, he encountered something he had never seen in his dental studies. Many of his patients had teeth that were as brown as chocolate candy. There was nothing in the dental literature that suggested a reason for this discoloration.

Without a clue as to the problem, Dr. McKay invited a famous dental researcher to visit. Dr. G.V. Black was skeptical but agreed to visit. They made a discovery that would eventually change the practice of dentistry and medicine to some extent. What they found was that the children with the brown teeth had very few cavities.

Initial tests of the water supply showed nothing that would affect the teeth. But more sophisticated analysis technology eventually led to the discovery of high levels of fluoride in the water. After 30 years of puzzlement, Dr. McKay found the reason for the discoloration of teeth, using the new technology

The Public Health Service and the National Institute of Health then looked at the concentrations of fluoride that were necessary to cause the discoloration. Recalling that children with discolored teeth also had minimal tooth decay, the researchers at NIH discovered that fluoride levels up to 1.0 ppm did not cause discoloration but could prevent tooth decay.

The City of Grand Rapids, Michigan volunteered to test the impact of fluoridation on its water supply. What they found after 11 years of the study was that tooth decay had declined by 60%. This led to other cities fluoridating their water supplies and fluorine becoming an ingredient in toothpaste.

The discovery of the benefits of fluorine did much more than reduce cavities. It changed the dental profession from a focus on the treatment of dental disease to the prevention of dental disease. While such a change in emphasis may seem like a no-brainer today, it was a breakthrough in thinking about healthcare.

Just imagine other areas of society where a prevention focus rather than a treatment focus could have an impact. The manufacturing community has adopted this change in focus with what is called six-sigma initiatives (Six Sigma – Wikipedia), but what about other possibilities? Seemingly every candidate for elected office has a tough-on-crime message – a treatment approach rather than a prevention approach. Efforts to develop an understanding of human differences in our schools (a prevention approach) have become political weapons and little attention is given to the impacts of pervasive hatred. Efforts to prevent harmful practices affecting our environment are thought to be too costly while we continue to incur ever-increasing costs of recovery from natural disasters. Unfortunately, sound prevention strategies are often framed as an attack on personal freedom.

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“An ounce of prevention is worth a pound of cure.” – Benjamin Franklin

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